When you had the PSA reading from the urologist and the GP, were these from the same blood draw? Sounds like they were separate blood draws that went to different labs. In any case, different labs will often give different PSA readings from the very same blood sample. They can actually differ by one full point or more.
If you had two separate blood draws for the PSA at the Quest lab, I believe that the PSA level can move back & forth during the same time period. Someone else can confirm this or advise that this is not correct.
Yes, I would say that a biopsy would be warranted since your PSA has doubled over the past year. I'd suspect a harmlessly enlarged prostate (BPH), but your doctor said the DRE was normal. And apparently you did NOT have sex or ride a bike in advance of this particular test.
So that would leave a possible prostate infection or prostate cancer. But be aware that your PSA is not that far out of the normal range. In fact, it might actually still be within the high end of normal.
This does not mean that you do not have PC. But a lower PSA number like yours suggests a curable case if you should be dx with it. This is only a general rule of thumb, but PSAs above 10 are more often associated with any distant spreading.
So, even if you should turn out to have PC, it is likely all still tucked into your prostate and can definitely be cured with surgery or radiation.
But, before you begin to get too worked up, you might consider a biopsy with a highly skilled urologist. If all is okay, then you should keep checking your PSA every year. You have done that pretty regularly and that is a good thing to continue.
Good luck!
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.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.
Post Edited (HighlanderCFH) : 5/17/2013 2:41:21 PM (GMT-6)