What's a high Psa level?

Hi Tetley, for a man in his 50s a PSA above 3.0 would be considered higher than it should be and for a man in his 70s a PSA of 4 or 5 would perhaps trigger a biopsy. However, there are men diagnosed with a PSA in the hundreds and the highest we have had here was 13,000. Even so, it isn't the PSA that determines what should happen next, it would be down to his Gleason score (which was determined at the biopsy)

It seems your dad is on Active Surveillance (AS) which menas that he has regular PSA tests and probably an annual biopsy, scan & DRE. My guess is that your dad's Gleason is G(3+3) 6 or G(3+4) 7 and/or that the biopsy & scans showed he had a very early stage tumour (a T score of T1 or perhaps T2a???) in which case AS may have been what your dad wanted and was advised would be his best option. There are many reasons why men choose AS including a desire to avoid what can be pretty appalling side effects (bearable if your cancer is a problem but an unnecessary difficulty if the cancer is so small that it is unlikely to cause any problems.) My father-in-law chose AS because he didn't want to risk being impotent, for example. The important thing about AS is making sure that regular checks are done in case it starts to progress - it sounds like this is what your dad's specialist is doing - hopefully all is well and your dad can carry on with the AS.

Try not to be stressed about it - download the toolkit from the home page of this site and then ask dad whether he still has a copy of the diagnosis letter. If not, his GP would be able to tell him what his last G & T scores were and then when he gets his next results you will have a better idea of how things are going and whether AS is still the right choice for him.

Morning Tetley.
My husband's PSA started at 5.7 when he was in his early 70s.
He opted for Active surveillance because he had no symptoms and was worried about side effects of treatment.
He was told by his nurse when she informed us he had cancer that he was likely to die with it not of it as it was a slow grower.
Fast forward a year and the PSA went up to 6.3 and we were advised to think in terms of treatment.
Last June, at age 73, he had Low Dose Seed Brachytherapy.
Just to confirm that your dad was in all probability told the same regarding where the cancer was going so no, he wasn't burying his head in the sand.

My husband was monitored throughout the Active Surveillance period so I am assuming it was the same for your dad? PSAs, biopsies?

No mention of PSA between when first logged in 2012 and latest in 2014 in post or profile. It would be interesting if there were tests done to see progression. But this is really academic now other than perhaps to help understand why no further tests scans or biopsies were done previously (that we are told of anyway). What we do know is that a biopsy is now being done and this and any other scans should establish diagnosis and what treatment options there are.

Hello Tetley,

Sorry to read that your dad's readings are prompting further intervention, but glad that something is being considered.

In 2010 he was diagnosed and it was thought to be a pussycat cancer, slow grower that he would "die with" not "from". It is quite likely that he was told that and was not burying head in sand. Unfortunately pussycats can become tigers it seems.

A couple of factors that you and he might want to consider when you start to look at treatment options. What is the life expectancy in your family line? This may affect his treatment choices?

You should be able to obtain detail of previous biopsies, ask your GP.

Lots of options for him it seems, so take heart.

atb

dave