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PSA level increases 800% in less than a year??

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Posted 5/11/2016 8:50 PM (GMT 0)
My Age 41.

Family History. Dad diagnosis with prostate cancer at 65 (2013). His PSA was 4.4 when biopsy was done. Gleason was 5+5 (10)

I did start TRT because of low levels (less than 300) in 2015.

My tests:

July 2015 (first test @ 40): PSA 0.89 / Total Testosterone: 288
April 2016: PSA 2.82 / Total Testosterone: 128

See urologist. Said to stop TRT for a week and do another test. DRE results was asymmetric prostate, but everything else felt okay. Said that is common.

May 2016: PSA 8.40 / Total Testosterone: 28

Over 800% increase in 10 months.

Follow up with urologist on May 23rd.

Now my bp is probably through the roof as I wait.
Posted 5/12/2016 1:20 AM (GMT 0)
Quite a rise for sure, could it be prostatitis? Was there mention of a course of antibiotics then PSA retest?
With your family history, i would be all over it, although at age 41, it would be possible but rare that you would have PC.
There are way more knowledgeable guys than me here so mostly, i just want to bump this up for you in hopes that one of those guys sees it and responds.
Posted 5/12/2016 2:49 AM (GMT 0)
I agree with Prat that prostatitis is the most likely cause, especially with that sudden rise, your castrate level of testosterone, and your age. He might give you an antibiotic and test again, or he might tell you to wait a few months and re-test. (Prostatitis doesn't respond to antibiotics a lot of the time - you just have to wait it out.) I guess you know not to have an orgasm or bike riding for 2 days before your PSA test. I hope you can get back on TRT soon.

- Allen
Posted 6/8/2016 2:57 PM (GMT 0)
Well an update... did week of cipro. PSA went down to 2.04 and free psa 15%. Urologist said that is better, but did not like the free psa number. So ended up doing a biopsy last week. Results came in last night:

biopsy showed infection plus... 2 of 12 cores gleason 6. One was 25% and other was 40%

Follow up next week with urologist, along with my wife, to go over next steps.

Good thing I started at 40.
Posted 6/8/2016 3:55 PM (GMT 0)
Sorry that you have to join the club, but you have time with the G6 to decide what to do, if you do anything. Time for the research to kick in and involving the wife will help. Read the sticky thread for those just diagnosed - that will help. Good luck on your journey. Keep us posted. Take care. -JR
Posted 6/8/2016 4:20 PM (GMT 0)
Sorry to hear about the G6, but that's a very low risk and likely you'd be a candidate for active surveillance.

Don't rush into anything, you've got plenty of time to make an informed decision.

Andrew
Posted 6/8/2016 4:23 PM (GMT 0)
I would get the slides re-read by that Epstein dude.
If there was still infection present at the time of Bx, good chance in my mind the cell types were misinterpreted.
Not saying that PCa won't be in your future, but I'm thinking you're still in the clear.
And ditto on the G6 if in fact that's a correct interpretation. Take your time in planning.
Posted 6/8/2016 8:31 PM (GMT 0)
Thanks for the replies.

Yes, my doctor said we do not have to dive right into this now. Plenty of options (He is big in HIFU) and ways to go about this and there is time (just dont take forever). Judging from his demeanor I would agree. I have been reading the threads and got quite a bit of info from my dad who has been battling this for 3 plus years.

My wife is freaking out more than anyone else and trying to reassure her all will be good. It was caught early and it is not advance stages of lung cancer...

Of course I got a huge tongue lashing from her last night because I texted her from the doctor's office after I got the results "looks like cancer". Obvious not the right communication channel for something like this. :|

I will look at the getting the slides look at again.
Posted 6/8/2016 8:40 PM (GMT 0)

JacKis1 said...

Of course I got a huge tongue lashing from her last night because I texted her from the doctor's office after I got the results "looks like cancer". Obvious not the right communication channel for something like this. :|


Oh my...indeed. This will be one of your big memories of the day. The reason I say that is from what you have described so far, you are in the "low-risk" category. Some doctors (not me) have characterized low-risk PC as similar to a case of dandruff. Well, that may be understating it, but hopefully you get the point being made. Some other doctors have even proposed that pathologists stop "branding" low-risk PC cases with the name "cancer," for the obvious reasons...you don't text your wife from the doctor's office to tell her you've got dandruff. Well, that discussion (about not calling low-risk PC "cancer") had largely fallen by the wayside recently now that men with low-risk cases are more frequently deferring treatment until and if it is needed.

Lucky for you, HW/PC has a great place to start learning more. Go to the sticky thread at the top of the page to read more about risk categories, biopsy reading and other important topics. Look for the sticky thread titled, "Newly diagnosed with PC - read this thread first"

Here's a direct link: www.healingwell.com/community/default.aspx?f=35&m=2652250

Post Edited (JackH) : 6/8/2016 4:25:33 PM (GMT-6)

Posted 6/13/2016 8:57 PM (GMT 0)
So.. after lots of reading on this forum, Dr. Walsh's book (my dad gave it to me to read), and talking to my urologist this morning, sound like the best decision is to go ahead with radical prostatectomy. My urologist was not too keen on the active surveillance approach because I am young and this is my window of opportunity. He said that are many approaches to treatment, but I am young and surgery it the best route.

I am relatively healthy and in good shape. He feels that I would recover with very little issues. He can not be 100% certain about what will happen after the surgery, but he fells that my odds are way more in my favor to have little (if any issues) with all the after/side effects from the surgery AND getting rid of the cancer. He said who knows what will happen in 10 years or what if it is actually worse than what the biopsy said. That is not something I want hanging over my head.

Of course, the wife is not 100% on board with the idea - but I do want to live at least another 41 years. So we are talking through this. I will get a second opinion though. I did ask about sending the slides to an expert like mentioned here and I will work with the front office staff to do that for me. Sounds like they do that from time to time.

A lot to digest. Feels like another burden on the family. Between my brother, sister and I, we are already taking care if my dad with his treatment which has been taxing. But the courage, strength and attitude my dad has show over the last 3 years only gives me an upbeat and positive attitude about this. My dad was given at 10 to 15% chance of survival at 5 years and I know he will prove them wrong.

Thank you to all of you on this forum for the information you provide. Very, very helpful.
Posted 6/13/2016 9:23 PM (GMT 0)
Hi Jack

Sorry about your Dad and your diagnosis at such a young age. I agree it is great that you started your PSA testing early since your Dad has prostate cancer. I had my younger brother start testing as soon as I was diagnosed and he is in his mid forties. Also I can see where your Dad is such an inspiration to you.

Just so you know I am not second guessing your decision if you have your mind made up. With your Dad's history I can understand your thought to get this over with now. However, as I am sure many others here will soon tell you, it might be wise to slow down a bit and really look into other options and get 2nd and 3rd and even 4th opinions before you pull the trigger. We only get one shot at doing this so I think we owe it to ourselves to take the time necessary to get fully educated on the options and fully informed as to the true degree and amount of cancer we may have. It is a very important decision. I know when I first was diagnosed my thought was to just make a decision and get it done. Fortunately my girlfriend got me to slow down and get more opinions and once I got started with the process of educating myself as to the options and getting my true diagnosis through more testing it was a little easier to breath and take the time needed.

Where ever your decision takes you I wish you and your Dad well....Jim
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