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75 year old with a four-point-something PSA. Doctor says wait and recheck in three months.

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Posted 10/10/2016 7:32 PM (GMT 0)
Hallo
I was told my PSA was 4.8 after 30 days of antibiotic it's now 4.2 my doctor said I should Waite 3 mo. And get another PSA I'm wondering if any of you had this type of waiting.im 75 yo
Thanks

Gave your post a subject line -- PeterDA

Post Edited By Moderator (PeterDisAbelard.) : 10/10/2016 2:33:49 PM (GMT-6)

Posted 10/10/2016 8:30 PM (GMT 0)
Hello Angelo,

Welcome to the forum. Sorry you have worries but glad you found us. Hope we can help.

What you describe is not at all unusual, especially for a 75 year old. As men age their PSA readings tend to creep up and the 4.0 cutoff level was chosen to be sorta kinda worrisome for a man of 60 or so. For a 40 year old it would something that needed to be checked out right away, but by the time a man gets to his mid-seventies, a four-point-something PSA is a minor thing that most urologists will just watch to see what it does.

So, yes, most of us have had that sort of waiting. Your doctor's advice sounds reasonable.
Posted 10/10/2016 8:53 PM (GMT 0)
Hi, Angelo,

I'm a bit younger (68), but I was in a similar place not so long ago. My PSA had been holding at 3.X for a couple of years, then went up over 4. We waited until my next semi-annual test, and when that went over 5, we went on to biopsy.

Most of the time, when an older man's PSA is "mildly" elevated, even if it is cancer, it is usually a lower-grade, slower growing variant of the disease, and the few months of waiting for the next test has been found to have no real effect on the outcome if there is cancer present. From what they estimated in my case, the cancer has possibly been forming for up to 10 years before it became detectable via PSA and biopsy.

Take a deep breath and slow down. You're probably in this for a long ride whether it is just to monitor things or if there is cancer present.
Posted 10/10/2016 8:56 PM (GMT 0)
Thank you
This is the first time my PSA was above 3.3 I had a turp done about 2 years ago
Once again thank you
Posted 10/10/2016 9:01 PM (GMT 0)
Welcome to HW.

That kind of waiting is normal. It's very possible that 4.2 is a normal PSA for you. Rechecking in three months is prudent.

I doubt this means anything other than a few extra blood tests.

That the PSA dropped after antibiotics suggests that an infection was the real cause. Other causes of high PSA wouldn't respond like that.

You'll be fine,
Andrew
Posted 10/10/2016 9:50 PM (GMT 0)
welcome Angelo!.... these guys really know their stuff, so I would feel good about what they are saying , ,,I`m new to the forum too....Just a little from me ....in 2015 (67yrs.) my PSA was 4.6.( I hadn`t had it checked for about 4 yrs . after I quit JCP and lost my ins)....the 4.6 was a shock since it was always pretty low...went on antibiotics for a few months and it only dropped to 4.5 .....wanted to forget it ....doc. said lets check it in 6 months. 6 months later in came in at 6.8..biopsy time and that brings me up to now -radiation starting next week ....so ...like the guys said , your probably OK...and if you do have some cancer it will become apparent in the coming months-years, but for now , if it stays in the 4 range your good in my opinion. The way I see my cancer , it was growing for a LONG time and I wish I had the PSA tests done in that period after leaving JCP. May have caught it some sooner. Good advice by the guys to keep up with the tests on a regular basis.... GOOD LUCK and keep us posted -David
Posted 10/10/2016 9:56 PM (GMT 0)
Thank you much for taking the time to give me support I wish you well in your coming treatment,I'm sure you are going to be fine
Best regards
Posted 10/10/2016 10:50 PM (GMT 0)
Hello..Pick up a copy of Dr. Pat Walsh's book "Guide to surviving prostate cancer". 3rd edition. You can pick up a copy at the library or on eBay..That way you will know exactly what is going on should you end up having a biopsy..But like the guys have said and agreed on, take it slow and see how things develop.
Posted 10/11/2016 4:52 AM (GMT 0)
Try not to get ahead of yourself. Too much reading and internet searching will certainly turn up some symptom to worry you. Right now, you are basically normal with a proper follow-up being scheduled.

As stated above, the odds are great that you do not have prostate cancer. And, if you did, it may be indolent, like mine, and never be a threat to your longevity, or need any treatment.

Relax, breathe deeply, enjoy your health.
Posted 10/11/2016 11:58 AM (GMT 0)
Thank you all for the feed back ,it's deeply appreciated
Posted 10/11/2016 2:12 PM (GMT 0)
At age 75, you have about 75% chance that you have prostate cancer (PC) in a mild form. It is a natural part of aging. Doctors have established different cut-off points for triggering biopsies based upon age because the development of low-risk PC, and the resultant increase in PSA, occurs naturally with age. There are several different but similar versions of this same table available online by searching for "age specific prostate specific antigen"

    Age-Specific Reference Ranges for Serum PSA
    Age Range (Years)....Asian Americans....African Americans....Caucasians
    ....40 to 49...............0 to 2.0 ng/mL....0 to 2.0 ng/mL....0 to 2.5 ng/mL
    ....50 to 59...............0 to 3.0 ng/mL....0 to 4.0 ng/mL....0 to 3.5 ng/mL
    ....60 to 69...............0 to 4.0 ng/mL....0 to 4.5 ng/mL....0 to 4.5 ng/mL
    ....70 to 79...............0 to 5.0 ng/mL....0 to 5.5 ng/mL....0 to 6.5 ng/mL


This should put you at ease. There is not reason to run out and buy Dr. Walsh's book (which is heavily focused on an aggressive surgical treatment, which there is no indication you should even start thinking about now), but it doesn't hear to start learning more about the natural part of prostate aging, which is a topic most men don't know much about. Be aware that being in the PSA "gray zone" (under 10 ng/mL) often lead men to having a prostate biopsy, which is an invitation to the "slippery slope" of PC overtreatment for very low levels of PC...prostate cancer has gotten a bad name due to the high levels of PC overtreatment in this country in the last 10-15 years.

Start your prostate education by knowing this: today, a prostate biopsy is not done to look for prostate cancer, because with today's capabilities to find tiny amounts, you will likely find some low-risk PC. Rather, the purpose of a prostate biopsy today is to identify whether there is aggressive PC which actually needs treatment.

Proceed towards the "slippery slope" with caution...this is what your doctor is doing...

Post Edited (NKinney) : 10/11/2016 8:15:17 AM (GMT-6)

Posted 10/11/2016 3:30 PM (GMT 0)
My brother in law, at a similar age as you, also saw his PSA going up. It got up to about 7 and they did a biopsy which showed some intermediate grade cancer. After age 70, the best surgeons will not operate and instead use various radiation based treatments to control the cancer, if it needs to be controlled. My brother in law used a form of external beam radiation over two months. That was four years ago. His PSA continues to be undetectable and he did not suffer any lasting side effects from the radiation.

Thus, you continue to wait to see the PSA trend and whether it indicates that any other actions need to be taken. It is entirely possible that even if you do have PCa, that it may be the low risk type that does not require treatment. about two thirds of men end up in the low risk group. So keep you thinking positive and remain patient.

I agree that the Patrick Walsh book will overload you wjth information about surgery which you will not use due to age. I would instead direct you to websites like the Prostate Cancer Foundation or the American Cancer Society that have great information about PCa and the various treatment options that include the Active Surveillance methods for low risk men.
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