What to expect PSA number 4.7? 72 yr old

@joem
If I had to do the testing process over again, I would ask for a PSE test which has 94% accuracy, supposedly, while the PSA test has 57% accuracy. If that blood test showed a problem, then I would do the MRI... Here is the link to BioDynamics and you can also email Steve Arrivo, a Senior VP there, who is more than willing to answer any questions you may have.
steven.arrivo@myobdx.com
https://www.oxfordbiodynamics.com/?utm_campaign=email-signature&utm_medium=email

Your PSA indicates you should look into what’s going on in your body. A PSA is a check-engine light. Something isn’t working right. It could be minor or the tip of an iceberg. My PSA was 4.1; it was the just the tip. There are options for you besides radiation. Find the one that’s best for you. Good luck.

My suggestion would be, if you have kept track of your PSA over many years, then you have historical data that can help you see how it has trended over time. Has it kept steady and this one is an abnormality? Has it been trending up over time? I'd suggest a repeat PSA in a month or two. The proper way to go forward with testing beyond PSA is next and MRI. Standard systematic 12 core biopsies are largely random samples of tissue from the prostate, sort of taken from zones. Chances are great that those 12 cores can miss a tumor. You want the MRI first so if something shows up on the images, the urologist can now "target" that area during biopsy. Slow down in order to be right. It is critically important that you be treated for all of these procedures by highly experienced doctors and centers of excellence. If you can't find that where you are, it's to your advantage to seek it out and travel to where you can receive it. There are also additional tests 4K Score for one that can shed more light on the probability you have prostate cancer. You could also ask for a PSE test, something that is just out on the market. The PSE test as I understand it increases the accuracy of predicting prostate cancer to 90 percent when combined with a PSA test. https://www.news-medical.net/news/20230208/New-blood-test-can-detect-prostate-cancer-with-greater-accuracy-than-current-methods.aspx

PDCAR, thank you for your input on this request. I will speak to my healthcare provider to request a PSE test after reading the information on the accuracy over the traditional PSA tests.
Thank you
Joe

My Primary Care Physician suggested that I see a urologist when, at age 69, my PSA went from 3.8 to 4.3 over the course of 1 year. The urologist did a physical exam and could feel no abnormality, but the MRI that he ordered did show some areas of concern, and the subsequent biopsy indicated prostate cancer with a Gleason score of 7=4+3.

I agree that you should see a urologist as soon as possible. I expect that you will have a physical exam, MRI and, assuming that there is a reason to suspect prostate cancer based upon those two exams, a subsequent biopsy. After that, you'll have to see what the results are, because that will determine what treatment options are available to you.

Joe,
Slow down you are getting way ahead of yourself . Obviously you know very little about prostatee cancer and any treatment options . FFirst , as we all do . Educate yourself and be yoour own best advocatee with the information you learn . Purrchase Dr Patrick Walsh's 5th Edition book " Guide to Surviving Prostate Cancer " .
Dr. Walsh is the world's foremost authority on prostate cancer . He is the Distinguished Professor of Urology Emerius at the Brady Urological Institute at John Hopkins in Baltimore . Having read this book you will realise how much you are off base , panicing and jumping the gun .
1st Prostate cancer is slow growing , and even if you have prostate cancer . You are NOT going to die tomorrow , you like most every male , have had it for years 10 to 15 years without knowing .
RULE # 1 IF YOU HAVE CANCER : DON'T PANIC AND CHOSE A TREATMENT YOU WILL REGREAT LATER
Tale your time , educate yourself , and consult with your Urologist and plan your next steps .
My advice at this juncture . Get a followup PSA & Free PSA TEST . Your Urologist may next send you for an MRI - If so get one with a 3T Machine not the older 1.5 machines . An MRI will guide your Urologist whether to proceed to the next step a Biopsy . If so go for a Transperineal MRI Fusion Biopsy NOT a Transrectal Biopsy .
There is less chance of an infection for obvious reasons - fecal infection . ( potential sepsis infection ) .
Finally . Settle down - don't rush into a bad decision . Keep your family in the loop . Take a family member or friend to your doctors consultations . An extra pair if ears can pick up things you may miss . When you hear the term :
'You have cancer " You are in shock . it is a kick in the gut and you typically will miss part of the doctors next communication -- Thus the extra set of ears .
Good Luck .

You need to see a good urologist who can guide you in your journey. PSA alone is not a diagnosis. The urologist can do simple things first, such as a digital exam. Then, if he feels it would be beneficial, he can schedule a special MRI to examine the prostate. One step at a time, but if you are bothered by the PSA, get to a urologist.

Beware...........a digital rectal exam can only assess the posterior side of the prostate, that side facing the rectum. It is of no value in assessing the anterior side of the prostate, that side that faces to the front. While a good share of cancers show up in the posterior region, a good number of them also show up in the anterior region. Mine happened to be anterior. I went for years having a DRE showing nothing and feeling good about it. All the while I had cancer growing in the anterior portion of my transition zone. A 3TMRI is the best assessment technique available today.

Agreed .
Mine could not be felt on my regular DRE . Additionally my GP concluded my rising PSA was due to my BPH condition .. ALSO WRONG . Furthermore I have been on Dutasteride for 4 years -- when I discovered ( not via my GP ) that taking Dutasteride for a number of years you DOUBLE YOUR PSA , or , even multiply it by TWO & ONE HALF TIMES . I saw a Urologist . had a 3T MRI RADS 5
Yes I had cancer and was pissedd at my GP .

I watched the doubling time. If your PSA went to 4.7 from a 2 something, then yes, it is a problem. If it raised a bit at a time, then maybe not. Mine went from a 2.3 to a 4.5 in 1 year. I got a biopsy and was Gleason 10, stage 3C....good luck.