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PSA from 1.4 to 2.1 to 2.5 - Worries

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User
Posted 20 Apr 2024 at 11:05

Hi. I am 54 years old, fit and healthy. My PSA was 1.65 1 year ago. Then in July ( 6 months later) it was 1.43 then this last January 2024 it was 2.14. This worried me so I just got checked this week ( 3 months after the 2.14) and I am at 2.47!


 


I also have had 2 DRE this year which was smooth but midly enlarged 35cc


I made sure that 3 days before the test there was no ejaculation or excercise, there no infection or anything else that would have artificially raised it


 


Im very worried. Does this mean I have cancer? Thank you :)

Edited by member 20 Apr 2024 at 13:36  | Reason: Not specified

User
Posted 20 Apr 2024 at 13:58

Hi Adrian, thanks for the reply, Ive not posted on a forum before. I saw my urologist 3 months ago and he performed DRE (which was fine - modestly enlarged to 35cc) and said the PSA of 2.14 ( from 1.4 6 months prior) was fine but too see him again if theres another rise. As today was 2.49 im just convinced its cancer. I didnt ejaculate or exercise from 72 hours prior to test and dont have any symptoms of any type of infection so if theres no artificial cause for a rise of that much (it looks like 2 big jumps) then surley must be cancer. Im so worried :(


 


You say its a slight rise but as you can see these are my recent results, looks like a big rise to me?


Feb 2020 - 1.11


April 2021 - 1.08


July 2021 - 1.04


March 2022 - 1.64


January 2023 - 1.65


July 2023 - 1.43


January 2024 - 2.14


Today - 2.49


 


 

User
Posted 21 Apr 2024 at 14:46
Since you are already under the care of a urologist who was happy in January that this is benign but said to see him again if it rose, it seems fairly simple - just ask to see him again. A pattern of rises such as yours is more likely to be prostatitis or UTI than prostate cancer but it is right to see the uro again and ask whether a MRI scan can be done to reassure you.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 20 Apr 2024 at 13:40

Hello mate.


Sorry that you felt the need to find us, but glad that you have. Welcome to the forum.


No, the slight rise in PSA, doesn't mean that you have definitely prostate cancer. I believe they are still within the normal range.


You are right in keeping an eye of your PSA, especially as there has been a small rise. What have your clinicians advised?

User
Posted 20 Apr 2024 at 13:58

Hi Adrian, thanks for the reply, Ive not posted on a forum before. I saw my urologist 3 months ago and he performed DRE (which was fine - modestly enlarged to 35cc) and said the PSA of 2.14 ( from 1.4 6 months prior) was fine but too see him again if theres another rise. As today was 2.49 im just convinced its cancer. I didnt ejaculate or exercise from 72 hours prior to test and dont have any symptoms of any type of infection so if theres no artificial cause for a rise of that much (it looks like 2 big jumps) then surley must be cancer. Im so worried :(


 


You say its a slight rise but as you can see these are my recent results, looks like a big rise to me?


Feb 2020 - 1.11


April 2021 - 1.08


July 2021 - 1.04


March 2022 - 1.64


January 2023 - 1.65


July 2023 - 1.43


January 2024 - 2.14


Today - 2.49


 


 

User
Posted 20 Apr 2024 at 14:20

Hi Tel, welcome to the forum; your story is almost identical to mine. At 53, I had a normal range PSA which increased by a quarter point over 8 months. If I followed the NICE guidance I'd do nothing about it, but contacted urologist who organised an urgent MRI and bingo. Cancer in the right lobe. Won't bore you with histology at this point. Four days later had a biopsy (under general anaesthetic - didn't fancy being awake for that) which confirmed the diagnosis and 2 weeks later I had a RALP. Excellent post op recovery; I'm now just over a month since surgery with almost normal continence and totally normal erectile function (had nerve sparing surgery) so better than I hoped for. 


Your PSA is climbing from the figures you published, so I would ask for a urology referral and an MRI. Hopefully, it'll be fine and you can then relax, but if not, with such a low PSA, it'll almost certainly be localised with a potentially very high chance of cure. The NICE guidance is geared for the bulk of patients with prostate cancer who tend to be older and likely to die from other causes rather prostate cancer. It doesn't really serve 'youngsters' like us who hopefully have a much longer life expectancy.


Your normal DRE doesn't exclude prostate cancer; if you have a small tumour in the transitional zone it won't necessarily be picked by  finger exam. Also, you have to wonder why your PSA is climbing albeit in the normal range. 


I hope I haven't alarmed you and happy to support in any way I can.


Andy

User
Posted 20 Apr 2024 at 15:13

Oh dear, thank you for your story. Im now 100% convinced its cancer 😟

User
Posted 20 Apr 2024 at 16:30

You are not going to know till you’ve had tests! I also know many people with fluctuating PSAs who haven’t had cancer. Go back to your urologist for another assessment. 

User
Posted 20 Apr 2024 at 16:31

Originally Posted by: Online Community Member


Oh dear, thank you for your story. Im now 100% convinced its cancer 😟



Try not to think negatively, Tel.


PSA tests are only an indicator.


As a precaution, Andy has justifiably related his experience. However that doesnt mean yours will follow suit.


Andy has previously stressed that we should be lead by clinical advice rather than personal experiences or forum advice.


Has a clinician  been reviewing your results? If so, what has been advised?

Edited by member 20 Apr 2024 at 16:37  | Reason: Typo

User
Posted 20 Apr 2024 at 16:36

Even if it is prostate cancer you don't necessarily have to dive straight in to some radical treatment. You may just need active surveillance for a few years and let life carry on as normal until the time comes to do something 

User
Posted 20 Apr 2024 at 17:48

That’s true; although a difficult one to live with particularly when you are very young. A large proportion of us with early disease will have progressive disease in our lifetimes that will require intervention later on. I chose to have a RALP in my 50s when I’m fit and well rather than have it in my 60s when I may have suffered other comorbidities and make my surgery riskier. Also you can never guarantee how your cancer will progress in terms of developing unpredicted early metastatic disease. Saying all that it’s a very personal choice and in my case I couldn’t live with the uncertainly of observation particularly as I have small kids and want to see them grow up. 

User
Posted 20 Apr 2024 at 19:18

Thankyou all for your helpful replys. This forum is a great help. For myself viewing the 2 BIG psa increases from 1.6 to 1.4 to 2.1 to 2.5 just seems so black and white. With the absence of any infection or exercise / ejac in the last 72 hours what other possibility could there possibly be? Am I missing something? Could it possibly not be cancer or am I just being deluded about the inevitable? 


I just dont know how the psa can jump twice so high without it being cancer


I have been on TRT for a few years but I dont know how that would cause this.


Thanks again guys


 


 

Edited by member 20 Apr 2024 at 19:20  | Reason: Not specified

User
Posted 21 Apr 2024 at 14:46
Since you are already under the care of a urologist who was happy in January that this is benign but said to see him again if it rose, it seems fairly simple - just ask to see him again. A pattern of rises such as yours is more likely to be prostatitis or UTI than prostate cancer but it is right to see the uro again and ask whether a MRI scan can be done to reassure you.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 21 Apr 2024 at 17:58

thanyou lynn. ive thought about infection or protasis but ive been fine, not been unwell at all. Im so concerned as I cant see any scenario where the 1.4 to 2.1 to 2.49 in 1 year is not cancer. 😕😕

 
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