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Posted 2/3/2009 5:24 PM (GMT 0)
 I am 68 and live in Colorado. I just got my latest result from the PSA test. It shows my PSA has risen from 1.6 to 5.1 in 15 months so I know enough to know that is alarming. I see my urologist in a few weeks. For some reason my urologist has never done a DRE with me so I want that done. Also I have read about a free PSA test. If the DRE test doesnt indicate a problem I believe I want a free PSA test before agreeing in a biopsy. Does that sound reasonable? Can a free PSA test be taken from the same blood drawn for a PSA test? I it expensive? Does most insurance cover it? Are doctors reluctant to do it? Thank You.
Posted 2/3/2009 5:38 PM (GMT 0)
Welcome. Sorry your elevated PSA has brought you here.

Free PSA can be done from the same blood and the lab usually keeps the blood for a week, so if you are under one week you maybe able to have the FPSA run on the most recent draw. I cannot imagine why a Dr. would not write the order for it, if my Dr. refused to write a reasonable order because of some lack of confidence he had I would find a new Dr. I cannot imagine it not being covered by insurance but there are always exceptions.

Are you having symptoms of BPH which can cause rapid elevation of PSA? And your comment about never having had a DRE is scarey lawsuits abound over failure to diagnose. There is a test only recently introduced to the US called PCA3 which differs from PSA in that you can have elevated PSA and no cancer but the PCA3 focuses strictly diagnosing cancer, it is a urine test and the urine is collected immediately after the DRE.

Good luck. Scott
Posted 2/3/2009 5:56 PM (GMT 0)

Hi:

A couple of comments:

1. I wouldn't wait "a few weeks" to see a urologist.  True, if you have PCa it is probably slow growing, but why in the world would you want to sit around and wonder?

2. Most insurance will pay for a free PSA test and it can be done along with the blood sample from a regular PSA test.  If your previous blood sample isn't around...just call your PCP and tell him or her that you want the test done.  Go in and give the blood and have them run the test (no sex for 48 hours prior to any PSA test).

3.  I don't know why you are seeing a urologist and it may have nothing to do with the prostate.  BUT...with that PSA increase you definitely do need to have a DRE.

4.  In general now, since you are concerned, you need to TAKE CHARGE...

Good luck and tell us how you progress.

Tudpock

Posted 2/3/2009 6:25 PM (GMT 0)
Udgrad,
My PSA was never above 3.9 but my free PSA was 11% (it is supposed to be above 25%). This was alarming and enough to have a biopsy that confirmed PC. Medicare does not pay for the free PSA test which is why it is not done on a regular basis but that shouldn't stop you since it is only about $25.
Posted 2/3/2009 7:09 PM (GMT 0)
Hi again: I just spoke to my urologist's nurse. She said the doctor wasnt concerned about the rise in my PSA due to my BPH problems plus my age (68). Also when I had my PSA test in 2007 I was taking a drug which lowers the PSA but I am not taking it now following Greenlight laser surgery. But I am concerned so he will see me earlier. I do want a DRE plus another PSA test with a free PSA test. I see my urologist about 3 months due to me having a pair of kidney stents in me due to mu ureters being damaged by stones resulting from back-up urine from the BPH and the stents must be exchanged every 6 months due to calcification. This is done as an outpatient. My PCP doesnt deal with my urology issues. She referred me to the urologist. Thanks for replies. Bill
Posted 2/3/2009 11:23 PM (GMT 0)
Hi Bill,

Given the new information concerning ureter stents and BPH I can see why that the PSA is not being given more importance.

It is still not not be dismissed, but it is also clear that you have a serious uriniary issue most likely including BPH which is actually more common than prostate cancer but unfortunatley still painfull and difficult to treat.

Please let us know, all of these issues are treatable and you need to be treated by a caring and competent Dr.

Scott
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