New, PSA 20, Just Starting Process

"Could BPH get the PSA up to 20?"

It could... but you are in for some serious testing by Urology. I can relate to the gap in PSA testing. My PCP retired in 2015, and I did not get tested again until this past Spring. Sorry to say, it did not go well. Best of luck.

Perhaps.

But I would collect more information first. I wouldn’t even be thinking about treatments yet, until I had full information about the status of my condition.

If you know your PSA and your prostate volume, you can calculate your PSA Density; that’s an indicator you can use to determine if your BPH may be the cause of your elevated PSA. (Also, have them check for a UTI as well as prostatitis.)

Typically, a repeat PSA test is done to confirm; then a 3T mpMRI. Those results will then lead you to next steps.

so you will need another PSA test in a few weeks- is it rising? dropping ? if it is not going down, then MRI with contrast..if suspicious areas, then prob biopsy/PET scan..are you having symptoms ??- like blood in urine, semen , pain etc..?? ( infection, enlarged prostate, recent injury can all raise PSA levels..)

get with good urologist and IF you do have PC, then find good oncology team nearby you so you can get the best treatment..

hope it is not Pros Cancer but if so, not the end of the world...dont panic.. but do educate yourself...follow thru..if your doc seems non chalant, get another one who will take care of business

Other than the advice offered, I would get a PSE test run ASAP. Several of us have had this test and the PSE test is more accurate than PSA alone in determining if you have Prostate Cancer. You are in an amazing forum and aren't alone in this. Do some searching on youtube about the PSE test. I was diagnosed when my PSA was 12 and the PSE came back in the 90% ranking of me having Prostate Cancer.

Hi. Wishing you the best, and take deep breaths, as these first results were the most stressful time period for me. A friend of mine quoted me the Eagles saying, "don't let the sound of your own wheels drive you crazy". The unnecessary treatment concern is real, you are asking good questions, but that concern is hypothetical right now and really not applicable to many prostate cancer cases (the choice of active surveillance or treatment is often very clear). If you reach that point, you will have the results of an MRI and a biopsy, possibly a PET scan, along with the input of your urologist, a possible second opinion, and the lived experiences of everyone in this community to guide you through the process.

Yes, the PSE test would be useful to Eliminate the possibility that it’s prostate cancer.

I would be very careful about getting this treated if there is an issue. You could end up with very serious cancer if you let it go.

Your doctor should do a digital rectal exam to see if he feels anything in your prostate. You can have an MRI, which finds well whether your prostate has anything in it that is problematic. This can all be done before you have a biopsy.

We had a friend whose PSA would hit 50 but after multiple biopsies, they never found cancer.

BPH can cause your PSA to rise as well as as a large prostate, Frequently that is caused by an infection and they will give you antibiotics to treat the infection and reduce the PSA as a result.

You have a multiple choices when you go to the urologist.

My PSA tests have fluctuated all year from a high of 8 to a low of 4.4. My first MRI indicated an enlarged prostate of 95 ml and a pirads 3. So my PSA density is below 0.15 which I hear may be encouraging. Anyway, I’m having a second MRI today which I hope goes well. So all of this to say get more testing done so you have more info about velocity, density, anything suspicious with your prostate itself, before pursuing a biopsy or treatment. “Don’t let the sound of your own wheels drive you crazy” is really appropriate.

@ezupcic
With a large prostate, you have a higher chance of having a PSA that is higher than normal, Which is what you are seeing.

Have you had a BPH problem? Is it possible you need antibiotics to reduce an infection and also get your PSA lower?

The PIRADS 3 It is encouraging since it’s very unlikely it has anything to do with prostate cancer. A four or a five is much more troublesome.

Not a time to panic.

A PSA over 10 is not usually BPH, but you should go through all the protocols to find out what is going on. My PSA was 31. It was cancer. I had a RARP a couple of years ago. Final post surgery pathology report was Gleason 4+3 (60% 4) and pT2. My PSA has been undetectable since surgery.

Thanks for the advice, no I’m not freaking, going in order. Yes, my 2 PSA tests came in at 20, about a week apart.

I will call the urologist soon, today, for the next step. I will look into the PSE test.