Stable elevation of PSA

Posted by drj @drj, Nov 8 8:33am

My brother-in-law's PSA has been running around the 7 ng/mL level for several years. HIs urologist has found nothing to explain this including biopsies and suggests that is simply his normal level. Has anyone heard of such levels being benign or "normal"? I believe it is infrequent, but not uncommon, in some men to see some bumps up in PSA that do not repeat next time, but steady elevations?

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ezupcic | @ezupcic | Nov 8 8:36am

Has he had an MRI?

Dean Gibson | @dkgibson | Nov 8 9:50am

It depends on how old he is:
https://www.ourcancerstories.com/prostate-cancer/detection-and-diagnosis/psa-test-prostate-cancer

jeff Marchi | @jeffmarc | Nov 8 10:37am

A friend of ours had a PSA of 50 but had a huge prostate. He was tested multiple times and Cancer was never found.

Has Your brother-in-law told that his prostate is larger than normal? That can be a factor as well as having BPH.

drj | @drj | Nov 8 10:49am

In reply to @ezupcic "Has he had an MRI?" + (show)

@ezupcic

Highly athletic (extensive, daily pickle ball, hiking). He has not had an MRI. He's in small town southern Oregon, His urologist considers this his new normal.

drj | @drj | Nov 8 10:57am

In reply to @dkgibson "It depends on how old he is: https://www.ourcancerstories.com/prostate-cancer/detection-and-diagnosis/psa-test-prostate-cancer" + (show)

@dkgibson

Well, there is a moderate correlation of prostate size with age and a moderate correlation of prostate size with PSA, therefore a moderate correlation of PSA with age. I wouldn't put much value on considering age unless one makes the mistake of putting much value in cutoff values. The greatest value in PSA is in trending PSA levels over time.

xahnegrey40 | @xahnegrey40 | Nov 8 10:59am

In reply to @drj "@ezupcic Highly athletic (extensive, daily pickle ball, hiking). He has not had an MRI. He's in..." + (show)

@drj does he cycle too ?? regular cycling can push out extra PSA too..if biopsy is clear then he is clear...( I assume no blood, no pain, normal amount of nocturia ?)

ezupcic | @ezupcic | Nov 8 12:56pm

In reply to @drj "@ezupcic Highly athletic (extensive, daily pickle ball, hiking). He has not had an MRI. He's in..." + (show)

I live in Portland and this year my PSA fluctuated between 8.1 and 4.4. Two MRI’s were Pirads 3 and most recently 2. But also an enlarged prostate of 95 ml and most recently 70 ml. I’m 62 and at the moment just monitoring various numbers.

jeff Marchi | @jeffmarc | Nov 8 1:39pm

In reply to @ezupcic "I live in Portland and this year my PSA fluctuated between 8.1 and 4.4. Two MRI’s..." + (show)

@ezupcic
That large prostate is going to give you a high PSA number. Do you have BPH, problems peeing?

Doesn’t really sound like it’s time to worry yet, Though Pirads 3 can be a problem, or it may not.

Are you saying that a more recent MRI showed that the same Pirads 3 is now Pirads 2? Well, that’s good news, Maybe you don’t need to do anything.

ezupcic | @ezupcic | Nov 8 2:41pm

Yes it’s a Pirads 2 now. I’ll do another PSA in December. If it’s elevated but below 8 with my enlarged prostate I may continue with regular monitoring rather than a blind biopsy at this time.