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PSA spike: any feedback re possible prostate cancer?

Posted by keithl56 @keithl56, Dec 4 8:20am

I just got lab results showing that my PSA went from 1.9 to 3.7 in the last year. I know that I am still in the normal range but have read that an increase greater than 0.75 in a year could be cause for concern. I have an appointment with my PCP the week after next but wanted to see if anyone had any feedback re possible prostate cancer.

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jeff Marchi | @jeffmarc | Dec 18 11:04am
In reply to @stephen59 "It’s can be confusing on what to do. I’ve had PSA rise from 3 to 4.4..." + (show)
Profile picture for stephen59 @stephen59

It’s can be confusing on what to do. I’ve had PSA rise from 3 to 4.4 then 5.
Then MRI with contrast which showed high risk lesion Rad 4.
Biopsy turned out to be negative.
Last PSA after biopsy was 6.4! Dr said I “ most likely have cancer.”
Thinks he missed it on the biopsy and wants to do another. Biopsy wasn’t fun, and not sure if I
Want to
Do it again.

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@stephen59
Are you getting a MRI/Ultrasound Fusion Biopsy? That is really essential in order to make sure the PIRADS 4 lesion has at least 3 cores out of it. The biopsy only gets about 1% of the prostate so they may have missed the cancer, like the doctor says.

They can get to more of the prostate with a transperineal biopsy. It is also less likely to caused an infection. Can your doctor do that?

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keithl56 | @keithl56 | Dec 18 1:41pm
In reply to @northoftheborder "The first thing they'll likely do is repeat the PSA test. Many normal activities can cause..." + (show)
Profile picture for northoftheborder @northoftheborder

The first thing they'll likely do is repeat the PSA test. Many normal activities can cause a temporary fluctuation like that, so they'll try to determine if your last reading is the start of a trend, or just a temporary blip.

Best of luck, and keep up with the screening!

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@northoftheborder

Just left my PCP and they repeated the PSA test, should have results in a few days. If still elevated, then I have to go to the urologist.

My PCP told me that when he was diagnosed with prostate cancer that his PSA went from 0.9 to 2.7, not exactly reassuring

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stanjumper | @stanjumper | Dec 18 3:29pm

My PSA went from 4 to 15. My wife who is a nurse demanded that I do the Galleri blood test immediately afterwards. The results identified Prostate cancer from more than 100 types of cancer. Subsequently, I did a battery of tests including biopsies that showed aggressive cancer growth. The Galleri test is somewhat expensive but certainly pushed additional testing to an urgency.

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stephen59 | @stephen59 | Dec 18 4:49pm
In reply to @jeffmarc "@stephen59 Are you getting a MRI/Ultrasound Fusion Biopsy? That is really essential in order to make..." + (show)
Profile picture for jeff Marchi @jeffmarc

@stephen59
Are you getting a MRI/Ultrasound Fusion Biopsy? That is really essential in order to make sure the PIRADS 4 lesion has at least 3 cores out of it. The biopsy only gets about 1% of the prostate so they may have missed the cancer, like the doctor says.

They can get to more of the prostate with a transperineal biopsy. It is also less likely to caused an infection. Can your doctor do that?

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@jeffmarc thanks for the information
I will message him and
Ask if he can.

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acoope | @acoope | Dec 19 10:19am
In reply to @keithl56 "Thanks for the input. My appointment is 1:00 today. My PCP had/has prostate cancer so I..." + (show)
Profile picture for keithl56 @keithl56

Thanks for the input. My appointment is 1:00 today. My PCP had/has prostate cancer so I trust that he'll be on top of it. He told me that there is virtually no reason for any man to die of prostate cancer as long as they screen regularly. Last year he told me that for my age (69) that he was amazed at how small and smooth my prostate was, so hopefully this test was some type of outlier.

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@keithl56 the DRE on myself was smooth and normal. Then followed up with biopsy and 9 of 12 samples were positive. Two months came surgery and during surgery it was determined that the cancer had spread and it was then diagnosed stage 4. So not to worry you but it can go either way. In hindsight I wish mine was found earlier

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keithl56 | @keithl56 | Dec 19 10:57am
In reply to @acoope "@keithl56 the DRE on myself was smooth and normal. Then followed up with biopsy and 9..." + (show)
Profile picture for acoope @acoope

@keithl56 the DRE on myself was smooth and normal. Then followed up with biopsy and 9 of 12 samples were positive. Two months came surgery and during surgery it was determined that the cancer had spread and it was then diagnosed stage 4. So not to worry you but it can go either way. In hindsight I wish mine was found earlier

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@acoope

Thanks for the info. I just got the call that my PSA is still elevated and have been referred to a urologist for follow up.

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bellasdad | @bellasdad | Dec 19 11:28am
In reply to @keithl56 "Thanks for the input. My appointment is 1:00 today. My PCP had/has prostate cancer so I..." + (show)
Profile picture for keithl56 @keithl56

Thanks for the input. My appointment is 1:00 today. My PCP had/has prostate cancer so I trust that he'll be on top of it. He told me that there is virtually no reason for any man to die of prostate cancer as long as they screen regularly. Last year he told me that for my age (69) that he was amazed at how small and smooth my prostate was, so hopefully this test was some type of outlier.

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@keithl56 - My urologist did PSA, ISOPSA, MRI, then biopsy. Too many want to rush straight to the biopsy because they want to do them in the office under local and bill the $$. The ISO and MRI can sometimes rule out the biopsy so don't let them skip a step. My tests led to a biopsy and a 3+4, but at least I knew the biopsy was necessary.

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keithl56 | @keithl56 | Dec 19 12:04pm

Thank you for the advice. I definitely want to avoid the biopsy if possible, based on what I have read.

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