CONCERNED ABOUT PSA

It seems that you should visit with an urologist and get on a 3 month testing schedule where you prepare for each test by being “calm” the day or two before each test to get baseline values. Your PSA variances could be due to anything but they are starting to get up to levels that should be checked out given your age. A urologist usually is more experienced with DRE’s than your standard doctor and might be able to tell other things about your prostate like BPH, etc. Never underestimate the power of a man’s ability to rationalize about anything when it comes to health issues.

Also, note that DRE cannot examine the surface of the entire gland. DRE can be invaluable though — a friend’s life may well have been saved 15 years ago by his Primary Doc who felt a very small anomaly while doing a DRE. Best wishes.

My father is 87 years old and has never had prostate cancer but in 2014 he had a biopsy done because his PSA was something like 8, but it came back negative.
Then in 2020, just before the pandemic, he had TURP surgery because two weeks earlier he went to the ER due to not being able to urinate.
The urologist who performed the TURP surgery told my father that his prostate was the largest he had ever seen in his entire career. The pieces that are cut out during TURP were submitted to pathology and all were negative for cancer.
When he was being prepared for surgery that morning I saw his medical folder and apparently he had BPH problems since the 1990s, when he would have been in his sixties.
So although there's no prostate cancer history in my family I have a direct relative with prostate problems due to enlargement, and that too I guess is hereditary??

Medvetz63 said...
...So although there's no prostate cancer history in my family I have a direct relative with prostate problems due to enlargement, and that too I guess is hereditary??

Good question!

Heritability and genome-wide association study of benign prostatic hyperplasia (BPH) in the eMERGE network(2019, Full Text)

"Abstract
Benign prostatic hyperplasia (BPH) results in a significant public health burden due to the morbidity caused by the disease and many of the available remedies. As much as 70% of men over 70 will develop BPH. Few studies have been conducted to discover the genetic determinants of BPH risk. Understanding the biological basis for this condition may provide necessary insight for development of novel pharmaceutical therapies or risk prediction. We have evaluated SNP-based heritability of BPH in two cohorts and conducted a genome-wide association study (GWAS) of BPH risk using 2,656 cases and 7,763 controls identified from the Electronic Medical Records and Genomics (eMERGE) network. SNP-based heritability estimates suggest that roughly 60% of the phenotypic variation in BPH is accounted for by genetic factors. We used logistic regression to model BPH risk as a function of principal components of ancestry, age, and imputed genotype data, with meta-analysis performed using METAL. The top result was on chromosome 22 in SYN3 at rs2710383 (p-value = 4.6 × 10−7; Odds Ratio = 0.69, 95% confidence interval = 0.55–0.83). Other suggestive signals were near genes GLGC, UNCA13, SORCS1 and between BTBD3 and SPTLC3. We also evaluated genetically-predicted gene expression in prostate tissue. The most significant result was with increasing predicted expression of ETV4 (chr17; p-value = 0.0015). Overexpression of this gene has been associated with poor prognosis in prostate cancer. In conclusion, although there were no genome-wide significant variants identified for BPH susceptibility, we present evidence supporting the heritability of this phenotype, have identified suggestive signals, and evaluated the association between BPH and genetically-predicted gene expression in prostate."

[Emphasis mine]

There have been other studies, too, which you can review at Google Scholar or PubMed.

Djin