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PSA dropped from 15.9 to 5.8 after biopsy. No cancer. How??

Posted by gefears42 @gefears42, Apr 6, 2023

I had a 14.9 PSA test, week later had another PSA test of 15.9. Did biopsy 3 weeks later expecting to hear I had prostate caner. Doc said the biopsy came back No Cancer. Now 4 weeks after biopsy, PSA came back at 5.6. How is that even possible?

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web265 | @web265 | Apr 6, 2023

It's certainly not an exact science. It is believed that there are things that can elevate your PSA temporarily as well, certain activities, being dehydrated, cycling etc.. I'm certainly no expert but that does seem like quite a drop.

Also, I'm a little reluctant to mention but there have been cases of false negatives in the biopsies. I believe I've read here that there was even that was positive, with low Gleason numbers, then a follow up a few months later was negative.

If you're referring to a trans rectal with no prior MRI having positive results for guidance, depending on how many cores/samples are taken, it's possible to take the samples from areas with no cancer. Hopefully that is not the case here.

If it were me, I'd request regular blood tests till you know it's fully stabilized for peace of mind. Stay positive but vigilant. Here's hoping it's just a blip in your PSA numbers!

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1 reply
gkm | @gkm | Apr 7, 2023

Since the biopsy is taking random samples it may be that none of the "snips" contained cancer. This happened to me on my second biopsy. However, my follow up biopsy confirmed prostate cancer with a Gleason score of 3+3 which allowed me to continue on Active Surveillance. Prostate cancer is generally slow growing so there is no urgency.

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2 replies
bens1 | @bens1 | Apr 7, 2023

My urologist gave me an antibiotic initially to see if I had an infection that might have caused my psa to rise to 10.2. The biopsy later confirmed it was prostate cancer but still, it may be worth having a conversation with your doctor about that.

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gefears42 | @gefears42 | Apr 7, 2023
In reply to @gkm "Since the biopsy is taking random samples it may be that none of the "snips" contained..." + (show)
@gkm

Since the biopsy is taking random samples it may be that none of the "snips" contained cancer. This happened to me on my second biopsy. However, my follow up biopsy confirmed prostate cancer with a Gleason score of 3+3 which allowed me to continue on Active Surveillance. Prostate cancer is generally slow growing so there is no urgency.

Jump to this post

Thank you!

REPLY
gefears42 | @gefears42 | Apr 7, 2023
In reply to @web265 "It's certainly not an exact science. It is believed that there are things that can elevate..." + (show)
@web265

It's certainly not an exact science. It is believed that there are things that can elevate your PSA temporarily as well, certain activities, being dehydrated, cycling etc.. I'm certainly no expert but that does seem like quite a drop.

Also, I'm a little reluctant to mention but there have been cases of false negatives in the biopsies. I believe I've read here that there was even that was positive, with low Gleason numbers, then a follow up a few months later was negative.

If you're referring to a trans rectal with no prior MRI having positive results for guidance, depending on how many cores/samples are taken, it's possible to take the samples from areas with no cancer. Hopefully that is not the case here.

If it were me, I'd request regular blood tests till you know it's fully stabilized for peace of mind. Stay positive but vigilant. Here's hoping it's just a blip in your PSA numbers!

Jump to this post

Thank you very much!

REPLY
wellness100 | @wellness100 | Apr 7, 2023

Prostatitis, ie inflamation?

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rxharleydude | @rxharleydude | Apr 8, 2023
In reply to @gkm "Since the biopsy is taking random samples it may be that none of the "snips" contained..." + (show)
@gkm

Since the biopsy is taking random samples it may be that none of the "snips" contained cancer. This happened to me on my second biopsy. However, my follow up biopsy confirmed prostate cancer with a Gleason score of 3+3 which allowed me to continue on Active Surveillance. Prostate cancer is generally slow growing so there is no urgency.

Jump to this post

Spot-on guys!! Initially my PSA had started rising very slowly. The urologist did a transrectal biopsy and only retrieved 12 snips. No cancer was found! However, my PSA continued to rise and six months later, he elected to do a trans perineal biopsy under anesthesia he took 30 snips and “bingo” , prostate tumor, Gleason 4+5 high grade! This was about 12 years ago. It’s been a battle ever cents!

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cstrutt52 | @cstrutt52 | May 26, 2023

A high PSA is no guarantee of cancer. Other things can cause high levels. A low PSA is no guarantee that you do not have cancer. If a biopsy is random, it can miss cancer. You should have an MRI. That will pinpoint any lesions. The lesions can be ranked (PI-RADS) that can give you the percentage chance it is cancer. Then then a guided biopsy, using ultrasound and mixing the image with the MRI, can test the lesions. Only then will you know for sure.

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gentlemanrancher | @gentlemanrancher | May 31, 2023

Could be Prostatitis similar to a Urinary Tract Infection.
I took Bactrim for 2 months and my PSA dropped over 10 points then a few months later it went back up. It's hard to treat a Prostate infection says my buddy who is an Internal Med MD.

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