First Time Post about PSA

Hello,

I'm 47 male and I had some blood in my semen back in October, I did have the Vasectomy back in April so in the back of my head I think this could be related.

I went to see my Urologist who didn't bat an eye; DRE was negative, Urine tests were negative but the PSA test came back at 3.8, this was my first ever PSA test. He put me on Bactrim for two weeks and in my next visit he said it came down to 2.7 which was a significant drop. All along he has felt that I don't have PC and it's been treated as inflammation. I should be 2.5 or below for my age so I'm just right there. He said if my PSA had come down to a 2.4 then he'd see me in a year. I know the stats say that we all have a risk for PC but the only issue I had was the blood, which has not returned and the PSA dropped with a round of antibiotics.

What are your thoughts?

Ditto to what Andrew said, It is much more likely that you are dealing with prostatitis.

Just relax, and have six month PHI tests for a year. If those are good, then go annual.

ASAdvocate said...
Ditto to what Andrew said, It is much more likely that you are dealing with prostatitis.

Just relax, and have six month PHI tests for a year. If those are good, then go annual.

Thank you for the encouragement!

PSA due to PC, rarely drops. Many docs wouldn't be concerned until you got closer to 4.0 or had a positive DRE.

It's likely this is only time you'll have to be concerned about this.

Andrew

NKinney said...
I'm going to jump in to offer a very important correction/refinement that most newcomers like you don't understand yet (and many learn about only after it's too late!)...

Jamie1970 said...


This very helpful and encouraging and IF PC were present it's so early that it's curable from what I'm told.

The great majority of PC case incidence diagnosed from a biopsy which was done based on moderate PSA test results does not need "curing" at all. The previous decade was the peak of a PC overtreatment epidemic, and much of the literature out there is still in a "treat every case equally" mentality...whether it's a tiny speck of virtually harmless low-grade PC or aggressive high-grade PC.

Perhaps this is too much info for you for now, but just know that for a significant number of PC cases, the treatments are far worse than the disease...

Thank you for the follow up on this; I should have clarified my statement that this was from my Urologist and not directly from me or a Google search.

I do agree that over treatment has been an issue just from my time of my own research. I think it is the C word that immediately give someone like me a scare when I am new to all of this. However, that scare has pretty well subsided now. Much of that is just through prayer. Some of that is through the comments on this board and also with various friends who have had prostate issues.

What I didn't really know was that we men, for the most part, will deal with some sort of prostate issue in our lifetime, I just didn't think I would deal with it now. But, I'm glad that I am and will continue to stay on top of this each year going forward.

My Urologist is treating it as inflammation as suggested on this board already.

I did start a second round of Bactrim last night but stopped it this morning after a big reaction to it; flu like symptoms, sweating, fever of 101, chills, shakes, etc...So, I'm content at this point to have it checked again in a few months.

Thank you for the post and it was not too much information, if anything it gives me the thought of not overdoing anything that I don't have to at this point.

So, a quick follow up to my initial post back in late November.

As I mentioned before my PSA was a 3.8 after going to see the URO for blood in the semen. DRE and urine all negative. After a bout of antibiotics the level went back down to 2.7. This was my third and final visit with this URO as he no longer accepts my insurance. He gave me the following options; Wait 3-4 months and retest, biopsy (which he personally would not do if it were him), PHI, Imaging, or second opinion. He even offered to refer me to his friend at John's Hopkins for a conversation (to be honest that freaked me out a bit).

I was able to find a new URO based on some of my research and some recommendations from a doctors and friends who know him or see him. He's also known as a conversational doctor which is what I need at this stage, just someone to talk to which the first guy was not.

The first thing that this doctor said to me on December 21st was, "my goal for today is to put your mind at ease." He had already reviewed my chart. Nothing about my 3.8 PSA concerned him and he and my first URO were pretty much unfazed about the blood in the semen. Both, in fact, were speaking some of the same language which was refreshing because what IF I got two totally different opinions?

He took the time to go through PC, PSA, etc...and explain it to me like it was never explained before. His DRE was also negative and he said I had an indistinct prostate; which he said is nothing to be alarmed about. He will test me again in May and see where it is at and he said don't be alarmed IF your PSA is high again. He said the fact that it came down is a good sign of prostatitis and nothing more.

So, basically we are in the monitoring stage at this point. He went on to stay that most men will have some sort of prostate cancer in them if you did an autopsy on them when they died. In other words, it's common or at least more common than I thought. He also said that the medical community has put out a lot of scary information about PC that we are now paying the price for; evidently he feels as if we've scared more men that we should have.

Sorry for the long post and you may disagree with some of his statements but overall I was very pleased at what he had to say and we will go from there. I'm very pleased with him and his willingness to have the conversation with me.

Hello,

I'm back! Well as you can see my PSA level was 3.9 back in October; two weeks of Bactrim took it down to 2.7; I went to my new URO in December and he was not worried. Yesterday I had my PSA test results and it jumped to 5.6; he still believes it is inflammation or infection but way say you guys?

My PSA was on the high side two years ago, so my GP started to monitor my PSA every 3 months.

It turned out I did have cancer but I also had a fluctuating PSA due to the likes of prostatitis, although it was never diagnosed.

Just before I was to start RT I took 325mg of aspirin a couple hours before a PSA blood test. My PSA dropped from 6.1 before my biopsy in late September to 5.2 in mid December.

Get a PHI (prostate health index) test. That might give better info.

What's the free PSA % ?

It is bouncing around like prostatitis. I'd be reluctant to do a biopsy, but I can see the URO suggestion one.

Andrew