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question regarding psa in young people

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Posted 9/10/2019 10:02 PM (GMT 0)
I advised my son, at age 36, to get a baseline PSA, which he did. His PSA came back at .6 or .7, dont recall which. That was two years ago.
Last year he retested and it came back at .8.
He just retested at age 38, and it is 1.0.
Each time it was a different lab, because the Dr's changed.

I am very concerned. Should he be seeing a urologist? Or wait for the next test, next summer?
He is 38 and single, will be 39 in April. This would be my worst nightmare.
My own PSA was .7 at age 50, and a few years later at 1.3 is when my Dr sent me to a uro and at 1.7 is when a biopsy was recommended, which was negatve. That was at about age 60

Am i overeacting? Cause for concern?
Just to add, i know i should probably know the answer, but its tough to be objective when its this close to home
Posted 9/10/2019 10:14 PM (GMT 0)
What is the normal range of PSA values for the lab where it was run? You can't evaluate the numbers without knowing the normal range. And different labs have different normals and results do not correlate very closely.
Posted 9/10/2019 10:24 PM (GMT 0)
i believe the normal range for all of the labs is 0 - 4.0.
But i am focusing on the trend.
Posted 9/10/2019 10:47 PM (GMT 0)
Prat, he has a prostate and there are numerous reasons for small increases in PSA in such lucky guys. Prostatitis is just one of them. I don't see the a reason for concern here. But it sure wouldn't hurt to see a urologist (depending on the urologist) for a good DRE and if there is real worry an ultrasound.
Posted 9/10/2019 11:02 PM (GMT 0)
I'm sure you've researched normal PSA's for different ages. The one chart on Medicine.net shows normal PSA's of a maximum of 2.5 until age 49.

You well know my medical credentials, so here's my take.

His PSA is no where near abnormal (according to the one and only place I looked). My guess is that it's as normal as not (maybe more so) for PSA's to rise (trend upwards) in males during mid-life.

Worst case scenario is.....he gets to 2.5 and has to have a biopsy. I say worst case because....those guidelines are there for a reason. And that reason is.....for every forty year old man who has a PSA test that came back at around 2.0.....and said men went and got a biopsy.....my guess is.....many would find some cancer. However.....those men are now faced with something that another 10 years of waiting would be faced with if they had waited to test. And the death rate from PCa would not be any lower.

The point is, one can go looking for trouble and find it. Or, one can let it come to him. And the results would (almost certainly) be the same.

Good luck Prat (I know it weighs on you. Moreover....I'm not a father)
Posted 9/10/2019 11:03 PM (GMT 0)
Argent hit on the real answer. Since your son still has a prostate, any number of events (sex, exercise, recent diet, etc) could cause a very slight PSA reading. Those results don't necessarily indicate a trend without being certain that his life immediately prior to the blood draw was identical each time. However, not suggesting he ignore it since he has family (you) with PC history. 39 is awfully young for PC but not unheard of. Others have suggested he see a urologist which is his best bet. Start getting PSA tested by same lab and try to do same things week prior to testing.
Posted 9/10/2019 11:29 PM (GMT 0)
I think you're overthinking it Prato. Your son may one day develope PCa that requires treatment. Maybe he won't. In my view the best thing you can do is educate him to know the difference between a PCa that needs treatment and one that does not. Hopefully he will never need to use that information - but he will be ahead in the game if does. Maybe by that time technology will make your worries obsolete.
Posted 9/11/2019 12:05 AM (GMT 0)
Thanks for the comments guys, they brought me back to earth.
I know right now it’s not PCa and even if it was a biopsy isn’t called for. He mentioned he may go to QUEST on his own just to get a baseline established with a lab you can use on a regular basis no matter where is Dr goes I’m not even gonna push him to do that I think the best thing right now is to probably just forget about it for a while, and next year if it rises again make sure he sees a urologist.

Even if you could do a biopsy now 90% chance it would be negative even if there was cancer there with such a relatively low PSA
Posted 9/11/2019 12:48 AM (GMT 0)
I am reasonably athletic and had a small DVT @ 42...tested negative for all genetic clotting factors and had no (known) predisposing factors. But my primary just happened to run a PSA and it came back at 2.1...two years later @ 44 yrs old it came in at 2.7...rest is history. Looking back it seems likely that the early pca triggered something weird in my clotting which many cancers tend to do and caused the DVT.

