PSA not always accurate

Posted by thomasalm @thomasalm, Jan 18 9:55am

My PSA went from 3.1 to 5.4. Then after resting at Mayo it went to 4.4 then to 2.8.
All this time I had Gleason 9-10 and metastatic issues to nodes.
Has anyone had similar experience and can you share any feedback?
I guess the bottom line is the PSA is not foolproof and if you have family history or symptoms of cancer demand an MRI and biopsy.
I went in for my annual physicals but it didn't matter. Ugh.
I had RP 40 days ago at Mayo Rochester.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I’m on my 2nd recurrence. I have my PSA test done every 4 months. It also bounces up and down in small readings. I asked my oncologist about the fluctuation. He said you could even have different test results if you had 3 tests done per day ! Which no one does of course. He’s just looking for an average rise and rate of rise. Stephen.

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Agreed, PSA is not always accurate, but it is a very useful telltale possible prostate cancer issues.

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I am 69 and my PSA was was 2.7 and went to 5.4 two years later. They took another one with the same value and and recommended a MRI but said they were not sure insurance would cover it. I had it done and the MRI came back as 5 most likely to have significant cancer. The biopsy and the following surgery in Sept 2022 showed Gleason 7 stage 3A. I had two locations with no margin. The first PSA was >.02. While my insurance paid for the MRI because of cost they do not like you to get an MRI. My father had protate cancer and my Uncle died from it. I am glad I had the MRI.

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PSA of 4 along with digital finding of enlarged prostate equaled Gleason 9. I was advised to utilize the same lab with ultra sensitive testing post Radical Prostatectomy

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It can and does. Here's my clinical history. Mine has fluctuations which was urologist has no explanation.

There are sone "things" you can do, try and follow the same routine in the days immediately leading up to the test, avoid sex, intense exercise, riding one's bike, stay hydrated, use the same lab, same time of the day..

Still, my urologist is not concerned about individual results, he looks for trends, continuous increases over time.

Mine has gone up three times over the last year. At our last consultation he said let's not image now for several reasons:

The variability in my history
I did not follow my "routine"
Waiting another two months would not entail risk if it increases again but would increase the probability of imaging locating any sites of recurrence.

Kevin

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Hi hope you'll are having a good day. My Dad has prostrate cancer and it has already affected his legs he can not walk as we speak. I will like to know if there are support and directions you can give me as I move in to take care of him.

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@firespooks

I’m on my 2nd recurrence. I have my PSA test done every 4 months. It also bounces up and down in small readings. I asked my oncologist about the fluctuation. He said you could even have different test results if you had 3 tests done per day ! Which no one does of course. He’s just looking for an average rise and rate of rise. Stephen.

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Apparently a Covid shot can affect PSA test Do PSA 3 months after

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@melcanada

Apparently a Covid shot can affect PSA test Do PSA 3 months after

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Does it make the PSA reading higher or lower ?

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The Utube doctors video said higher

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@jonsara

Hi hope you'll are having a good day. My Dad has prostrate cancer and it has already affected his legs he can not walk as we speak. I will like to know if there are support and directions you can give me as I move in to take care of him.

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That would sound very much like he has metastasized prostate cancer, with possible metastases in his spine and maybe elsewhere. There are focused radiation options that might knock down specific metastases. Lots of wisdom and experience here reflected in Mayo Connect. Keep reading and learning. Suggest you consider watching some of the excellent videos produced by Prostate Cancer Research Institute pcri.org. In laymen’s terms.
I’m not a doctor, only a prostate cancer survivor. I think you and your dad should focus on Quality of Life. I would also recommend reading some of the work of Dr. Atul Gawande. He’s a surgeon. One of his books “Being Mortal”. Also an older pbs documentary. One of the things he writes about is how too many people have more surgery in the last six months of their life – sometimes neither extending their life nor giving them good quality of life. Doctors are not skilled saying that the next treatment may have no positive impact.
You could do a visit with the Mayo Clinic and see what they say.
Best of luck to you and your dad.
Remember that caretakers should not neglect their own health of well being while caring for someone else.

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