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PSA Levels and subsequent tests

User
Posted 27 Jan 2017 at 20:35
Hi everyone,

Please help me, Dads just received PSA blood tests, second set in 8 weeks.

His levels have gone from 5.8 to 6.1 in just over 8 weeks.

His GP was incredibly negative and said he will need an immediate Biopsy (he is 71) he doesn't really have any other symptoms. Slow flow and gets up a couple of times a night.

The GP gave him the finger test and said all felt normal, but that it definitely cannot be an infection and she is majorly concerned about a Cancer diagnosis.

He doesn't want a Biopsy and I'm hoping to get some more information on PSA scores and what they can mean :o(

Thanks for your time

User
Posted 27 Jan 2017 at 21:54

Hello Lumpiepie and welcome to the site

Firstly you say the GP says it definitely cannot be an infection. Was dad tested for infection?

PSA does not, of itself, categorically mean that when it's raised then it's cancer. There are a number of reasons for raised PSA so the GP shouldn't jump to conclusions.

However, if you look at her reaction in a positive light then her prompt action may be to your dad's advantage if indeed he does have cancer.

I don't know how it works at your dad's surgery but at ours the GP wouldn't be organising a biopsy so I think it's probably that what she means is that she will refer him. When dad sees a consultant he will repeat the DRE and it will be for the consultant to ask for a biopsy depending on what he finds.

Don't get hooked up on the PSA results at this stage, save your energies for helping your dad and encouraging him to be a bit proactive by attending any appointments he gets.

If you, or somebody else, could go with him not just for support but also as a second pair of ears that would help in the long run.
Go to publications on this site and download the leaflets that make up The Toolkit. They explain things in simple terms and may help you and your dad to ask relevant questions, which by the way are a good idea to write down and take with you.

They'll be other members along to advise you but in the meantime, try and stay calm

Best Wishes

Sandra

Edited by member 27 Jan 2017 at 21:56  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 27 Jan 2017 at 22:39
Lumpiepie

I had a TRUS biopsy. For me, it was no worse than a visit to the dentist. We are obviously all individuals and react differently and I'm sure there are others who had a bad experience, but for me, it really wasn't that bad.

Talk to one of the specialist nurses from PCUK. Tell them your worries and ask your questions. They are brilliant.

Ulsterman

User
Posted 28 Jan 2017 at 00:06

How horrible for your dad - it seems the GP has given him unnecessarily negative messages. She cannot know that it isn't an infection unless she has already arranged hospital tests of his blood and urine and received the results - some urine infections are notoriously hard to diagnose because they don't show up in the dip tests that GPs do in the surgery, and prostatitis is difficult to diagnose as well. Either could cause a PSA of 6.1 and infection could also cause that rise which was only 0.3 in 8 weeks ... hardly a dramatic increase.

The best way for dad to know is to agree to the hospital referral - the urologist is best placed to spot things like deep seated infection, BPH (enlarged prostate) etc. If the urologist thinks a biopsy is a good idea, s/he will be able to explain to your dad the pros and cons and hopefully reassure him.

It may turn out in the end that dad does have prostate cancer; 70% of men in their 70s have it but for most it never causes any problems. At this stage, far too early for the GP to be so sure.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Jan 2017 at 00:16

Sorry, I have just seen what your actual question was. The PSA score doesn't really mean anything except that it needs following up. At your dad's age, a PSA of 4 or over would be considered a little high but we have men with PSA up at 20 or 30 who just have a big prostate, while people like my husband can have a PSA of 3 and have cancer. The highest we have on here was 13000. So a PSA of 6 doesn't confirm that it is definitely cancer, how aggressive it is or whether it is curable. All it does is say 'this needs looking at'.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Jan 2017 at 09:55

I'm quite quick to condemn GP's for not acting upon an elevated PSA. But to me this GP appears to be taking the right steps. She obviously feels it's not BPH as she has felt the prostate and reports it feels normal.

Yes she has mentioned a biopsy and the C word but she will be referring to a consultant who will be able to give a more informed opinion and who will decide if a biopsy is required or not.

I personally think the GP is doing the right thing i.e. referring your dad to the specialist/expert

I hope things go well

Bri

User
Posted 28 Jan 2017 at 20:39

As Lyn and others have said, a raised PSA is an indication something is happening, but not necessarily cancer. My PSA was 72 in September from a previously steady 3 to 4 over several years. That was almost certainly due to a tooth abscess, because my PSA returned to mid 3s in December - over 3 separate PSAs - after tooth was extracted.

I agree with Brian that it is good the GP has jumped all over it, and will refer your dad. She could probably have had a better and more considerate approach to what she told your dad and the manner in which she told him. The urologist will determine the next steps with you and your dad. Read the Toolkit as suggested and I'm sure you are planning to go with your dad, so be prepared to ask lots of questions, don't hold back voicing any concerns. Then come back and ask questions of us.

Good luck and stay positive.

Chris

User
Posted 29 Jan 2017 at 15:36
Hi

Welcome.

Does your dad have previous psa values ?? Are you able to post those please ? Ie why 2 tests in 2 months

?

Please visit my profile. Also my brother just diagnosed with Psa 3.57 Gleason 7. He is 69. He had mpMRi 2015 and his only biospy autumn 2016.

Hope this helps. As others have posted psa is just one 'indicator' in diagnosis. Currently biospy provides the most effective analysis.

Is dad worried about biospy ?? Or doesn't understand the procedure ?

Gordon

User
Posted 12 Feb 2017 at 16:13

Hello,

My dad has had about 3 blood tests all of which have come back with a high PSA level. He was booked in for a biopsy at the hospital but due to bad organisation at hospital this was never done. since, we have read that MRI scans are better at picking up prostate cancer as well as being pain free. So just thinking if your dad doesn't want the biopsy this could be an option for him? definitely something to ask your doctor about. 

good luck and best wishes to you and your dad. x

User
Posted 12 Feb 2017 at 18:47

Hello kw1993and welcome

So what is the position with your dad now, given the inefficiency at the hospital. What other tests have been done for him.

Is he following up on the high PSAs (and how high were they, does he have other related problems ie needing the loo more frequently etc)

If you want advice just ask, but might be better to start your own thread in case yours gets lost in this one

We can't control the winds - but we can adjust our sails
User
Posted 13 Feb 2017 at 21:57

Hi Johsan,

I will start my own thread now and will detail info in there, thanks for suggesting. 

K

 
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