A referral to an urologist if your insurance requires one. Try to make an appointment at a center of excellence at once. They will likely do a PSE or IsoPSA before deciding on MRI or biopsy.
Have you ever had a problem with BPH or an enlarged prostate?. Did you go in and get your PSA test after riding a bicycle?. All of those things can cause your PSA to be a lot higher than it should be. It still is around normal for your age. As mentioned a PSE test would be very useful to know whether or not to do a biopsy.
I agree with the other commentors about finding a urologist and getting a PSE test before a biopsy. When in early 2024 I had a rising PSA that went from 2.8 to 4.25 over about 15 months, my urologist followed a pretty convential path and ordered another PSA test and an MRI (3T) with contrast. The MRI was a piece of cake, but then I'm not claustrophobic. The MRI tech gave me an IV, and then I lay in the MRI for about 20 minutes with a set of headphones playing music. The hardest part was just trying to lay still. The MRI showed a lesion and the radiologist report (which I got at the portal of the lab which did my MRI) said it was PI-RADS 4 (high risk of cancer). Interestingly the follow up PSA had come down to 3.24. I got a 2nd reading of the MRI results and the 2nd radiologist also gave me a PI-RADS 4 so I went ahead and got a fusion biopsy (which gives high confidence they biopsy the actual lesion). The biopsy found plenty of cancer, so the last drop in the psa was a false signal. I guess my point is while there are various ways to proceed, just be sure to follow up on it. It might well be nothing, but if it is prostrate cancer you'll have many more options finding it early as compared to late. BTW, I'm not a medical professional but just a layman, so take my comments with a grain of salt. Best wishes.
I can't offer any more advice than what's been offered here: ask for a PSE test to give you a good highly accurate blood test to see what's up.
Let me repeat what my urologist said to me before everything started: "I have patients with a high PSA and no cancer and those with a low PSA that have cancer, which is to say that the PSA in and of itself is nothing to be concerned about". What we often refer here to as your "check engine light" - so go get it checked and don't worry about it until it's time to worry and, if that day comes, we are here for you.
Mine went from 1.75ish to 3.6 in a year and now I have stage 4 metastatic prostate cancer. Just because many doctors say not to be concerned with anything under 4, doesn't mean much. That going that far within a year means there is something going on. Don't wait and be firm. If you don't like their answer, then get a second opinion from the best cancer care center you can find.
I'm with Bonanzaman. Mine jumped during Covid mess when I went 18 months without a PSA screen. I went to Urologist office and saw a PA. He said not to worry and to get another PSA in 6 months. In 6 months it had doubled and MRI showed stage 4 w/ mets.
If that PA had done a simple digital rectal exam ... tried and true ... I'd likely have had a different trajectory.
My husband's PSA was 5.1 in June 2022 aged 63, fit and healthy, told by GP we'll monitor it 12 months later it was 12.1. We then found out you should always be referred once you are 3. He had zero symptoms. Had prostate removed in Dec 2023, but it had already spread, he's now stage 4 with aggressive cribriform, currently awaiting more CT and nuclear bone scans to locate the cancer spread now and determine what treatment plan. He wishes he had researched it more at the time as it could likely have saved him if we knew more initially. I'd definitely opt for a referral. Good luck with your journey.
My husband's PSA was 5.1 in June 2022 aged 63, fit and healthy, told by GP we'll monitor it 12 months later it was 12.1. We then found out you should always be referred once you are 3. He had zero symptoms. Had prostate removed in Dec 2023, but it had already spread, he's now stage 4 with aggressive cribriform, currently awaiting more CT and nuclear bone scans to locate the cancer spread now and determine what treatment plan. He wishes he had researched it more at the time as it could likely have saved him if we knew more initially. I'd definitely opt for a referral. Good luck with your journey.
Why aren’t they doing a PSMA pet scan. That has replaced the bone scan and the CT scan. As long as your PSA is above .5 or so the PSMA PET scan will show Metastasis in many more places than the CT scan will.
Have you gone to a center of excellence to get a second opinion? It’s pretty clear that the place you are getting treatment may not take your best interest into account. Are you working with a Genito Urinary Oncologist, The ones who specialize in prostate cancer, not a medical oncologist who works with all different types of cancer and doesn’t specialize and keep up with the latest technology.
Of course, if you live in Canada, you may not have a choice.