I think the only reason more young guys aren't caught early is that they don't test until 50...I get the concern for overtreatment however the guys with something going on at 40 are the ones you want to catch. I had no family history but will advise my son to get tested at 35.
Posted 9/11/2019 12:51 AM (GMT 0)
No you aren't overreacting however he is also at the age where the prostate starts growing so depending on that rate that could also explain some of the increase as well.
Posted 9/11/2019 1:46 AM (GMT 0)

Erichardson234 said...
No you aren't overreacting however he is also at the age where the prostate starts growing so depending on that rate that could also explain some of the increase as well.

Yes this is something I wondered about, could it be that his. Prostate is growing a bit, in his late 30’s, no see if that’s too young.
Posted 9/12/2019 3:16 AM (GMT 0)
Prato,

Nice to see you are so active here. I've rarely visited in the last few years.

You may recall that I was diagnosed with PCa at the young age of 41. After successful surgery, I asked Dr. Tewari about my sons' risks of PCa. He told me that each of them should get a baseline prostate MRI at the age of 30, and then periodic monitoring thereafter. (He didn't specify, but I suppose he's referring to PSA test.)

Gedman
Posted 9/12/2019 4:32 AM (GMT 0)
Ken, it's a cause for concern and he should see a urologist, but of course you're overreacting! Sounds to me like you feel one shoe's already dropped and the other is hanging by a thread. Deep breaths, my friend. Mindfulness.
Posted 9/12/2019 5:30 AM (GMT 0)
I would start getting a more sophisticated PSA test done (phi) - and get a free PSA reading as well and watch that trend.
Posted 9/12/2019 5:43 AM (GMT 0)
Prato, its not so much the level as the pattern of the rise. If it is a steady rising PSA over several years, then it is probably of concern to most Urologists, regardless of the level of PSA and his age. Make sure he gets a DRE annually and if you are really paranoid about it and have lots of spare cash, you could send him for a multi parametric MRI every few years. Catching it early has some advantages in treatment, say with SBRT, where there are lower side effects for a young man, without worry about it already escaping the capsule.
Posted 9/12/2019 12:14 PM (GMT 0)
Thanks all for your responses.
So I guess what I (and ultimately he) have to decide, and would appreciate some perspective on, is this:
Is it reasonable considering the low level of PSA, for him to wait a year, and next year go back to the SAME lab, with an understanding that if it’s up again, THEN he consults a urologist?
My thinking is that at 1.0, no urologist is going to do anything but monitor.

Gedman, great to see you here.
Posted 9/13/2019 9:15 AM (GMT 0)
Yes, it’s reasonable for him to wait a year.
He should hook up with a urologist now, to calm his dad and because there’s a family history of PCa.
He should have a DRE.
He should take control of his own health. What he does and when he does it is his business.
Posted 9/13/2019 12:31 PM (GMT 0)
Yup, I have two completely different 36 year sons living far from us and have shared what I can about my PCa and family history as well as other health concerns. It is tough to “interfere” the correct amount without them ignoring me as another public service announcement from Mom and Dad. It is just as hard to get the invincible boys to get annual physicals much less PSA testing. I tell them to consult with their doctors at age 40 and get the baseline PSA testing done due to family history. I will remind them annually and keep them posted on my journey but they have it to get it done themselves like SP said.
Posted 9/13/2019 3:10 PM (GMT 0)

Saipan Paradise said...
Yes, it’s reasonable for him to wait a year.
He should hook up with a urologist now, to calm his dad and because there’s a family history of PCa.
He should have a DRE.
He should take control of his own health. What he does and when he does it is his business.

Excellent advise, Rich, and I agree completely.

Let's pray that Prato's grandchildren are spared any involvement ;-)
Posted 9/13/2019 4:34 PM (GMT 0)
Thanks Rich. In fact he didn’t see a urologist the first time when he was 36 so he has a go to guy and I look at his credentials and he seems pretty good .
I agree he’s in charge of his own health. At the same time it would be a shame for him to suffer in the future because he didn’t take advantage of my knowledge. He’s an extremely smart man, and is very diligent about doing his annual physical and his PSA this was not something I have to tell him to go
He’s an extremely smart man, and is very diligent about doing his annual physical and his PSA this was not something I have to tell them to do.
So my job is to make sure that he is educated and has the information he need to make the right decisions .
I’ve told him that he gets it.
Doesn’t mean I’m not gonna worry about him, I want obsessed, but I will certainly worry when it comes to TSA testing time for him Just as I worry about PSA testing time for me
I appreciate your measured advice

Mumbo thanks for your comments we are in the same boat so you clearly get where I’m coming from. I appreciate that , let’s pray that all three of our sons never have to come here
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