rapidly rising psa bx neg x1
Here are my details:
age 60 in excellent health Father died at 93 unrelated to his PCa or his low grade Bladder Ca which he had for over 15 years PCa treated with hormones and Bladder Ca treated 6 month periodic scrapings on cystoscopies
psa 23.5 March 20, 2011
psa 25.2 with simultaneous free psa of 9% May 17
psa 34.00! on may 23 AM
POST blood test: DRE and prosatic massage normal ( nothing expressed) May 23 evening
Biposy on May 24 neg cores 12/12 no sign of inflammation or PIN totally benign
Prosate size 61
normal bone scan and cystoscopy
Urologist doesn't want to refer me to MSKCC since bx neg
MRI scheduled in 4 weeks presumably to be followed by repeat bx or I will try to talk them into MRI directed bx
Anyone with an explanation how psa could rise 9 points in 6 days after rising 1.5 points in 2 months? Could that be a result of inflammation despite none found on bx?
Last edited by freepsa; 06-05-2011 at 04:12 PM.
Your prostate is twice normal size, but that alone does not produce a PSA of 34...First step would be a run of antibiotics and see how the PSA responds to that..If no response, I would have a Color Doppler Ultrasound examination performed by an expert, even if if it means traveling to have this examination performed..Another option is a 40 core saturation biopsy..
In a few rare cases, the PC can hide in spots unreachable by the TRUS 12 core biopsy procedure..But with a PSA of 34, SOMETHING is going on and Urologists get paid to find out what that something is....
PSA at age 55: 3.5, DRE negative.
65: 8.5, DRE " normal", biopsy, 12 core, negative...
66 9.0 DRE "normal", BPH, (Proscar)
67 4.5 DRE "normal" second biopsy, negative.
67.5 5.6, DRE "normal" U-doc worried..
age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5. 10/14 PSA 0.6, T-11. 1/2015 PSA 0.106. 4/15. 0.4, 9/15 1.4, 3/16 Zytiga, 0.04
Ok, let me try this: A jump of 25 to 34 in 6 days could be explained by:
a) normal fluctuations with large margin of error
b) rapid malignant PCa curently confined mainly to anterior or transition zone and thus not found on 12 core
c) an inflammatory process that got suddenly worse
I bet on c as the most logical. Why would PSA climb 1-1/2 points in 2 months and then jump 9 points in 6 days. Any takers other than my insurance company?
Any "insult" to the prostate gland..Having sex, horseback riding, bicycle riding, any major physical exertion can cause a temporary spike in PSA levels...Having wild swings in PSA levels while not common happen often enough so that, BY ITSELF, is no a cause for great concern..Again, have you been treated with a run of antibiotics to see what the response to that is? If you move the decimal point in one notch, you went from 2.5 to 3.4, a fairly common fluctuation percentage-wise..I would be MUCH more concerned that my PSA was over 20 and I needed to find out what was going on...