Next step after increased PSA, 9 mos after prostate cancer diagnosis

You definitely have had a significant increase in PSA Since May. Waiting one more month is not too much, That will give you a real good idea of the doubling rate.

Do you know how large your prostate is? That is a factor in PSA size. Have you had any BPH issues, problems peeing, That can raise your PSA.

Were you riding a bike just before getting your PSA test? That can raise your PSA. Don’t do that for a couple of days before getting your PSA test.

If it rises, even a point in the month, that is too much, since it would be close to doubling in four months. That would definitely call for a new MRI. That is what doctors look for a doubling rate that is too fast. After waiting another month, if your PSA continues to rise at a good rate, you could go somewhere else and get a second opinion on treatment.

Thank you for your response.

I do have an enlarged prostate & have for 15-20 yrs. Fortunately, other than a minor issue from time to time, I've not had most of the regular problems that many seem to experience with this condition.

I do exercise regularly & it is possible I could have ridden a bike the day prior to the PSA test. I know I did not ride the day of the test.

I guess my primary concern is that I've read that if the PSA jumps as much as mine has in less than 90 days, it could signal a very aggressive new tumor. Perhaps a low possibility, but any possibility is too high in my current mind. It makes me quite nervous & a month seems like a long time.

Thank you again for responding. Your input is valued.

@dhi Most jumps in this range are from infection or other inflammation of the prostate. Still need to get it checked in a month. Sex or bike riding can increase PSA but usually not by that much. Recommendation is to refrain for 48 hours before test. A course of antibiotics may allow a retest in 2 weeks. Prostate cancer is a disease with a lot of waits for results in it.

@jim18
I appreciate you taking time to respond, as well as for the information.

Do you know your other numbers which may provide more insight into your recent PSA increase, and the possibility of something more serious lurking unseen:
> PSA Density
> test for UTI or prostatitis
> biomarker (genomic) test results
> genetic (germline) test results

If you can rule out other possibilities, then you can focus on possibility of cancer.

@brianjarvis .

Any of this information is from when I had the MRI & biopsy last Nov. At that time my PSA was 3.51, now 7.87. The biopsy showed mild chronic prostatitis in two samples.
I am not aware or familiar with biomarker or genetic test results. I do have cancer, Gleason 6, in one sample as of last Nov.

Thank you

Others have mentioned sex and biking. I’ll offer prostatitis. I’ve been struggling with erratic PSA for a couple of years—I’m Gleason 6 AS for 5 years. It’s troubling but I’ve seen increased from 5 to 7.5 a couple of times. Doxycycline for 2 weeks, wait two weeks and back to 5–more or less my baseline. I’m planning a follow up biopsy—it’s been 4 years since last one. Urologist thinks it’s not the cancer but we’re going to do the biopsy to know more.

@dhi The reason those other tests are important - especially for a Gleason 6(3+3) - is that there’s some debate in the medical community as to whether a true Gleason 6 should even be called “cancer.”

Some in the medical community say that a “3” cell structure can’t metastasize and therefore shouldn’t be considered as a G7+. (That a 6(3+3) is a harmless benign tumor - that it shouldn’t necessarily be treated.)

Others in the medical community disagree. So, the debate continues.

This is a presentation by Dr. Scholz referencing a study involving 26,000 cases that concluded that a “true” Gleason 6(3+3), never metastasizes: https://youtu.be/NV8QHzbgamI

So, other tests may be needed - in conjunction with regular PSA monitoring - to insure that it’s a “true” G6 and that there’s nothing more serious lurking unseen that isn’t being picked up by MRI and biopsy.

@brianjarvis
Thank you for your time & information. Much appreciated.