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PSA reading of 7

Posted 13 Nov 2017 at 16:48
My name is Andy and I’m a 40 year old male in good health. About 6 weeks ago I spotted blood in my semen and went straight to the doctor. I wasn’t feeling particularly well at the time with flu like symptoms. The doctor tested my urine which also had a small trace of blood although he said that would be pretty normal if my semen had it as well. Given that I have turned 40 this year he said it would be good to have a PSA blood test done as well, so 5 days later I went to the nurse to get the blood taken. My flu like symptoms had eased at that point. The nurse re-tested my urine and said there was no blood, and I haven’t had any boood in my semen since. However I went to the doctor a month after seeing the nurse to get my PSA result and it came back with a high reading of 7. The doctor performed a DRE and couldn’t feel anything abnormal. They have referred me on the urgent 2 week referral to see a Urologist which is next Monday. The doctor seemed to think I’d have a biopsy straight away which worries me as I thought they’d run another PSA or scan first. I’ve felt a bit rough again the past few days but don’t know whether that’s just anxiety about the forthcoming appointment. I don’t have any issues urinating although I do have hemorrhoids which sometimes flare up and some general pain in the rectum/groin area. Basically my mind is all over the place as I know a PSA reading of 7 is quite high. My father in law has an aggressive prostate cancer (he was diagnosed at 60) and his PSA was 6.5 when diagnosed. Logically I’m trying to tell myself that it would be unlikely to have prostate cancer at 40 but the high reading has got me worried. If anyone has any similar experiences to share or what to expect from the Urologist I’d be really grateful. Thanks
Posted 13 Nov 2017 at 19:25

Hi Andy,

Unfortunately, a small number of men are diagnosed with PCa in their forties and where this is a possibility, it is important to investigate quickly and where appropriate take early action because the cancer has many years to develop. Some hospitals tend to scan first and then biopsy. This has two advantages, it can help show any suspicious areas to direct the biopsy and it means the prostate does not have to heal before a scan can be done. Others hospital do biopsy before MRI.

Until any positive biopsy cores show otherwise, there could still be other reasons for a high PSA. You could have still have some urinary infection (these can sometimes be difficult to identify , and enlarged Prostate or PIN cells that are not quite normal but have not yet changed sufficiently to be called cancerous. Certain other activities can also raise PSA such as riding a cycle a day or so before the test and sexual activity before the test. The latter if very rigorous can also lead to some blood in semen and urine.

You may still have another PSA test and DRE by the Urologist before having a biopsy. I assume it was your GP who suggested you would go straight to biopsy.

Posted 13 Nov 2017 at 20:38
Thanks for your reply Barry. I’m hoping for an infection (as strange as that sounds) just because I had a show of blood which hasn’t repeated since and I wasn’t feeling well at the time. I’ve also read that prostatitis is common in younger men. I’m certainly hoping the Urologist goes for another PSA, DRE and scan before a biopsy as I’ve heard a PSA result is only meaningful when taken as a trend. Anyway, i’ll Know more in a week. It’s the waiting that’s hard. Thanks again.
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