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A friend's PSA went from 10.6 to 16 in 6 months: BPH or cancer?
A friend of mine has a history of cancer in his family and of BPH. At A PSA at over 10 they gave him an MRI and a biopsy which showed nothing. His Urologist put him on antibiotics, gave him another test and his PSA was up to 16. His urologist gave him more antibiotics and he is going to have another blood test shortly.
Can an enlarged prostate cause the PSA levels to go this high without having any cancer? Any experiences with this?
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Don’t have any experience of PSMA PET Scans for the primary PCa detection, but perhaps others on this forum do. I presume that her would have difficulty getting insurance to pay for it, but perhaps others either know or have ideas about this topic as well. I just read some reports that cited the use of PSMA PET Scans for primary PCa detection, but I believe the scans were used to detect spread outside of the prostate as information to be used for determining the initial treatment: https://www.sciencedirect.com/science/article/pii/S0001299823000557
In the spring I had a PSA of 6 and got a negative PC biopsy. They put me on 2 years of 6 month PSA testing. I just got a 12 of a PSA. So yes it's possible my dad had PSA and BPH and my family has a significant cancer profile. I have an appointment with my urologist soon and we will be discussing this further. Read some of the post I have made here.
@heavyphil
Never heart PSA was only 51% accurate. Is this to show if have cancer? Having a high PSA does not mean cancer it means irritation in prostrate. Rising PSA numbers show irritation and can come from cancer, enlarged prostrate, infection, irritation from bike riding, etc.,
PSA test I was told by my PCP, R/O, and urologist is a test to determine if additional tests are needed to determine cancer or other issues wiht prostrate not a determination of whether you have cancer or not.
I have a family history of prostate cancer (father) and experienced BPH and a fluctuating PSA for a number of years. Urologists monitored my PSA closely and I have had several MRI's and biopsies over the years. Last year I had my yearly urology appointment - PSA was stable, nothing found on the DRE. At the appointment I asked my urologist about the new urine based tests that use biomarkers to look for indications of cancer, and he indicated that he was familiar with them and that they were effective; he ordered the ExoDx test for me. Results were elevated (anything less than around 15-16 is considered normal; above that indicates a probability of cancer that should be treated. My score was 36 which means a 36% probability of clinically significant prostate cancer.) My urologist ordered a 3T Multi-Parametric MRI which was clear, and following that result said it was up to me whether he did a biopsy or not. We decided to go ahead with the biopsy and the urologist did a saturation biopsy (24 cores); 2 cores showed 5% cancer in the core. I decided to have surgery and am very pleased with the outcome.
Not surprisingly, I see a lot of value in the ExoDx test (or similar) to help identify cancer that may not be indicated by DRE, changing PSA, or an MRI.
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2 Reactionsthanks rider51. Perfect answer. And you asked for the test, essentially saving yourself. Well done.
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3 ReactionsFrom what I’ve read PSA is ‘only’ about 51% accurate in detecting actual prostate cancer - there are a huge amount of false positives and many men are biopsied and put thru testing and anxiety needlessly for BPH, irritation or infection.
PSE measures SIX blood components- including PSA which is but ONE marker - so if the results come back elevated there is a 94-97% chance that you do have cancer.
So if it walks, quacks, flies and does 3 others things that a duck does, it is definitely a duck.
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2 Reactions@heavyphil
PSA tests don't reveal cancer only that the PSA is elevated, rising, or falling. My PCP, urologist, R/O were concerned with the constant rising numbers over a long period of time and not the actual PSA number. It is the other tests done to determine if cancer is causing it.
PSE is not something I have heard about. It is sounds like a much more accurate test to determine the probablity of having cancer. But you would still need the biopsies to confirm.
Is this PSE widely known test? Wonder why would not hear about at Mayo Jacksonville and UFHPTI?
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1 ReactionIt came out at the end of 2023. Just Google it and all the info is there.
The 4K score is another test which includes PSA and 3 other markers but none of my doctors knew - or cared - about it.
I had it done on my own and I scored 9. Not bad, right? 7.5 and under is normal. But I had a solid Gleason 4+3 unfavorable. My friend had a 27 but his cancer was 3+4 so where’s the correlation in that?!
I guess this newer PSE test adds 2 more markers which narrows the odds considerably toward a true Positive result.
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1 ReactionIt looks like the PSE test was introduced in the US in September of 2023:
https://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market
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3 ReactionsMy experience was almost the same as yours, although I had PSMA-PET scan and bone scan before committing to surgery. No regrets at 4 1/2 months out.
For more details on my experience you can find my COMMENT in the link below.
mulberry | @mulberry | May 27 5:43pm
https://connect.mayoclinic.org/discussion/76-too-old-for-surgery/