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Understanding PSA spike and what questions to ask
Prostate Cancer | Last Active: Mar 16 1:17pm | Replies (14)Comment receiving replies
I'll mention my current situation and would welcome comments. Active surveillance for several years, Gleason 6, group 1, low intermediate Decipher, annual MRI, 6 month PSA tests. About a year ago I had mild symptoms of a UTI infection--went away after day or so. About a month later I had a PSA test and it rose from a stable 4.2 to 8. Scared hell out of me. I mentioned to my primary care the symptoms and he thought maybe prostatitis--gave me a two week dose of antibiotic, waited 2 weeks, retested and back down to 4.4. About 3 months ago same thing happened with symptoms, different antibiotic, went away easily, PSA checked about a week or so after antibiotic and up to 5. I've been doing as much research as possible, and seems types of prostatitis can exist even while urinalysis and cultures come back clean. And can affect PSA. So, not sure where this goes, but just another bump on this road we don't want to be on.
Replies to "I'll mention my current situation and would welcome comments. Active surveillance for several years, Gleason 6,..."
I would echo @survivor 5280 and get the PSE test. You’ll know with 94% accuracy if you have cancer or not.
Not to muddy the waters even more, some PCa’s don’t abide by a linear PSA test, meaning that lower values do not always indicate the aggressiveness of the disease. Right now PSA testing is the gold standard but it is still inadequate compared to many of these newer tests which look for more than one cancer kallekrein (antigen). Best,
Phil
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Sorry, that sounds like a nightmare to deal with. There are all kinds of things that can cause PSA false positives - I chased them down too. After my first PSA I asked for a second to verify, giving myself six weeks of total abstinence from all things that impact the PSA. The doctor told me "unlikely it will change anything but go for it". The second time it was the same and when I did that they also did the PSE so I knew, I just didn't want to admit it. I hope you can get to the bottom of it.