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A referral to an urologist if your insurance requires one. Try to make an appointment at a center of excellence at once. They will likely do a PSE or IsoPSA before deciding on MRI or biopsy.
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5 ReactionsHave you ever had a problem with BPH or an enlarged prostate?. Did you go in and get your PSA test after riding a bicycle?. All of those things can cause your PSA to be a lot higher than it should be. It still is around normal for your age. As mentioned a PSE test would be very useful to know whether or not to do a biopsy.
-
Like -
Helpful -
Hug
13 ReactionsI agree with the other commentors about finding a urologist and getting a PSE test before a biopsy. When in early 2024 I had a rising PSA that went from 2.8 to 4.25 over about 15 months, my urologist followed a pretty convential path and ordered another PSA test and an MRI (3T) with contrast. The MRI was a piece of cake, but then I'm not claustrophobic. The MRI tech gave me an IV, and then I lay in the MRI for about 20 minutes with a set of headphones playing music. The hardest part was just trying to lay still. The MRI showed a lesion and the radiologist report (which I got at the portal of the lab which did my MRI) said it was PI-RADS 4 (high risk of cancer). Interestingly the follow up PSA had come down to 3.24. I got a 2nd reading of the MRI results and the 2nd radiologist also gave me a PI-RADS 4 so I went ahead and got a fusion biopsy (which gives high confidence they biopsy the actual lesion). The biopsy found plenty of cancer, so the last drop in the psa was a false signal. I guess my point is while there are various ways to proceed, just be sure to follow up on it. It might well be nothing, but if it is prostrate cancer you'll have many more options finding it early as compared to late. BTW, I'm not a medical professional but just a layman, so take my comments with a grain of salt. Best wishes.
-
Like -
Helpful -
Hug
9 ReactionsI can't offer any more advice than what's been offered here: ask for a PSE test to give you a good highly accurate blood test to see what's up.
Let me repeat what my urologist said to me before everything started: "I have patients with a high PSA and no cancer and those with a low PSA that have cancer, which is to say that the PSA in and of itself is nothing to be concerned about". What we often refer here to as your "check engine light" - so go get it checked and don't worry about it until it's time to worry and, if that day comes, we are here for you.
-
Like -
Helpful -
Hug
6 ReactionsI agree with the others. Get a PSE test with the PSA. The PSE test is purported to be 94% accurate while the PSA test, alone, is 55% accurate.
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2 ReactionsAgreed Go to a Urologist and get a PSE.
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1 ReactionMine went from 1.75ish to 3.6 in a year and now I have stage 4 metastatic prostate cancer. Just because many doctors say not to be concerned with anything under 4, doesn't mean much. That going that far within a year means there is something going on. Don't wait and be firm. If you don't like their answer, then get a second opinion from the best cancer care center you can find.
-
Like -
Helpful -
Hug
6 ReactionsI'm with Bonanzaman. Mine jumped during Covid mess when I went 18 months without a PSA screen. I went to Urologist office and saw a PA. He said not to worry and to get another PSA in 6 months. In 6 months it had doubled and MRI showed stage 4 w/ mets.
If that PA had done a simple digital rectal exam ... tried and true ... I'd likely have had a different trajectory.
-
Like -
Helpful -
Hug
4 ReactionsMy husband's PSA was 5.1 in June 2022 aged 63, fit and healthy, told by GP we'll monitor it 12 months later it was 12.1. We then found out you should always be referred once you are 3. He had zero symptoms. Had prostate removed in Dec 2023, but it had already spread, he's now stage 4 with aggressive cribriform, currently awaiting more CT and nuclear bone scans to locate the cancer spread now and determine what treatment plan. He wishes he had researched it more at the time as it could likely have saved him if we knew more initially. I'd definitely opt for a referral. Good luck with your journey.
-
Like -
Helpful -
Hug
4 ReactionsWhy aren’t they doing a PSMA pet scan. That has replaced the bone scan and the CT scan. As long as your PSA is above .5 or so the PSMA PET scan will show Metastasis in many more places than the CT scan will.
Have you gone to a center of excellence to get a second opinion? It’s pretty clear that the place you are getting treatment may not take your best interest into account. Are you working with a Genito Urinary Oncologist, The ones who specialize in prostate cancer, not a medical oncologist who works with all different types of cancer and doesn’t specialize and keep up with the latest technology.
Of course, if you live in Canada, you may not have a choice.
-
Like -
Helpful -
Hug
4 Reactions