elevating prostate

On 11/14/2012, my blood test showed that my PSA was elevated from 2.5 to 3.3. My Dr. recomemded me to see a urologist, becuase the PSA was elevated too fast in short time.  My urologist recommende biopsy. The biopsy was done on 12/12/2012 and the result of biopsy was negative. On 4/4/2013 my PSA result showed it was elevated again to 4.1.  My urologist recommended to waite two weeks and do another PSA test.  If the result is the same and still elevating, he recommended another biopsy. 

Any suggestion, please!!!!

Thank you.

 

It is true that sometimes it takes a whole flock of biopsies to locate a tumor. That's because a standard biopsy only samples a tiny percentage of the entire prostate.

Can you tell us your age? Also the approximate dates of those two PSA tests. Did the doctor say anything about the DRE and whether the prostate felt enlarged? If you have BPH (non-cancerous enlargement of the prostate), your PSA will naturally be a bit higher than it otherwise could be.

Also, did the doctor perform a DRE BEFORE you took the PSA test? In general, there should be NO type of activity that can excite the prostate in the 72 hours before the blood test. This includes a DRE, sexual activity, bicycle riding, etc. Any of those activities can put a temporary spike into the PSA number.

If the PSA remains elevated, perhaps a more detailed biopsy (called a saturation biopsy) might be something to consider in the future. This type of biopsy usually takes around 40 (more or less) cores instead of the usual 12. It would be more likely to detect any tumors in the prostate.

One good thing to keep in mind is that, depending on your age, the overall PSA number is NOT really very high. It is the upward trend (in what apparently is a short span of time) that is raising a red flag. In any case, with an overall lower PSA number, any PC that might be found would very likely be early stage & very curable.

Wishing you the best,
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.