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PSA went from 3 to 5 in 9 months, but MRI was negative for cancer
I have had multiple (6-8) MRI's and Biopsys since 2016 following a Gleason 6 score. All were clear. I also had aquablation surgery in January of 2025 to relieve pressure. Post Op tissue was biopsied and clear. PSA was measured again in February of 2025 at 2.75 and again in December of 2025 at 5.2. I had another negative MRI today. Dr told me in December of 2025 that the numbers are going up too fast to be BPH. He said cancer or an infection. I have neither of those. Why is my PSA going up at this rate if my only symptoms indicate BPH? Can BPH related PSA scores increase at this rate?
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I’m a little surprised the doctor said that. BPH can be due to an infection which can come on quickly and cause the PSA to rise a lot. Then the people with BPH take ann antibiotic and with in a very short time, their PSA can drop from 11 to 4 or three. Do you know the size of your prostate? That can be a factor as well especially if BPH has enlarged it.
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1 ReactionSomething that may be more important than the PSa is something called PSA Density. You get the PSA Density by dividing the PSA by size of prostate. You want to have a number of below 0.15 ng/m for PSA density. Migh be something to check out.
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1 Reaction@diverjer Prostate size is 45 cc or 45 ml. PSA is 5.19 ng/ml. - 5.19 ng/ml divided by 45 ml = 0.115
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1 Reaction@jeffmarc MRI data indicated a volume of 45 cc
Was your MRI a Pirads 1 or 2 with no suspicious lesions?
@cspringford
That’s real close to normal size so the PSA should be about normal. Many people’s Prostates are in the 30s so could be that you do have BPH and it’s enlarging it a little bit and causing the PSA rise. I’m not a doctor so urologist would know better than I what to do.
Might be you need to see a different Urologist. It is true an infection can raise the PSA.
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1 ReactionThat looks like a good density number. Size of prostate don't look that bad either, I think kinds of depends on age? Looks real good compared to mine 68.75. But with my PSA of 4.16 my density still came out .06 which is okay. What was bad on my MRI was a score of PI-RADS Category 5. Have some fusion biopsy scheduled more than a month away. They said that was a soon as they could get me in. That leaves me with lots of anxiety, would like to know what biopsy finds and get going, but no have to wait. Just like I had to wait 6 weeks for MRI.
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1 ReactionPrayers
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1 ReactionWhat was the MRI pirads score prior to the original biopsy? Did your Gleason 6 PC lesion image well at that time?
Same area for the pirads. The Gleason 6 never showed up on ANY of the MRI's. It was visible on the first biopsy taken 10 years ago. a single dot on a golf ball. I have had 6-8 MRI's and about the same number of biopsies since 2016. ALL have been clear of any cancer. It seems like BPH is the only concern, but the doctor says that the PSA is rising too rapidly for that. We just keep going in circles. More MRI's and biopsies, same clear results. That is good, but if the doctor believes that there is an underlying problem, then what is it? It obviously isn't prostate cancer or they would have discovered it by now.