1. < Prostate Cancer

What to expect PSA number 4.7? 72 yr old

Posted by Joe M. @joem, Oct 30 5:29am

At 72 yr old is a 4.7 PSA reading common, not saying that it’s normal.
Should I wait a month and have a new test?
I have seen that the normal course of action is next schedule a biopsy and then radiation.?

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Joe M. | @joem | Nov 2 9:33pm
In reply to @clandeboye1 "Agreed . Mine could not be felt on my regular DRE . Additionally my GP concluded..." + (show)
@clandeboye1

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 .

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I am sorry to hear that. Thanks to your advice I should I should not rely on the GP but in a specialist, a urologist.

REPLY
grandpun | @grandpun | Nov 3 7:52am
In reply to @clandeboye1 "Agreed . Mine could not be felt on my regular DRE . Additionally my GP concluded..." + (show)
@clandeboye1

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 .

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"clandeboye", thanks for reminding me how lucky I was that my PC was 'found' quickly. I'd had BPH for a few years so I had dutasteride + tamsulosin and yearly urologist visits; never found with DRE. When PSA rose/doubled; real PC testing started with an MRI (saw it on right side), TR biopsy (14 cores negative), another trans- perineal biopsy found Gleason 3+4 on Nov 2022 and RALP early Jan 2021.
I was ignorant but very lucky.
God Speed to you. May you be on the up-swing.

REPLY
pdcar4756 | @pdcar4756 | Nov 3 8:39am
In reply to @clandeboye1 "Agreed . Mine could not be felt on my regular DRE . Additionally my GP concluded..." + (show)
@clandeboye1

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 .

Jump to this post

The radiologist who read my first MRI in 2022 missed my lesion. I walked around for two years with this cancer inside me until another MRI in 2024 and a different radiologist saw it as PIRAD-5. Hard lesson learned. Don't trust these people. If your intuition tells you something is not right (and mine did).........and I let my urologist talk me out of it...........seek second opinions or third opinions if necessary. Fact is it costs you little as most insurance plans pay for such opinions. And seek the centers of excellence for those opinions. I will be exploring malpractice options this winter.

REPLY
1 reply
ricardo7 | @ricardo7 | Nov 3 8:52am

Get another psa test after a couple of not too active days. A psa test is not definitive test. Ask for an mri scan first. If your psa level goes down it does not necessarily mean an improvement. Take all the tests and advice you can. Good luck

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chipe | @chipe | Nov 3 10:25am
In reply to @pdcar4756 "Beware...........a digital rectal exam can only assess the posterior side of the prostate, that side facing..." + (show)
@pdcar4756

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.

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My point is that a digital exam is, IMHO, one of the most basic yet needed exams for your prostate. Many tests have shortcomings, including PSA levels, but when combined, they prove pretty effective in the discovery/treatment of PC.

My prostate was "lumpy" for 2.5 years before I insisted on an MRI. My PSA levels hovered around 2. It was the MRI and biopsy that proved the cancer and it was large, aggressive and outside the prostate but not metastasized.

All of the diagnostic tests, put together, paint a much more accurate picture.

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1 reply
clandeboye1 | @clandeboye1 | Nov 3 10:43am
In reply to @pdcar4756 "The radiologist who read my first MRI in 2022 missed my lesion. I walked around for..." + (show)
@pdcar4756

The radiologist who read my first MRI in 2022 missed my lesion. I walked around for two years with this cancer inside me until another MRI in 2024 and a different radiologist saw it as PIRAD-5. Hard lesson learned. Don't trust these people. If your intuition tells you something is not right (and mine did).........and I let my urologist talk me out of it...........seek second opinions or third opinions if necessary. Fact is it costs you little as most insurance plans pay for such opinions. And seek the centers of excellence for those opinions. I will be exploring malpractice options this winter.

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On 2nd and 3rd opinions .
My 1st -- 5 Core Transperineal MRI Fusion Biopsy came back negative . This was in direct conflict ( 98 % of the time ) with my MRI PI-RADS 5 . My 2nd - 15 Core biopsy came back 6 Cores in the target zone Gleason 2 +3 = 6 I had a 2nd opinion , all 6 came back Gleason 3 +4 =7
A 3rd opinion came back - 4 were Gleason 6 and 2 were Gleason 7 . Now I have :
Negative , G6 , G7 & MOST G6 with some ( 2 ) G7 . GO FIGURE ' And these were supposed to be top pathologists at major research & teaching hospitals .
Let's not forget " A prostate biopsy is one of the more difficult , or the most difficult , too analyzise ." As they say : Beauty is in the eye of the beholder ,

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kenhorse | @kenhorse | Nov 3 8:38pm

My PSA was 6.3 when the red flag went up. 30 days later it was 6.1 but they wanted to do a biopsy anyway. 12 cores, 6 of which were 4+4.

I was 68 at the time

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ricardo7 | @ricardo7 | Nov 4 10:03am
In reply to @chipe "My point is that a digital exam is, IMHO, one of the most basic yet needed..." + (show)
@chipe

My point is that a digital exam is, IMHO, one of the most basic yet needed exams for your prostate. Many tests have shortcomings, including PSA levels, but when combined, they prove pretty effective in the discovery/treatment of PC.

My prostate was "lumpy" for 2.5 years before I insisted on an MRI. My PSA levels hovered around 2. It was the MRI and biopsy that proved the cancer and it was large, aggressive and outside the prostate but not metastasized.

All of the diagnostic tests, put together, paint a much more accurate picture.

Jump to this post

Totally agree. Psa tests can vary on a day to day. The mri gives a better idea and the biopsy is the best test. You also need to have a “sympathetic” person to analyse the results. If in doubt, get tested. Don’t get fobbed off if you want better proof.

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VancouverIslandHiker | @vancouverislandhiker | Nov 4 10:56am

Joe - Is this velocity much higher than previous ones ? I think another PSA would not hurt . Are you under care of a URO ? Yes at 4.7 , you need to understand what is going on. Could be a number of things that drove PSA up ! Any intrastate cancer or glandular cancer family ? Let me know ..... God Bless ... James on Vancouver Island .

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chipe | @chipe | Nov 4 12:15pm

Rant mode on: I agree with all of the above. My PC was also "missed" so when first discovered I had an advanced, aggressive PC which required immediate action. But even though the biopsy came back bad, the MRI showed cancer outside the gland, etc., the "hurry up and wait" was still there. It seems that many urologists take the "wait and see" approach, which is wrong in my opinion. Is it because it's so common? Is it because it's *supposedly* a slow-growing cancer? I don't know, but from many of us on this site we went from blissfully happy to "oh crap I have cancer" in a heartbeat. 0 to 60 in 1 second?

I don't understand the mentality of the medical/insurance brain trust in taking such a laissez-faire approach to a life-threatening disease.

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