Anyone with High PSA & No Cancer?

A friend of ours had a PSA of 50 and a huge prostate, but had multiple biopsies and they never found anything.

He died of a completely different type of cancer.

An old rule of thumb was that a PSA of 10 (pre-treatment) meant about a 50% chance of prostate cancer. The odds rise steeply after that, but I don't think they ever hit 100%.

And again, that's only initial screening: once you've had surgery, radiation, ADT, etc, the math is different, of course. And we have many other ways of following up to increase certainty these days.

@jeffmarc Hello, do you know if he ever had an MRI?

Salut!Unchiul meu are 90 de ani ,hiperplazie benigna de prostata,si un psa de peste 900.Doctorul ia spus ca prostata este "pietrificata" la palpare.Urineaza relativ satisfacator.Fara alte analize.

Remember that a PSA test is not a cancer test.

The PSA number is similar to a “check engine” light in a car; it indicates that “something” may be wrong down there, and that further checks should be made “under the hood.”

Might be as simple as a UTI; might be prostatitis; might be BPH; might have had sex the night before the test; the urologist might have done the DRE right before the PSA test; might be something else simple….or it might be something more serious, such as prostate cancer. Just need to have further checks.

Following an elevated PSA, the first steps should be to rule out the half-dozen other things that might cause PSA to spike.

Once those are eliminated, then check the prostate cancer route.

@mikeg73
I do not know. Never asked him that question, His problem goes back at least 15 years. They might not have been doing MRIs back then.

It is confusing understanding the levels of PSA and having or not having cancer. In 2014, at 68, a biopsy showed I had cancer when my PSA was 3.70; 4.00 would have been normal for my age. After the removal of my prostate then, I had a recurrence 14 months later and I received 40 sessions of radiation. This radiation plus hormone therapy kept my PSA in 0.05. At times it went up to 1.58. In June 2019 my cancer was diagnosed as stage 4, incurable. I was given a survival of 3 to 4 years. In August 2023, still alive, I asked my oncologist to suspend all medications until my PSA rises to 1.00. He agreed. My PSA rose to 0.84 and my oncologist ordered a PSM PET scan in August. Nothing was found. The medical team agreed to keep monitoring my PSA every 3 months.
So, I have been living with cancer for 12 years now.
At 80, what is bothering me now is neuropathy, which is affecting my two legs.
I hope this explanation helps you to be positive.
Good luck

My husband had a high PSA, and the urologist said he couldn't find anything and was "baffled". We went to a different urologist, who biopsies him "differently " and found it immediately. He had a robotic total prostectomy and end up with Gleason 7. Always get another opinion. 11 years cancer free now, but never skips the special PSA test for microscopic spread.

BTW: Recent information derived over years of observation suggests that annual PSA tests result in a 13% increase in survival rates. It brings up a point that, with years of personal PSA data a precipitous increase needs to be taken seriously. A one-off high should also be looked into nonetheless. However, although still likely to have a benign cause, if it is a cancer it may be further along, with a higher risk of spreading. Annual PSA screening would catch disease earlier, offering more options, including those with less effect on quality of life (QOL).

In 2006 I had a PSA of 6 then a biopsy showing a small amount of Gleason 6 in one core. My PSA went down in later tests meaning likely prostatititis at that time. Over the years my PSA continued to slowly increase. In 2012 with my PSA at 7 I read a book by Dr Scholz named "Invasion of the Prostate Snatchers," and was able to get an appointment to see him. He used Color doppler ultrasound and determined there was no problem at that time. I went back to him every year until 2020 when Covid hit and it wasn't safe to fly so I stopped seeing him. Then in 2024 with my PSA at 15 I went back to him and he found there was still no sign of cancer. My Prostate size at that time had increased to 100cc, which is quite large and likely the cause of the high PSA. My last PSA in April this year was 19.4 when I was 83. So 20 years since my one and only biopsy it would seem my choice of Active Surveillance was the right choice. I have never had an MRI and since I'll soon be 84 I probably won't unless my PSA takes a large jump. I recommend buying Dr Scholz's second book "The Key to Prostate Cancer" which covers all aspects of Prostate Cancer, and includes chapters written by 30 other specialist in the field.