PSA rise in a year what to expect

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PSA rise in a year what to expect

by arizonadolphin on Mon Jul 04, 2016 10:18 PM

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My husband is 50 his psa on 05/15 was 2.2 on 11/15 it was 3.4 and on 05/16 up to 5.4 that's a psa jump of 3.2 in one year exactly. His free psa is 3.8% as of 05/16. His dre was positive with nodules noted. He has been scheduled for biopsy. Just wondering what comes next. He has no family history of pca. Thank you Worried wife

RE: PSA rise in a year what to expect

by Philget on Wed Jul 06, 2016 09:30 PM

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The next step is, of course, biopsy and diagnosis. The relatively high free PSA is a good sign. On the other hand, the positive DRE and the PSA rise do raise a suspicion. If he's diagnosed with cancer, the first thing you should both do is take a deep breath and remember that prostate cancer is very treatable and most often curable. You'll be faced with the task of choosing a treatment. It can get confusing. But you'll have time to decide. Rarely is it necessary to make a prostate cancer treatment decision immediately. There's some great info on the web to help you. Last time I looked the Prostate Cancer Research Institute had a lot of helpful info for men who had just been diagnosed. Best of luck. I'm ten years out from diagnosis and am doing fine with no sign of cancer.

RE: PSA rise in a year what to expect

by tomatoman on Thu Jul 07, 2016 12:12 AM

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I have a book that looks at this type of situation pretty carefully.  It's "Dr. Peter Scardino's Prostate Book", 2006. According to this book average PSA for over 50 & under 60 is 2/6 to 3.5. The PSA normally rises with age. Your husband's was normal until his latest reading, 5.4, which is high for his age, more like a 79-year-old. The book also explains that the PSA can vary without any good reason from day-to-day, as much as from 3 to 4.1, so your husband's is above day-to-day normal rise. Also it explains that a lot of biopsies prove to be unnecessary (40%).  Also regarding free psa the book has a chart (page 145) which shows that 0-10% free psa, with PSA "gray range" 4-10 means a 56% chance of prostate cancer, and higher % means less probability, so your husband's 3.8% is indicative of higher probability than 56%.  Regardless of all that, my thinkin is that it would be wise to confirm the high PSA reading with another blood test before proceeding to a biopsy.  PSA can be inaccurate due to a lot of reasons. If another PSA reads high then that would suggest a biopsy is necessary to make an accurate assessment. 

I also am a bit wary of biopsies as they could be a cause of the cancer spreading.  I don't have much to support that except my own reasoning, that a biopsy causes blood flow in the prostate area, by nature of the process, and therefore it offers the cancer cells a route to travel.  But nobody else seems to worry about that much.

My own situation back in 2008 was initially 8.1, which prompted a biopsy and then radiation therapy. PSA rises in 2012, 2013, and 2015 caused suspicion of metastizing, which led to hormone therapy sessions, which lowered the PSA to <.1.   

As alternative therapy I eat no meat, just seafood and vegetarian.  I eat foods that in theory kill prostate cancer, such as tomato soup, marinara sauce, pomegranite juice, curry powder, garlic, black pepper, jalepeno peppers, paprika, and occasionally apricot kernels. However, I have to assume that the hormone therapy is the main reason that my cancer is kept in check. 

RE: PSA rise in a year what to expect

by arizonadolphin on Thu Jul 07, 2016 01:16 AM

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Thank you both for your input he has gotten a referral to a downtown urologist vs the VA who wanted biopsy but can't get him in till November. I will take all blood work in with us to urologist. I am sure they will do another psa screen like I said and your book points out his psa rose quiet a bit in one year free psa that low isn't good and dre states asymmetrical nodules at apex and his younger age. Will post update after apt on 25 of July as to what they recommend.

RE: PSA rise in a year what to expect

by Philget on Thu Jul 07, 2016 02:29 AM

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On Jul 07, 2016 1:16 AM arizonadolphin wrote:

Thank you both for your input he has gotten a referral to a downtown urologist vs the VA who wanted biopsy but can't get him in till November. I will take all blood work in with us to urologist. I am sure they will do another psa screen like I said and your book points out his psa rose quiet a bit in one year free psa that low isn't good and dre states asymmetrical nodules at apex and his younger age. Will post update after apt on 25 of July as to what they recommend.
Whoops. A free PSA of 3.8 isn't reassuring at all, is it? It, the PSA and the DRE all suggest cancer, don't they? I'd want a biopsy asap so I could have more time to choose a treatment. The biopsy would also tell you if it was aggressive and if that was the reason for the rapid PSA increase.

RE: PSA rise in a year what to expect

by tomatoman on Thu Jul 07, 2016 01:31 PM

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I just want to correct a couple of things I wrote above that were errors on my part.

