Psa

My husband has had 3 psa tests done - all in the range of 6.0 After the first 2 - he was put on an antibiotic for 3 weeks. Went in for the test - still 6.0 range. He is 54 - dad had prostrate cancer - along with a couple of uncles. He has no symptoms - except very tired. Physical exam seemed ok. Dr. wants to wait 3 months - have the test again and then go for biopsy. We are thinking he should go now. His free psa was listed as .077 - not sure what that means - was not listed as a percent on the sheet. Any ideas? Could it be Prostatitis? Thanks.

Hi Randy. I have known a number of friends who have elevated PSAs in that range and negative biopsies. However, I don't see any reason not to do a biopsy. If PC is present, you always want to catch it early. Some folks have had 3 or more biopsies over a period of months. Prostate conditions such as prostatitis or BHP certainly can elevate the PSA, but since PC is the more serious condition, you certainly want to rule that out. Also if the biopsy is all negative, it would provide some relief of anxiety for both of you. That's just my layman's opinion, for whatever its worth.
Pat K

a PSA of 6 is in that grey area. Only about 35% of men with a PSA of 4-10 actually have PC. The free PSA is being used to prevent unnecessary biopsys. Its usually a % and the lower, the higher chance of PC. Generally, below 7% means a higher chance of PC. So...I dont see any problem with waiting and redoing the PSA. A biopsy is no fun and it seems rather unlikly that he has PC. Because of his age, if the next PSA is high, then do the biopsy.

Hello Lindkaye,

I disagree strongly with the above opinions. You and your husband need a lot of study, and I suggest a good book such as A Primer on Prostate Cancer by Stephen Strum and Donna Pogliano. You also need better test result info from your doctor, what is the actual percentage of free PSA to combined PSA? A low % indicates cancer, a percentage higher than 25% probably is not prostate cancer. Current thinking is that any PSA higher than 2.0 could be cancer, and the only way to know for certain is with a biopsy, and even that can miss at times. They say that prostate cancer is never an emergency, but you should not delay. Catch it while it is merely a brush fire rather than wait until it is out of control like a forest fire. My PSA got to 7.8 before I had surgery, but that was too late, as it had spread. I suggest non-invasive treatment such as hormone therapy if the biopsy shows cancer. Arm yourself with the facts, watchful waiting is not the correct choice.

Jim