What to expect PSA number 4.7? 72 yr old

My Primary Care Physician suggested that I see a urologist when, at age 69, my PSA went from 3.8 to 4.3 over the course of 1 year. The urologist did a physical exam and could feel no abnormality, but the MRI that he ordered did show some areas of concern, and the subsequent biopsy indicated prostate cancer with a Gleason score of 7=4+3.

I agree that you should see a urologist as soon as possible. I expect that you will have a physical exam, MRI and, assuming that there is a reason to suspect prostate cancer based upon those two exams, a subsequent biopsy. After that, you'll have to see what the results are, because that will determine what treatment options are available to you.

PDCAR, thank you for your input on this request. I will speak to my healthcare provider to request a PSE test after reading the information on the accuracy over the traditional PSA tests.
Thank you
Joe

My suggestion would be, if you have kept track of your PSA over many years, then you have historical data that can help you see how it has trended over time. Has it kept steady and this one is an abnormality? Has it been trending up over time? I'd suggest a repeat PSA in a month or two. The proper way to go forward with testing beyond PSA is next and MRI. Standard systematic 12 core biopsies are largely random samples of tissue from the prostate, sort of taken from zones. Chances are great that those 12 cores can miss a tumor. You want the MRI first so if something shows up on the images, the urologist can now "target" that area during biopsy. Slow down in order to be right. It is critically important that you be treated for all of these procedures by highly experienced doctors and centers of excellence. If you can't find that where you are, it's to your advantage to seek it out and travel to where you can receive it. There are also additional tests 4K Score for one that can shed more light on the probability you have prostate cancer. You could also ask for a PSE test, something that is just out on the market. The PSE test as I understand it increases the accuracy of predicting prostate cancer to 90 percent when combined with a PSA test. https://www.news-medical.net/news/20230208/New-blood-test-can-detect-prostate-cancer-with-greater-accuracy-than-current-methods.aspx

Your PSA indicates you should look into what’s going on in your body. A PSA is a check-engine light. Something isn’t working right. It could be minor or the tip of an iceberg. My PSA was 4.1; it was the just the tip. There are options for you besides radiation. Find the one that’s best for you. Good luck.

@joem
If I had to do the testing process over again, I would ask for a PSE test which has 94% accuracy, supposedly, while the PSA test has 57% accuracy. If that blood test showed a problem, then I would do the MRI... Here is the link to BioDynamics and you can also email Steve Arrivo, a Senior VP there, who is more than willing to answer any questions you may have.
steven.arrivo@myobdx.com
https://www.oxfordbiodynamics.com/?utm_campaign=email-signature&utm_medium=email

Thank you so much. There is no other way.

That sounds like my situation. The urologist/radiation oncologist were surprised how far advanced the PCa was during my biopsy’s with a PSA of only 8. On 2/2/22. Today it’s < .01 after radiation and on ADT therapy. ZYTIGA/PREDNISONE for 22 months .

I respect and value your courage. I will go to the urologist ASAP.

Sorry to hear that , was 1A in college , the war stopped and so did the draft, My brother who is 9 years older is now suffering the effects of agent orange from Vietnam .
In 7 months the cancer progress to stage 4.

I'd have the MRI. You can have low PSA and still have cancer. Now that your PSA has roused suspicion, calm your fears or gird for battle depending on the results.
Best luck