Regarding the likelihood of an unnecessary biopsy, (I wrote above 40%), the book states, page 143: "In 70 to 80 percent of cases, an elevated PSA that triggers a biopsy uncovers no evidence of cancer."

Also I wrote his PSA was like a 79-year-old (I hit the 9 instead of the 0), but to be more precise, his 5.4 reading was  more like a normal 75-year-old, according to the chart on page 138.

RE: PSA rise in a year what to expect

by julesaxon on Thu Jul 07, 2016 04:17 PM

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On Jul 04, 2016 10:18 PM arizonadolphin wrote:

My husband is 50 his psa on 05/15 was 2.2 on 11/15 it was 3.4 and on 05/16 up to 5.4 that's a psa jump of 3.2 in one year exactly. His free psa is 3.8% as of 05/16. His dre was positive with nodules noted. He has been scheduled for biopsy. Just wondering what comes next. He has no family history of pca. Thank you Worried wife

Sorry to read of your husbands PSA findings.  It sounds very much like my own experience 10 years ago.  My PSA was never anything to worry about but then it doubled from one check to the next within a year. I was till only 3.2 so, in itself not something to worry about.  But the sudden doubling was enogh to set me on a path of further investigation which eventually led to a diagnosis of prostate cancer.  That was in 2006 and the first of a further 5 cancer diagnoses, including two brain tumours in 12 months.  You ask what you might now expect and that is a question most, if not all,cancer patients will ask. My journey through 5 cancers is in my motivational. inspirational and encouraging book which is available from Amazon.

http://www.amazon.com/Fulfilling-Your-Dream-Battle-Cancer/dp

You do not have to learn what may be in front of you the hard way as I have been there and you can read about symptoms, diagnosis, treatment options, my choice of treatment, side effects after effects and living with prostate cancer over a ten year period.

I wish you very good luck and please do not hesitate to ask any questions you may have.  I can provide an e mail address if you wish

RE: PSA rise in a year what to expect

by julesaxon on Thu Jul 07, 2016 05:01 PM

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On Jul 04, 2016 10:18 PM arizonadolphin wrote:

My husband is 50 his psa on 05/15 was 2.2 on 11/15 it was 3.4 and on 05/16 up to 5.4 that's a psa jump of 3.2 in one year exactly. His free psa is 3.8% as of 05/16. His dre was positive with nodules noted. He has been scheduled for biopsy. Just wondering what comes next. He has no family history of pca. Thank you Worried wife

Take the biopsy because that is the ultimate conclusion of cancer or not and how far it may have progressed.

In my case the doubling of the PSA in short time and the DRE revealing a possible extrusion from the gland of the cancer tumour was the signal that I needed a biopsy to confirm any further diagnosis.

In my biopsy they took 6 samples from each side of the prostate gland.  All six on one side were cancerous while the other side was clear.  Allow the Urologist to use all the available info to come up with a Gleason score for any cancer diagnosis that comes.  My Gleason was 4+3 = 7 (out of a possible total of 10).  A fairly agressive diagnosis,  I had robotic surgery at University of Michgan Hospital to remove the prostate. My next check up is next month and it is important to me as my PSA has been slightly increasing again recently.  (And I have not had a prostate gland for ten years!!!)

RE: PSA rise in a year what to expect

by arizonadolphin on Sun Aug 07, 2016 12:42 PM

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Update we got a referral to a downtown urologist vs va or military treatment facility and had our initial appointment they did a DRE with three nodules felt and he is now scheduled for a TURP biopsy on 17 August with a fowl of up apt for results on 31 August. Holding my breathe it's not bad news. I will post again with biopsy results are received.

RE: PSA rise in a year what to expect

by julesaxon on Mon Aug 08, 2016 06:19 AM

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On Jul 04, 2016 10:18 PM arizonadolphin wrote:

My husband is 50 his psa on 05/15 was 2.2 on 11/15 it was 3.4 and on 05/16 up to 5.4 that's a psa jump of 3.2 in one year exactly. His free psa is 3.8% as of 05/16. His dre was positive with nodules noted. He has been scheduled for biopsy. Just wondering what comes next. He has no family history of pca. Thank you Worried wife
I encourage you to be decisive and take early action. The biopsy is the real indicator of whether cancer is present or not so go ahead and do it do that you can move on to choosing treatment. After having my prostate removed in 2006 my PSA srarted rising again around 5 years later which resulted in me having radiation treatment. Now, more than 10 years after having my prostate gland removed my latest PSA reading is higher than it has ever been. It just jumped from 1.9 to 4.5 in less than 6 months. We are concerned and hormone treatment may be my next option.
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