Help with PSA reading

OK, stand up and slowly walk away from the keyboard.

When you meet your doc he will tell you not to worry.

NEXT.

It is very true that you can have a low PSA number between 0 to 4 and still be diagnosed with PCa after having a biopsy which would confirm it. By the way, be sure to get a Transperineal Biopsy rather than a Transrectal one. The main risk with the latter is the doctor passes the biopsy needles thru your rectal wall to access the prostate with the possibility of fecal infection (Ugh). I have read in a number of places that you must select one lab only for PSA testing since each lab company has different testing methods. LabCorp for example uses the Roche ECLIA methodology. PSA does not mean you have cancer but rather is an indicator of whether your cancer is spreading if you've been diagnosed with it. PSA Test: What Can Skew a PSA Test? These 10 Factors Can Affect Your Numbers Age, Benign prostate enlargement (BPH), Prostatitis, Urinary tract infections, Prostate procedures, Sex, Digital rectal exam, Riding a bicycle, Obesity, Medications (including Statins). See https://universityhealthnews.com/daily/prostate/psa-lab-test-results-these-factors-can-affect-your-numbers/
Also see> https://blogs.webmd.com/mens-health/20181230/5-alternatives-to-the-psa-screening-test I believe I read on the internet that one should wait at least 72 hours before their PSA test (bloodwork) if any of the 10 factors are at play. I take Atorvastatin for cholesterol and never knew it might affect my PSA number.

55 healthy no cancer. I always had a PSA of .5. This year it went up to .9

That is like posting on a lung cancer forum cos your 5 year old daughter thought you were coughing more than usual.

@ldduck1968, how are you doing? What did you learn from you doctor about your PSA?

You are not offending us, we are all guys right? Here is what I read on the internet "All prostate therapeutic treatments cause ED in 6 out of 10 men. Also, it always causes lack of ejaculation, but not lack of orgasm. ED can be treated with PDES inhibitors only if erectile nerves have been successfully preserved. Radiotherapy has a negative effect on erectile function (can't recall the web page for this but use a sentence as a search phrase and you'll probably find it).
Then there is this "So, it's erectile dysfunction. That's the big concern, and there's no evidence that the risk of erectile dysfunction from radiation has any difference between the different delivery methods (proton, IMRT, SBRT, brachytherapy) and if you look at actual risk, the way we gauge that, let's say for a 60-year-old, someone who isn't already using Viagra or Cialis, the chances of erectile dysfunction when you radiate the whole prostate (which is typically done) is probably about 1 in 3. And we're talking about a type of erectile dysfunction that DOES NOT respond to Viagra or Cialis. So that's sometimes a little confusing. The rest of the world thinks if you need Viagra or Cialis, then you have erectile dysfunction. In the prostate cancer world, if you have erectile dysfunction but it responds to Viagra or Cialis, that's not counted as erectile dysfunction. That's counted as you're NORMAL". In summary, "Whether you do brachytherapy, SBRT, proton therapy, the risk of erectile dysfunction is the same.”

The PSA velocity is less than 0.75. So you should be fine. Intercourse definitely can affect PSA reading. At John’s Hopkins they suggest to wait 48 hours. Get PSA repeated in 2-3 weeks. Do not change lab. Got to same one. Regards. And relax.

I believe under 4 is considered ok. .9 is pretty low. I am 81 and have a PSA of about 5.3.... Anything less than 10 at my age is normal............

It spiked to over 4 about 2 years ago.

I now take a PSA total + free test that measures total PSA and free PSA. This gives an estimate based upon medical model of whether and if you "may" have aggressive PC. It is an educated guess.

In my case I am just monitoring.

Lot of misinformation and confusion out there....

OK. I'm am also currently 81 yr. Perhaps this is a teaching moment.

Let's look at my data from the recent 17 yrs and see if might help you assess your prostate health. [The prior 16 years, my PSA was < 1.0].

Date PSA, ng/mL Increase, ng/yr** % Free PSA***
5/07 1.2 -
3/09 1.6 0.2*
11/11 1.8 0.1
2/14 2.6 0.3
1/15 2.3 - 0.3
6/16 2.9 0.15*
6/17 2.8 - 0.1 25
10/18 3.9 0.5 * 18
9/19 4.1 0.2 20
11/20 4.9 0.8 20
11/21 6.9 2.0 16
* Averaged over previous two years

** < 0.5 ng/mL/yr is a potential guideline

PSA Total Reference Range:
40 - 49 year old: 0.0-2.5 ng/mL
50 - 59 year old: 0.0-3.5 ng/mL
60 - 69 year old: 0.0-4.5 ng/mL
70 - 79 year old: 0.0-6.5 ng/mL

*** PSA,% Free
Probability of Prostate Cancer for Men with Non-Suspicious
DRE Results and PSA between 4 and 10 ng/mL

Percent Probability
Free PSA of Cancer
0-10% 56%
10-15% 28%
15-20% 20%
20-25% 16%
>25% 8%

So here are total PSA tracking data, velocity, total PSA as a function of age, and % free data. This is the data I and my primary care physician had to interpret. Do you see parallels with your data?

How would you interpret this data? Which, if any, of this data would raise your eyebrow or prompt you to see a urologist? If so, when?

Others should feel welcome to chime in.

I have further data since 11/21 which I will share after you and others have had an opportunity to make an assessment of the data above.

Hi. The PSA flag went up for me in Jan 2022 when I was pursuing REZUM therapy on visit to Urologist for my BPH.
It measured 4.54 and opened pandora's box. That is when I had first PSA Free test. Since then
1/10/22 psa total 4.54 with free 1.28 = 28%
4/19/22 5.17 1.67 = 32%
8/23/22 5.22 1.65 = 32%
1/9/23 5.5 1.55 = 28%
Another due this month.
My understanding is the higher percent of free , the better. I now see 2 urologists, one for possible REZUM and other who specializes in PC.
Not sure I can interpret your PSA total and free numbers? What are the percentages of free??PSA total looks ok to me for age. I have low confidence that anyone really knows how to interpret these numbers with certainty.
I have backburnered my REZUM plans for now. My PC urologist says not too concerned about serious PC for now..