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Worried about High PSA

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User
Posted 10 Apr 2024 at 15:54

Hello,
I am 51. For the past few years my PSA has fluctuated between 2.5 and 3.5.
On 14-March-24 it was 4.4. So got retested thrice. On 22-March-24 it was 3.09. On 5-April-24 it is 17.5. On 6th April it is 16.5
Any idea what is happening ? Uro Oncologist thinks Prostatitis. Suggests another PSA after 1 month and MRI after 6 months. Should I wait that long or just ask for biopsy.

MP MRI was done on 6th April. Report below:

Peripheral Zone:
There is mild to moderate diffuse T2 hypointensity involving the base mid and apical region except for far lateral areas in the mid prostate. There is no significant restricted diffusion. There is symmetrical enhancement on post contrast evaluation. PIRADS 3

Neurovascular bundle: Unremarkable
Seminal Vesicle: Unremarkable
Prostatic capsule: Mild irregularity on the left side
Transition Zone:
Pseudo capsule and differentiation with peripheral zone is preserved. Mildly enlarged and benign changes are noted
Lymphnodes: No significant retroperitoneal lymphadenopathy seen
Other: No obvious bony lesion is seen. Bladder is collapsed.
Impression:
The imaging findings in the peripheral zone are intermediate ( PIRADS 3). Prostatitis can give similar appearance. To corelate with clinical examination
No size significant pelvic retroperitoneal lymphadenopathy seen.

User
Posted 10 Apr 2024 at 18:28

I'm a no expert, but a rapid increase over a short period of time like yours is almost always due to an infection;

eg, inflammation or UTI.

Do you have any urinary symptoms; eg, burning sensation, frequent urination, etc..?

Thanks,

Omar

User
Posted 10 Apr 2024 at 20:25

Hi,

I dont have symptoms. Am worried about the PSA rise.

Even if I ignore the jump my PSA has been high for my age since last few years.

Have looking for cases where people got similar jump and did not have cancer. 

 

User
Posted 10 Apr 2024 at 20:52

Like Omar, I'm no expert but I would agree with what he is saying. The erratic behaviour of the PSA results seems to point to infection rather than PCa. If your prostate is enlarged then it will produce more PSA. In the unlikely event it is PCa, it grows very slowly so waiting another six months isn't going to make any difference. Chris

User
Posted 11 Apr 2024 at 04:24

Your MRI is leaning towards "Prostatitis" as the cause for elevated PSA level.

At what age did you start checking your PSA, and what was your PSA level back then?

Also, do you roughly know the rate (PSA velocity) at which your PSA was rising through-out the years?

Thanks,

Omar

Edited by member 11 Apr 2024 at 04:25  | Reason: Not specified

User
Posted 11 Apr 2024 at 12:37

My first PSA was at 42 age. It was 1.3. I am 51 now so have 9 years history. Over the last 4 years it has fluctuated between 2.5 and 3.5. In December 2023 it was around 2.5. The pattern changed this year. On 14-March-24 it was 4.4. So got retested multiple times. On 22-March-24 it was 3.09. On 5-April-24 it is 17.5. On 6th April it is 16.5. On 10th April it was 16.8.

I also did MRI which shows PIRAD3 3. Maybe the next step is PSMA PET scan and biopsy. 

User
Posted 11 Apr 2024 at 21:41

This is what I suspected - your prostate (again, I'm not a trained medical provider) from early on produces "naturally" high PSA even at a much younger age; ie, total PSA 1.3 at the young age of 42 is normal, but yet slightly elevated for such age group. Similarly, fluctuating PSA 2.5-3.5 is also normal, but still slightly elevated for a 51. Now I'd be worried if your baseline PSA was under 1, and you're running at those elevated levels today.

Has your doctor ever made any comments about your slightly elevated (but still normal) PSA levels?

I suspect you have a chronic asymptomatic inflammatory prostatitis for years.

I'm curious to know what the doctor has to say.

Thanks,

Omar

Edited by member 11 Apr 2024 at 21:44  | Reason: Not specified

 
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