PSA 7.3 Biopsy ?

A PSA retest is always in order.

PSA can be high for a number of reasons. PC is one, but low on the list.

Before a biopsy you need to eliminate all other possible reasons.

The retest and second opinion are reasonable steps. Also, I want to know, why at 77, where you giving your first PSA.

Andrew

Hi, and welcome MeMyself&I.

I'm going to (sorta) echo what InTheShop said...but with a few updates/clarifications.

He wrote in his 2nd line: "PSA can be high for a number of reasons. PC is one, but low on the list."

I'm going to correct that and say instead that it's not low on the list. BUT what's likely is that at age 77 you probably DO have some low-level of prostate cancer which will never bother you...and what in the heck were they doing giving you a PSA test at age 77 when you have no previous issues??!!

Here's an interesting fact for you to know. Roughly 50% of 50 year olds have some small, minor prostate cancer which most don't even know they have and the never need to know. Same is true with 60% of 60 year olds. 70% of 70 year olds. 80% of 80 year olds. This data was found in an autopsy study conducted in Wayne County (Detroit) where they examined prostates of men of all ages who died of an accident. So, yeah, you probably have some PC...and so do nearly 75% of your high school classmates! Most don't know they have it, and they probably never will know it.

So why the heck was did your doctor go against the recommended standards by his/her professional organization (the American Urological Association) and give you a PSA test at age 77 when you've not had any previous issues? Here's exactly what the AUA recommendation to doctors is:

The Panel does not recommend routine PSA screening in men age 70+ years or any man with less than a 10 to 15 year life expectancy. (Recommendation; Evidence Strength Grade C)


• Some men age 70+ years who are in excellent health may benefit from prostate cancer screening.

Perhaps obviously, the rationale is that if you've made it to 70 with a low PSA, then that slow-growing PC that you probably already have (remember, 70% likely) will only continue to grow super-slowly and now cause a problem in your lifetime...you would never treat it, so why even measure it.

Here's the link to that AUA document:
www.auanet.org/guidelines/early-detection-of-prostate-cancer-(2013-reviewed-and-validity-confirmed-2015) (see Guideline Statement #5)


Go to your next doc meeting and ask: "Why are you not following AUA recommendations with me??!!"

142 said...
A PSA of 7.x does not get everyone's attention as high. That was mine, and I wound up with extensive involvement. PSA is just one indication of some sort of issue with the prostate.

I would suggest you go to a good urologist for that next check.

Welcome to Healing Well!

We have to get away from the archaic "one-size-fits-all" mentality which fell out-of-favor as obsolete with the professional PC care-providers more than a decade ago. The key reason that the recommendation for 142 is different than it is for you, MeMyself&I, is that he's probably your son's age, or close to it...he is more than 20 years your junior. The whole premise of the AUA recommendation is that you've made it this far...so it's highly unlikely that whatever slow growing PC you have is going to be a problem.

At your next doc meeting, when you are asking him "Why are you not following AUA recommendations with me??!!", you can also ask him to verify these recommendations. (Bring a printout of the link I provided.)

Post Edited (JackH) : 5/2/2017 3:11:47 PM (GMT-6)

"The key reason that the recommendation for 142 is different than it is for you, MeMyself&I, is that he's probably your son's age, or close to it...he is more than 20 years your junior."

Interesting assumption, JackH. You've just accused the OP of having been married possibly before puberty, but certainly before the law allows.

I was a very low PSA, but very high percentage of G4+5. After my initial treatments, plugging in all my numbers into the best of nomograms, and personal consultations with the best docs in the country, gave me only a 5% chance of living at least 3 years. I'm sure that everyone, OP included, would like to have a little better than those odds.

But yes, a first PSA taken at 77 is interesting. I wonder if they were doing it earlier, but never felt it was at a level they needed to mention.

I remain of the opinion that a good urologist should be your next visit.

YouYourself&You,

The majority of the damage that prostate cancer does in men's lives is caused by how scary the word sounds. Men hear that they might have it and they either run around like their hair is on fire -- pestering their doctors for tests and treatments they don't need -- or they huddle in their rooms afraid to breathe. This is unfortunate because prostate cancer is just not that scary a disease, especially for a guy who has a few years on him.

Your doctor told you you have a somewhat high PSA and you should get it checked out. How scary should that be? about as scary as having him tell you you are too fat and need to lose some weight. Not even that scary, come to think about it. Prostate cancer is usually a slow-moving disease and the odds that a newly-diagnosed man with your PSA will die from prostate cancer in the next ten years are only a couple of percent. It is a risk, mind you -- men do die from prostate cancer -- but so is carrying an extra 15 pounds.

You describe yourself as a generally healthy guy. If you are right, and you plan to live to be the world's oldest man, then it might be worth getting your PSA checked out. But the next step isn't a biopsy.

Getting a retest for your PSA isn't a bad idea. There are lots of things that can cause an elevated PSA -- if a man has sex within 24 hours of having his blood drawn that can do it, or rides a bicycle, or bull riding, or his doctor pokes at his prostate with his finger before the blood test, or if he takes some kinds of cold medicine, or has a prostate infection.. Its worth a re-test to make sure the reading wasn't just a temporary fluke. But a better idea would be to ask the doctor for a better sort of blood test called a "Prostate Health Inventory" or PHI.

The next thing after that would probably be to wait six months and test it again. What you look for in a PSA to show prostate cancer isn't an elevated PSA but one that steadily goes up. Because prostate cancer is usually a disease of decades waiting a few months between tests isn't a big deal.

I can help sort out some of your questions...maybe others can help with the rest...

MeMyself&I said...
What am I missing. On one hand I've read that PC is the 2nd most deadly disease for men, and on the other that even w/o treatment your life expectancy is excellent to survive 10 years or more and your survival rate only goes down hill after 15 years.

Maybe you've gotten some mis-information, or partial information which had key points omitted. I'll give you some details below, but here's the bottom line: Prostate cancer is among the more common and less lethal malignancies, yielding a large population of survivors.



What are the top 10 causes of death in the US:
1. Heart disease (610K deaths in the US per year)
2. Cancer, all types (590K)
3. Chronic lower respiratory disease (147K)
4. Accidents (136K)
5. Stroke (133K)
6. Alzheimers disease (93K)
7. Diabetes (76K)
8. Influenza and pneumonia (55K)
9. Kidney disease (48K)
10. Suicide (42K)

Together, these account for 76% of all causes of death in the US.


Cancer is the 2nd greatest killer in the US, but it is really many different diseases.
1. Lung (150K)
2. Colon (50K)
3. Pancreas (41K)
4. Breast (40K)
5. Liver (26K)
6. Prostate (26K)
7. Leukemia (20K)
8. Lymphoma (20K)
9. Brain (16K)
10. Kidney (14K)

Together, these account for 68% of all causes of cancer death in the US.

The number of new cases diagnosed per year in the US is about 200,000. Obviously, a huge percentage of diagnosed cases are non-lethal. Thus, the statement that prostate cancer is among the more common and less lethal malignancies, yielding a large population of survivors.


http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf