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Rapid Rise in PSA

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Posted 6/24/2013 3:55 PM (GMT 0)
Ok I am a newby.  PSA went from 2.17 to 4.37 in 15 months.  Biopsy showed prostate cancer 3+3=6 2.  Bone scan negative for any spread. Took my PSA 1 month after biopsy and 1 month after last PSA of 4.37.  It shot up to 6.58.  Doctor says that  is "surprising" and to take another PSA in a month.  What does it mean ?  I was first told I had low risk prostate cancer and time to make decisions. 
Posted 6/24/2013 4:03 PM (GMT 0)
There are many things that can cause your PSA to rise abruptly. Did you have sex the night before?  Are you a bike rider? Lots of things.  I would think as a G6, you would have time to make decisions (it's the same number I got back and I was Dx'd in March). Doing another PSA in a month sounds reasonable as it may be nothing. Wish i was more help to you, PSA is a touchy thing and not always accurate. More guys will weigh in shortly I'm sure. You found the right place. Try to relax.

Mike
Posted 6/24/2013 4:27 PM (GMT 0)
Nrennie,

Welcome to the club that nobody wants to join. Sorry you find yourself here but glad you found us.

As Mike said, there are lots of things that can give you an elevated PSA reading. There are the obvious ones -- sex in the 48 hours prior to having the blood drawn, or bicycle riding, or bull riding, or a digital rectal exam. The biopsy would have given you an elevated reading for several weeks but after a month it should have probably returned to normal. Also, some medicines can elevate your PSA (nasal decongestants, for instance.) So your doctor's suggestion to wait and recheck before you worry excessively is sensible (although I've never met a man who managed not to worry anyway.)

Gleason 6 cancer is considered low risk and can often be watched rather than treated and can almost always be watched long enough to make an unhurried decision about it. If your PSA rise is confirmed by subsequent tests (where you abstained from sex, moto-cross, and decongestants before the blood-draw) then that would factor into the shared decision making process that you and your doctor will go through. It would still be no reason to panic but might make some options seems more attractive and some less so.

Good luck. Keep us posted.
Posted 6/24/2013 4:42 PM (GMT 0)
Sorry about the rise. Hope it is temporary. Have you had a Free PSA blood test. That can sometimes be informative.

Also, what size is your prostate? Your PSA density (PSA divided by prostate size can also be informative.)

Anyway, good luck.

Posted 6/24/2013 4:59 PM (GMT 0)
Is there an issue having another PSA draw so soon after a biopsy? Could that be stirring something up? Not sure if that's also a valid concern. (Presumably the uro would know this if it was.)
Posted 6/24/2013 5:03 PM (GMT 0)
Welcome to our corner of the world. Sorry you need to be talking to us.

So many things can cause a rise in PSA. PC is just one. The doc is being prudent by retesting in a month. If the result is confirmed, you'll want to move a bit faster on the selection of a treatment.

In the mean time, keep up your research on what you'll want (or not want) to do about the PC. The rise is just another factor in selecting your treatment.

Hang in there and please keep us updated on your progress.

All the best,
Andrew
Posted 6/25/2013 3:01 PM (GMT 0)
Hey Nrennie -

Welcome to the forum that nobody wants to join (!) - you've come to the right place and will get some good advice and info here.

New members are encouraged to make a signature as part of their profile, listing pertinent info (so you don't have to keep repeating it). One thing you haven't mentioned yet is your age - age is definitely a factor in making a treatment decision. Younger guys tend to move more aggressively than older guys - but as you will soon learn, there are no hard and fast rules about treatment (and no end to the opinions)!

Best of luck as you start on this journey - keep us posted.
Posted 6/25/2013 3:18 PM (GMT 0)
The blood was drawn to soon after biopsy. Get a recheck and get a second opinion on the slides. not a second biopsy. Have the slides sent to a specialist in reading Pca slides. a uro that does a blood draw that soon after biopsy " probably " has a pathologic resource that doesn't read a lot of Pca slides. Im not upon the experts in PCA, others hopefully will offer that info. Oh and welcome to the Grouchomarx/ woody allen club. A small riddle which means nothing to your medical situation, just fun…...
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