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PSA went from 3.9 in November to 4.3 yesterday

Posted by yeoldefogey @yeoldefogey, 6 days ago

I am 54 and have been having urgency issues off and on for a few years, and occasional trouble emptying, but no problems during the night.
I am seeing my urologist in a week. My physical prostate exam was normal.
My insurance deductible is $7800, but obviously I don't want to ignore cancer.
What do you think the wisest next step would be? Biopsy? I understand the MRI scan isn't more than 75% accurate?
I guess I am just scared and confused by all the contradictory information...For example, in 2016 a study showed the survival rate was 10 years regardless of steps taken. There was a Washington Post article on that.
I recently entered the happiest relationship of my life and we are having so much fun like honeymooners, and I'm terrified I'll get something unnecessary done that will mess that up.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

jeffMar | @jeffmarc | 3 days ago
In reply to @ovstampco "I'd also like to throw out a question to any medical professional out there ..... have..." + (show)
@ovstampco

I'd also like to throw out a question to any medical professional out there ..... have you ever experienced someone with a very elevated PSA , lets say in in 10 range that didn't receive any treatment have their PSA level drop back to a " normal " range - I haven't heard any such stories but it would be interesting to know . I guess the real question would be has anyone ever heard of someones body fighting off a probable cancer by itself ?

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If someone had BPH that could happen.. Usually, they get treated with anabiotic’s, and it takes the PSA back down again. Well, at least that’s not treatment for prostate cancer.

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jcf58 | @jcf58 | 2 days ago
In reply to @rtmcknight "You may well see people disagreeing with me here and, to be fair, I know little..." + (show)
@rtmcknight

You may well see people disagreeing with me here and, to be fair, I know little more about RP than what I read here plus my initial research...

All common prostate cancer treatment regimes will seriously affect your 'honeymoon' abilities.

I was your age with a similar PSA and an 'equivocal' biopsy result at the time. Over the next five years I watched my number rise all the way to 26 before having another biopsy in late 2023 and beginning treatment (ADT + IMRT) in 2024. There were reasons for this delay but I would definitely not recommend it. Luckily my cancer had not spread beyond the prostate.

If I was in your position I'm pretty sure I'd have a biopsy, do intensive 'watchful waiting', and enjoy a couple more years of your honeymoon. Once that has matured into a stable, long term relationship, then I'd discuss it deeply with her and begin to explore treatment options.

Having the biopsy sucks. All the options suck. PC sucks. Good luck!

PS: Non-PC PC joke: How do you know that a prostate biopsy is worse than childbirth? Because a year or so after a biopsy no man ever said: "Hmm, maybe I'd like another one."

PPS: I bet you $1M the urologist will shake hands with you at least once per appointment. What other doctor does that? I'm convinced this is because we know they've had their fingers in so many butts and they want to reassure us that they've washed up 🙂

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Focal therapies may not qualify as common yet, but they are rapidly gaining favor for those who qualify. They offer much less risk of interfering with “honeymoon” activities! I did Tulsa Pro in July and had sex 1 week later. If yeoldfoggy does have cancer, he should at least investigate focal therapies.

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yeoldefogey | @yeoldefogey | 11 hours ago

So my urologist didn't know about the new PSE test. He was recommending the ExoDX test.
I was a bit taken back that he didn't know about the PSE.
I am debating between the two. I probably will, if I can, get the PSE before my next PSA test in three months.
Peace of mind is important to me these days.
My cousin has prostate cancer but it still doesn't show up on an MRI, for example.
Also, I am allergic to lidocaine so apparently I can't do the in-office prostate biopsy.

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1 reply
gently | @gently | 2 hours ago
In reply to @yeoldefogey "So my urologist didn't know about the new PSE test. He was recommending the ExoDX test...." + (show)
@yeoldefogey

So my urologist didn't know about the new PSE test. He was recommending the ExoDX test.
I was a bit taken back that he didn't know about the PSE.
I am debating between the two. I probably will, if I can, get the PSE before my next PSA test in three months.
Peace of mind is important to me these days.
My cousin has prostate cancer but it still doesn't show up on an MRI, for example.
Also, I am allergic to lidocaine so apparently I can't do the in-office prostate biopsy.

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ExoDX is a urine test used to determine the aggressiveness of cancer.
PSE is fairly new and attentive to the genes that determine whether or not you even have cancer, whether or not you even need a biopsy. Hoping you don't.

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