What PSA Score sent you to a Urologist?

Posted by jayhall @jayhall, May 17 12:47pm

I get PSA blood work done every 6 months. Last year my PSA was 3.25 and six months later it had increased to 5.5. My PCP sent me to a Urologist. The Urologist confirmed that if you score 5 or about it's wise to get a biopsy etc, to rule out Cancer and develop a treatment plan for your PSA. I'm curious what PSA score sent you to a Urologist.

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

973estetemple | @973estetemple | May 24 11:16am

In reply to @hammer101 "Jayhall - So many doctors rely on PSA level alone. This is so misguided and incompetent...." + (show)

@hammer101

Jayhall - So many doctors rely on PSA level alone. This is so misguided and incompetent. In addition to PSA level, they must look at the velocity (rate of increase) and doubling time. Even if your PSA level is relatively low (say 6, 7, 8), you could very well have intermediate or advanced prostate cancer. For myself, the doctor started doing PSA checks when I was 50 years old. I trusted the doctor to be competent, but she only looked at PSA level. In hindsight, I reviewed my records and my PSA doubled twice and was doubling a third time. Even with this rapid increase, she never indicated there was a problem/concern. Fortunately, I retired at 55 and went to a cardiovascular clinic to improve my diet in hopes to get off of cholesterol medication (Statin). Fortunately, the nurse practitioner was a friend from our church and she reviewed my entire medical record. After talking through my cholesterol issue, she asked me if I was addressing my prostate problem. Ignorantly, I replied, what is the prostate? Goes to show how much I relied on doctors at that point of my life - Never again, you must own you healthcare and take personal responsibility for it. I immediately did research, contacted the best possible center of excellence, and made an appointment with Mayo-Rochester. In the end, I was diagnosed with PC, Gleason 7 (4/3). I went with a radical prostatectomy and for the past 1.5 years had PSA level of undetectable - Praying this remains the case for the rest of my life!!

Bottom line, my PSA level was just below 8, but it had doubled almost three times. Ignorant doctors and "I don't want to worry you" doctors are very dangerous and should be avoided. We must own our healthcare and ensure the doctors are interpreting test results accurately - Please don't solely look at PSA level, you must also take into account the rate of increase (velocity and doubling time)!

Best of luck and I pray all goes well with your upcoming appointments.

Have a great day,

Jim

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We must own our personal healthcare and ensure the doctors are interpreting test results accurately -YES! WE ARE IN CHARGE OF OUR OWN BODY. We need to do our own investigation. Ultimately everything is up to us.
I am wondering - many here seem to engage in the surgical procedure of cut/remove prostrate but sometimes suffer consequences of the loss of urinary control and ability to have sex. Has anyone here had non-surgical and non-invasive radiosurgery or cyberknife? Do they work as prescribed? Appreciate your feedback!

hammer101 | @hammer101 | May 25 8:14am

973estetemple - There are several non-invasive treatments and I am sure you will get a lot of replies from those with personal experience using them. Be sure to review all the risks associated with the non-invasive treatments to ensure they align with your expectations. As with surgery, I would highly recommend doing a lot of research and going to a center of excellence for whatever treatment plan you decide on. It has been a while since I did my research on treatment options - Below is a list of potential side effects that I had gotten from a quick Google search of CyberKnife treatment of PC (most are temporary, but sometimes severe because of rectum or bladder wall exposure to radiation):
- Constipation, fecal urgency, fecal incontinence, hemorrhoid, rectal bleeding.
- Urinary retention, urinary urgency, increased frequency, incontinence, urinary bleeding.
- Blood in stool.
- Erectile dysfunction.

Good luck and hope you get a lot of feedback from men who have actual personal experience with radiation based treatment.

Jim

themurfs | @themurfs | May 25 11:47am

My husbands PSA went from 4.2 to 7.7 in 18 months. He was then referred to a urologist and a biopsy confirmed 4+3 =7 Gleason score.

stevpr8 | @stevpr8 | May 26 9:43am

I was referred to a urologist at psa 6 and an MRI followed. This MRI showed high suspicion of cancer and a biopsy followed. I also had a family history at the same age. ( 2 years prior I had a 5 and was sent by my internist for an MRI which didn't show any suspicion of prostate cancer and active surveilance was prescribed )
MRIs were ordered prior to any further decisions were made.

Colleen Young, Connect Director | @colleenyoung | May 26 1:54pm

In reply to @deebee41 "12 with gleason of 8 Had 45 days of radiation and 2 yrars of Lupron every..." + (show)

@deebee41, was it decided to go back on treatment? How are you doing?

jc76 | @jc76 | May 27 6:43am

@jayhall
Not only is the number important (4.0 is normal psa top level) but is the PSA level rising over time.

My PSA was at 3.75 so was still normal. But had been rising every PSA test and after we ruled out long distance bike riding (quit riding prior to test) my PCP recommended me to urologist. Then came the MRI, biopsies, and cancer diagnosis. Had Decipher, PSMA, Bone Scan and my prostrate cancer was confined to my prostrate and Decipher test showed low risk.

Catching early even though PSA level was till normal is the most important thing you can do for positive outcome. I mentioned again that a rising PSA level that cannot be determined coming from bike, riding, infections, irritations to prostrate shoud be looked at with a MRI and then additional appropriate testing.

johnoclark | @johnoclark | May 27 9:45am

My PSA went from 3 to 4 in 9 months.

gbrickler | @gbrickler | May 27 12:37pm

Be cautious of relying only on PSA. And possibly your current health care system. With increased frequency of urination and some difficulty passing urine I was seen by my PCP, at a major university health system that had provided my medical care for 12 years. PSA had increased slightly but < 4.0. Prescribed Tamsulosin, told it may take months to work. Symptoms increased, referred to urology NP, PSA still < 4.0. I requested additional diagnostics but NP would not approve, “Tamsulosin takes longer to work”. After 7 months I could not pass urine, ER visit at a different health care system, within a week at that system was diagnosed with stage 4 PC. Needless to say I did not return to the university health system, there is more to that story but I will not belabor it here. Moral: don’t put complete trust in PSA; you are your best advocate, if your treatment does not seem right question the physicians and seek a second opinion early. Also, while there is probably a place for the NP in health care, I will in the future not trust my life to a non-physician just for the convenience of the system.

deebee41 | @deebee41 | May 27 5:08pm

In reply to @colleenyoung "@deebee41, was it decided to go back on treatment? How are you doing?" + (show)

No treatment as of yet. Too much else going on with other cancer. Has not doubled in 10 months and showed no signs of spreading so far. Maybe Casodex or equivalent a bit later.

Colleen Young, Connect Director | @colleenyoung | Jun 5 2:23pm

In reply to @johnoclark "My PSA went from 3 to 4 in 9 months." + (show)

@johnoclark, welcome. Was this increase in PSA while monitoring during treatment? How are you doing?

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