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Posted 5/9/2009 7:33 AM (GMT 0)
Has anyone out there had such a fluctuating psa?

Husbands psa history.

05-5.9   AGE 52

05-7.9

05-6.35

Biopsy-neg

06-8.0

07-7.6

08-6.3

09-8.5

09-5.8

Doc says because 1st & last are the same, there`s nothing going on, so come back in a year.

We had our own psa & free psa done a week after the last one came back, 5.7 free psa 21.

Can`t see much on internet about the free psa. Do you guys think hubby`s is fine?

Next thing we could have a PCA3 test, its expensive, do you think we should put it behind us, and wait for next years PSA. 

Posted 5/9/2009 3:19 PM (GMT 0)
If it were my husband, I would recommend a second opinion and get a biopsy done. I would also reference the current PSA guidelines and ask your husband's doctor why it is ok that your husband's PSA is above the "normal" range. My father's FP did the same thing and waited two years watching my father's PSA while it hovered around 5.5-6 and finally my family intervened and had my father see a specialist, who confirmed that he had cancer and it ended up spreading. I feel confident that if we had caught it sooner, that it would have been curable and my father would not have had to go through radiation and HT like he is going through now. I hope your case is different and hopefully your husband's biopsy comes back negative, but I wouldn't wait to rule it out. I don't mean to scare you, but your situation reminds me of my father's and I am furious with my father's FP. Best of luck and keep us posted.
Posted 5/9/2009 9:08 PM (GMT 0)

Hi Tizzal,

I am new here too, and probably not the best person in the world to give advice, but my psa went 3.7-3.8-3.4-4.0, I had no symptoms really, just a bit of a dribble after urination from time to time.  Has he had a DRE done yet ?.  Knowing what I know now,and if I where in your position, I would be definately having a biopsy.  Biopsy's are not that bad, and to my knowledge about the only way of really finding out whats going on.  Good Luck, and stay positive..................cheers Nothard

Posted 5/9/2009 9:19 PM (GMT 0)
I have a friend that has PSA fluctuating between 4 and 6 has had two biopsies in the past three years and both came back negative. I cannot say do not worry, however it is highly possible that this is a norm for your husband. never hurts to get a second opinion just for peace of mind. Keep us posted as to how things go.

peace and love
dale
Posted 5/9/2009 10:44 PM (GMT 0)
I agree with Doting Daughter's advice here. I think she stated it well.

David in SC
Posted 5/9/2009 10:49 PM (GMT 0)
Tizzal,
The norm for free PSA is 25% or higher. My PSA never reached 4 and yet I had cancer. I suggest that you gey a second opinion and may be have a 20 core biopsy.
Posted 5/9/2009 11:33 PM (GMT 0)
Actually the "norm" for fPSA is not 25%. Rather, the 25% cutoff point you often read about is a level at which you have about a 90% chance of not having prostate cancer.
However that is not the norm. In fact in some studies, the median value for a men who did NOT have prostate cancer was only 18% while the median for those with prostate cancer was 8.8%.

Various studies use cutoff values anywhere from 14% to 27% depending on how much margin for safety they want to include under the value.
In this case Tizzal's husband value of 21% should NOT give her reason to think it means he has prostate cancer.
I would have more concern about the higher PSA values than the fPSA of 21%.

Franklen
Posted 5/10/2009 12:04 AM (GMT 0)

Thanks for all your advice,

In answer to Nothards question, hubby had a positive DRE back in 05 before the negative biopsy.

Would BPH cause the PSA to rise to those levels and then drop back down again?

Doc says he needs to see 3 consecutive rises to warrant another biopsy.

Think we will go for a PCA3 test. Though I`m not sure if that will confirm anything either.

Will keep you all informed.

Tizzal.

Posted 5/10/2009 12:40 AM (GMT 0)

Dear Tizzal:

Here is a link that may help you with the free PSA analysis:

http://www.psa-rising.com/prostatecancer/fpsa-flowchart.htm

And, as you will note, you may get some solace from the statement in this link "...most men with prostate cancer have a free PSA of less than 15%".

And here is a fairly complete, but somewhat complex, discussion of the PCA3 test:

http://www.prostate-cancer.org/education/preclin/Torres_PCA3.html

However, I would personally be somewhat suspicious of a doc that says "nothing is going on" with a man in his early 50's with obviously elevated PSA.  Has he ruled out BPH?  In any case, since you obviously have doubts about your physician's advice, I would suggest you find the best urologist you can and go to him/her for another opinion.  Just waiting another year does not make sense to me...

Tudpock

Posted 5/11/2009 12:40 AM (GMT 0)

Hello T,

After I was told that my PSA was 5.3, I researched and found several references to fPSA and had both done before I committed to a biopsy. The fPSA was 22% and i thought for sure that i was not going to mbe in this club. The doc said, well, statistically speaking, you have ~80 chance of no PCa and then said "what about the other 20%?" The gold standard at that point is a biopsy. Sure enough, I was in the 20%.

Posted 5/11/2009 2:28 AM (GMT 0)
Tizzal,
My stats are somewhat similar, except my 1st biopsy showed one sample being "atypical." My latest PSA was 5.2 with 21% free. I just saw my URO on Thursday and he recommended another biopsy just to be on the safe side. I'm scheduled for the 21st.

Another factor to consider is the size of the prostate. Your hubby's doc should know that from the first biopsy. I've read that a rule of thumb is that if your PSA is around 10% the weight of the prostate it might be considered normal.

Mike
Posted 5/11/2009 10:40 AM (GMT 0)

All your replies make for very interesting thought!

TeddyG & Gmike having very similiar stats.

Maybe we are just to early for anything positive to show up, seem to be in no-mans land!

Booked a PCA3 test, so will keep you posted.

Many Thanks

Tizzal

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