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Husband's elevated PSA level: What could it mean?
Hello, everyone. My husband, a few months ago, had a PSA of 6. His PCA prescribed antibiotics, which brought that number down to 4. He had a follow up appointment with a urologist today, scheduled a biopsy, and this doctor gave him a potential chance of cancer of 60/40%, and unfortunately, didn't seem supportive, or even explain other possibilities for his elevated PSA. I'm wondering if anyone has insight on this? My husband does not have a family history of prostrate cancer. Thank you, thank you!
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My prostate was taken out 16 years ago. Nine months ago I had a PSA level of 1.6. Two days ago I had another PSA Blood test and this time it doubled roughly 10 times during the nine months to a PSA level of 16.4.. I am concerned especially after reading sites as Mayo and other well known health facilities. However, I believe the information you stated is most helpful and I will certainly be doing my homework! Thank you so much!!!
A PSA level of 6 is concerning but I would take that advice from your doctor to get the biopsy because, your husband’s PSA is not overly high but could give you answers. I had a PSA of 4 and after the biopsy they found that over 30% of the the prostate was full of cancer with a Gleason score of 7. So with that said I would highly recommend getting the biopsy and go from there. I wish you well and God Bless!!!
@jeffmarc
Hi again, Jeff. I think that is great advice, and we are going to follow up with the OSU center. With the comprehensive care team, it sounds like they can provide advice, support, and solutions that might be so very helpful. Thank you so very much, again.
@katebaker What was the PSA before it was 6 and how long ago? If it was over 3 on a PSA test a year ago there is a good likely that it is BPH. However, if it was 2 than it is still double and more likely to be cancer. If the high PSA is due to an infection, it usually falls back close to the previous level after a course of antibiotics. Was there about a month between the first and second test? As far as biopsy the standard biopsy randomly samples less than 1% of the prostate. It is very easy to miss cancer unless the prostate is full of lesions. That is why getting an MRI first and a fusion or MRI biopsy to sample any suspected lesions found with the MRI is much better at providing a definite answer. Also, usually no biopsy if MRI finds nothing.
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2 Reactions@katebaker
You might want to ask your PCP to order a PSE test from Oxford Biodynamics. It's a blood test that boasts a 94% accuracy of how likely, or unlikely, your husband is to have prostate cancer based on looking at biomarkers. It is used to decide if a biopsy is needed or for recognizing a biological re-occurrence. They say that a PSA test alone is 55% accurate. Here is their product web page:
https://www.94percent.com/
If you do an MRI and/or biopsy, you might want to also do a telehealth with a center of excellence.
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2 Reactions@katebaker There is also the PSE test - 94% effective in diagnosing the presence of cancer. I would definitely have this test done before you do anything invasive. I believe it is made by EpiSwitch? Google PSE for the info!
Phil
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1 Reaction@bens1
This is so enlightening! We haven't heard of a PSE test, and will research it right now! We are so encouraged and grateful by the amount of help here we're already receiving! Thank you!
@heavyphil
Thank you, too, for this recommendation of the PSE and will research it now. We are so thankful!
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1 Reaction@trtupper
You should’ve had salvage radiation a long time ago. It should be done when your PSA hits .2 and yours hit 1.6. Where are you being treated? Something is wrong with your treatment if they are allowing you to have such a huge rise In PSA without being treated. You need to get a second opinion from a center of excellence, Actually, not a second opinion you need to change your place of treatment if they have anything to do with treating you after you’ve had this huge rise in PSA.
3 1/2 years after my prostatectomy, my PSA started rising and hit .2. At this point, my medical team put me on a six-month shot of ADT (Lupron) Followed by two months later eight weeks of salvage radiation. That is the standard of care.
At a minimum, you need a PSMA Pet test immediately to see if there are metastasis that can be zapped and Thus reduce your PSA significantly.
You also probably need to be on hormone therapy ADT, Which will reduce your PSA to close to undetectable pretty quickly.
If you tell me where you live, I might be able to recommend somewhere to go for treatment, Do not delay this you are facing the equivalent of a firing squad.
Here is the recommendation from the American Society of clinical oncology for what you are supposed to do when your PSA starts to rise after a prostatectomy.
From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL: Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%). Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL: Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL: Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.
This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/
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