Low PSA Score with PCa Symptoms

Hi,
I’m currently sitting at BWI after my Pca 2nd opinion at Hopkins.
54yo in otherwise good health. Father diagnosed at 58.

My psa was 2.xx something at my last primary care appointment. Nothing was ever mentioned.
In May, went to my Urologist for nothing more than getting a script for ED meds. It had been a while, so he asked if I’d had a PSA done recently. I pulled it up on my phone. He said it was high. Really? 2 something? You can definitely google up that a 2.4 PSA for a 54 yo is ‘normal’.

So he ordered another test (and actually another) . Still ‘high’ and then said I’d need a biopsy, which I did. Test showed Gleason 3+3, 3+3, 3+4, 3+4.
I won’t go on, but just pointing out a PSA in the 2’s can point to cancer sometimes.

My PSA was 2,74 when I was diagnosed stage t3b, Gleason 8

The urologist was quite comforting, and he said that in order for insurance to cover the costs of further tests (including multi parametric MRI), he would first put me on a high dose of Cipro in order to see if my condition might be prostatitis. The PA took blood for a total PSA score check (including free PSA), and of course the urine sample to run that check. The DRE: he said he could not detect any lumps on the posterior part of the prostate, but that many times a cancer is on the anterior side or within, and therefore, cannot be felt with a DRE. I decided not to start taking Cipro unless and until the lab results indicate prostatitis infection. I don't want to harm the good bacteria in my body for no reason. And I just don't believe it is any type of infection given the symptoms which have developed over the past 5-6 months.

My husbands was low Ca in family Biopsy Gleason 9 post Radical Prostatectomy it’s out.. onto drug and Radiation therapy..

Dr, did DRE on me yesterday. Said it felt normal as well.

I had a 1.8 the prior year before a 2.99 at my annual physical. Anything over a 2.5 triggers a trip to Urologist. I'm 60 yo btw. He ran a PSA a month later and I was 3.46. That triggered an ultrasound that was abnormal. That triggered a biopsy that showed a gleason of 7 (4 +3). That meant no watch and wait. I scheduled a RALP with my urologist who also is a surgeon and a trainer using the DaVinci robot. Had surgery on Aug 4 this year. Feel good now, operation not bad. If u need surgery get an experienced surgeon doing these. My surgeon does 3/week for tje last 17 years. DON'T panic. Even with a high PSA that does not mean PCa. My friend had a PSA of over 4 and his biopsy was clear. If u saw urologist yesterday I would think he recommended a ultrasound first. If you need a biopsy they can knock u out using same anesthesia as during a colonoscopy. No pain when knocked out and no pain after it was over. Unfortunately it takes about 6 months from first bad PSA number to actually getting treatment (if is PCa) so don't delay in getting your diagnostic tests. Best of luck. Odds are it's not PCa but follow thru with your diagnostics.

Below 4 is usually quite good. Mine went to 25 after 4 years since 40 days of radiation Lots of scans and MRI's Put me back on Zolodex which stops testosterones that feed PC cells and psa now 1.2 stable for a year, 5 years ago I sent my blood to 4kscoretest in NY $600 and that said I had aggressive cancer, It was aggressive, See web site. Now after 5 years since radiation it metastasized to L2 lumbar bone which I had intensely radiated 2 times taking out 1 inch of cancer on L2. So I am castrate sensitive and ADT is working. That is the end goal ADT after surgery or radiation to be working is my thought,
Get some test fast and have a plan short term and what if?

To clarify 2.74

Below 4, in my case, meant nothing until a urologist in Florida was reminded by my wife that I had been taking Avodart and then finasteride since 2009 which gives a lower PSA reading . You must double the reading and if on those drugs for over 7 years, some say to multiply by 2.5. My original bladder cancer DX was prostate cancer. Very much missed by my urologist at the time. Now Gleason 10, mcrpc after over 4 years of ADT, radiation, immunotherapy and now on 2nd chemo and not a candidate for Pluvitco. Stay persistent and reach out to every expert.

Have you looked into Pluvitco?