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Sudden Jump in PSA

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Posted 4/8/2024 3:43 AM (GMT 0)
Hello,
I am 51. For the past few years my PSA has fluctuated between 2.5 and 3.5.
On 14-March-24 it was 4.4. So got retested twice.
On 22-March-24 it was 3.09.
On 5-April-24 it is 17.5.
Any idea what is happening ?
Thanks.
Posted 4/8/2024 6:43 AM (GMT 0)
Are you getting tested from the SAME place every time?
Posted 4/8/2024 3:43 PM (GMT 0)
Yes same place.
Posted 4/8/2024 4:50 PM (GMT 0)
Maybe time for a MRI fusion guided prostate biopsy.
Posted 4/8/2024 9:03 PM (GMT 0)
I don't see any way your PSA could jump from 3-4 range to 17.5 in two weeks due to prostate cancer or lab differences. As mentioned previously, a prostate infection would be more likely and should be checked out by urologist. Something is out of whack that you need to get to the bottom of.
Posted 4/9/2024 12:14 AM (GMT 0)
You should be under the care of a great urologist. What does he/she say about the increase and what to do next?
Posted 4/10/2024 12:56 PM (GMT 0)
The rise to 17.5 seems to be a bad test....I agree that rise is way to fast in that short time. To really nail down your PSA trend, you need many tests over time that show what it is...it does fluctuate for it is very sensitive. I would also hydrate completely the day before your tests for hydration does affect your psa readings and do that every time for more accurate results. These are just my thoughts and still cancer free after almost 15 years now.
Posted 4/10/2024 3:41 PM (GMT 0)
Does hydrate make the PSA readings go up or down.
Posted 4/11/2024 12:46 PM (GMT 0)
I did 2 subsequent tests which showed PSA of 16.5 and 16.8. So there is huge jump. Uro have given 3 week medicine for prostatitis. I dont think prostatitis as there are absolutely no symptoms. Also had MRI on 6th april also did not give clear findings. There is diffuse hypointensity in peripheral zone in MRI. It could be caused by prostatitis or cancer. So I am planning to get PSMA PET test done.

MP MRI was done on 6th April. Report below:

Peripheral Zone:
There is mild to moderate diffuse T2 hypointensity involving the base mid and apical region except for far lateral areas in the mid prostate. There is no significant restricted diffusion. There is symmetrical enhancement on post contrast evaluation. PIRADS 3

Neurovascular bundle: Unremarkable
Seminal Vesicle: Unremarkable
Prostatic capsule: Mild irregularity on the left side
Transition Zone:
Pseudo capsule and differentiation with peripheral zone is preserved. Mildly enlarged and benign changes are noted
Lymphnodes: No significant retroperitoneal lymphadenopathy seen
Other: No obvious bony lesion is seen. Bladder is collapsed.
Impression:
The imaging findings in the peripheral zone are intermediate ( PIRADS 3). Prostatitis can give similar appearance. To corelate with clinical examination
No size significant pelvic retroperitoneal lymphadenopathy seen.
Posted 4/11/2024 12:54 PM (GMT 0)
I was reading this article. A tale of four prostates. This is about 4 UK urologists who got prostate cancer. Their names are ROGER KIRBY, DAMIAN HANBURY, JOHN ANDERSON AND SEAN G. VESEY. The story can be googled.

JOHN Anderson case was very interesting as his PSA jumped from 1.7 to 92.7 in four month.

John Anderson, aged 58, a urologist from Sheffield and President Elect of
the British Association of Urological Surgeons, was perfectly well and
without symptoms in early October 2011, and had a routine PSA test,
which came back at 1.7ng/ml. On 27 January 2012 (only four months
later) he felt a mass in the upper abdomen and a computed tomography
(CT) scan confirmed multiple liver metastases with no other detectable
abnormality. With a normal PSA four months earlier, no urinary symptoms
and no extrahepatic disease visible on the scan, the possibility of this
being related to the prostate never really crossed anyone’s mind. A
couple of weeks later, a liver biopsy confirmed a poorly differentiated
adenocarcinoma. Subsequent immunohistochemistry of the liver biopsies
stained positive for PSA, which confirmed the diagnosis of metastatic
prostate cancer. It was only then that the serum PSA was measured,
which had risen from normal 1.7 to 92.7ng/ml in four months.
Posted 4/11/2024 2:26 PM (GMT 0)
Have you had a PSA test since completing the meds? Anything is possible with almost all medical conditions but not likely. The internet makes it easy to find all things possible.

Prostate infections can be acute which I had years ago and there is little doubt that one is real sick and what the cause is which most doctors can figure out. There are also chronic infections that are more low grade or chronic in nature that do not always exhibit clear cut symptoms. Same holds true for many infections like sinus infections.

I was more concerned about the "collapsed bladder" finding that I know nothing about other than it sounds bad. Was this commented on?
Posted 4/11/2024 2:34 PM (GMT 0)
I have taken medicines for a week. 2 more weeks to go. Will do PSA test again after that. If PSA is still high will ask for PSMA PET scan. I did not focus on collapsed bladder as it was not in the final summary. Also I dont have any urinary symptoms. But will check on this now that you mentioned.
Posted 4/11/2024 2:44 PM (GMT 0)
A collapsed bladder is a normal bladder which is emptied of urine (normal finding). Distended bladder is one which is full of urine.
Posted 4/11/2024 3:41 PM (GMT 0)
My searches all took me to women's issues which I actually understand by having a wife:
"A collapsed bladder, which is more commonly referred to as fallen bladder or cystocele, is a female medical condition.."

Hopefully the prostate respond to the specific med prescribed and your PSA drops a lot.
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