Newbie here, just got a PSA score of 12 with no prior symptoms.

Welcome and sorry you have to be here. I assume your PCP ordered the PSA test. Have you been referred to a urologist? That would likely be the next step. High PSA alone could be any number of things other than cancer.

A high PSA is not ideal, but does not always signify the course of your illness. I had an even higher PSA (32), but my Gleason was 7 (about half 3+4 and half 4+3). I had an MRI that showed a lesion in half my prostate. I had a PET and it showed no cancer outside the prostate. Because of the high PSA, my RARP was a bit more extensive. The post-op pathology confirmed that the cancer was confined to my prostate. Ten days with a catheter was a nuisance, but nothing more. I had no pain from the surgery and never used any pain meds. Incontinence was a problem. Initially I was using 5-6 Depends pull-ups and even at two months was still 5. Every time that I stood from a sitting position, I lost control. Kegels helped a bit, but the first 2-3 months were pretty discouraging. At about 10 weeks post surgery I ran across a story about a patient finding quick recovery using a rowing machine. I started using a Concept II rower and found steady improvement. It took me about six months to fully regain continence, but my surgeon was surprised that it didn't take twelve months.

I also was 70 with a bad family history of prostate/breast cancer when I had a rising PSA that went from 2.8 to 4.25 over about 2 years as part of my periodic physicals. My urologist asked for another PSA test and ordered an MRI (3T) with contrast. The MRI was a piece of cake, but 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. Frankly, until the biopsy I felt I didn't have cancer. But the biopsy report was a rude awaking. That's when (for me) things got very real. I'm 13 months out from the treatment I chose. At this point, I'm doing very well and my psychological mood/state is the best it's been since being diagnosed. Nobody wants this disease, but catching it early and making informed decisions is waaaaay better than not. For me right now, life is good and moving forward. Best wishes.

My PSA was 11-12 when it was last measured and your next step will be to the Urologist. They will more than likely want you to have a biopsy. I won't be the only one to suggest this ask your Urologist to get you a PSE test as it is more accurate then the PSA.

@whezzymcduff
Well don't take offense but we don't want you to join our club. That is said that hopefully your high PSA was not caused by cancer.

You will see from posters, including me, that will pass on our experience that a high PSA does not mean you have prostate cancer. Nor does a PSA that is normal mean you don't have prostate cancer (I had normal PSA and I was diagnosed with prostate cancer).

Who did your PSA test? Your primary care provider (PCP) or urologist? If PCP my experience is your PCP should be referring you to a urologist and if not asked to see one. Most like, and again, can only give you my experience with this is that your urologist will do a DRE and most like order a MRI like mine did.

That MRI will show or not show suspicious areas. If you have an expereinced urologist they can determine if need biopsies. But without a biopsy the suspicious areas can only be seen as suspicious. So the next step would be the biposies and Gleason Score.

But that just my journey. You did mention they you have no symptoms. Does that mean you have no symptoms of BPH? Most cancers of prostate don't reveal symptoms unless spread to other areas or are very advanced inside prostate. That comes from my urologist.

You mentioned your health and bypass surgery. Just to let you know I went through all the tests and treatments and I have heart failure and a ICD/Pacemaker. Again we don't want to you to join our club.

If you have not so already, schedule an appointment with a urologist to check things out, high PSA readings don’t always mean cancer.

Ask for a PSE or IsoPSA test before jumping straight to tje biopsy. Find a urologist who does trans-perineal biopsies if it becomes necessary.

My journey started , like yours, with a high PSA that had trended and was 11.2 in September 2022. Urologist gave me an antibiotic but no good. The choice given to me was radiation or removal. @topf and @jayhall suggested a PSE test and it makes sense and I would have done that before my biopsy had I known about it. The PSE test will tell you if you are likely or unlikely to have cancer with supposedly 94% accuracy.

I had a biopsy with a 3+4 Gleason but contained. I felt that even with a low risk Decipher test score and a brother that had prostate cancer that had spread, time was my enemy and I tried to schedule everything ASAP.

After my research, as I knew doctors had their own unintentional biases, I chose an MRI based radiation machine vs one that used fused images. What they see in real time they can treat and the built in MRI yields less healthy tissue exposure and therefore potential side effects.

I was treated Jan/Feb 2023 and everything is fine based on every 3 months of testing.

I have a friend with a 11 PSA who went to leading urologist at Mayo in Jacksonville, He said his prostate was very large. Did some blood test (IPSO?) and said he did not think a biopsy was needed. Said many men with particularly large prostates have high PSAs. They agreed to watchful waiting.

Your high PSA may be a function of a large prostate gland growing as you age?

Once they run all the tests, get a 2nd, 3rd, and even 4th opinion. Generally, you should have time for all of this. I had a PSA of 5.5, Gleason 6, and biopsy with one core positive (10% of the core) out of 12 core samples. Decipher score was LOW. With all of that, my Urologist pushed for a Radical Prostatectomy. After multiple other opinions, I went to Moffit Cancer Center in Tampa and ultimately was put on active surveillance. All the other Urologists ruled out Radical Prostatectomy, but differed on radiation, etc. It pays to go a cancer research center such as Mayo or another, and get several opinions.