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First ever PSA and told abnormal?

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User
Posted 05 Jul 2018 at 11:46

Hi All,

So did my first ever annual work health check and apart from needing to lose a bit of weight I had a PSA test for the first time which came back as 3.8.

On their advice I had a chat with my GP and he sent me for a repeat test telling me the usual, don't go bike riding and stay away from the wife!!

That result has come back as 3.9. I'm a 53 year old guy so it's flagged as abnormal since over 3.0 I think is the cutoff?

Ive read a lot about PSA tests of course and some people have been high with no sign of PC of course plus of course vice versa, but I don't really know what to make of it.

I have no symptoms at all quite honestly and am due to discuss with GP on 11th. Do I insist on 'tests' or just monitor?

My Dad had his prostate removed in his mid 70's it was so enlarged but not cancerous.

Any thoughts?

Thanks guys.

User
Posted 05 Jul 2018 at 12:11
Steve,

Many men who have PCa are fit and don't have any symptoms. Did you provide Your GP with a urine sample to see whether you had a urinary infection which is a frequent cause of an elevated PSA? Did your GP do a DRE (feel your prostate with a finger through your rectum to help ascertain whether you had a very enlarged Prostate (another contributor to raised PSA) or to feel whether it was hard/soft/irregular/lumpy? This easily done things should be investigated before more involved tests are done.

Barry
User
Posted 05 Jul 2018 at 12:27
When I had my first PSA test aged 55 It was 2.2 and I was told that under 4 was ‘normal’ for my age. Fast forward 7 years to my next PSA which was 13.9, the Urologist I was referred to said he would have insisted on regular PSA tests after the 2.2 reading but conceded “I do meet a lot of men with prostate cancer”.

Bear in mind, ejaculation, any kind of prostate stimulation such as cycling, horse riding or something more exotic can have a short term effect on your score, so it’s best to abstain from such things for a couple of days before your next blood test.

I trust you have nothing to worry about.

Cheers, John

User
Posted 05 Jul 2018 at 15:25
The annoying thing for me is that Her Loveliness had a total hysterectomy three years ago, and yet she still gets invitations for cervical smear tests despite her cervix being long gone into a medical incinerator.

In contrast, I was neglected for those seven years between PSA tests, and a GP refused to do a DRE, saying ‘We don’t do that these days’, and I ended up with Tommy the 15mm Tumour and a (so far) post-operative limp dick of diminished stature. If I had been diagnosed much earlier, who knows what my outcome might have been. Anyway, still breathing, still smiling.

Cheers, John

User
Posted 06 Jul 2018 at 09:40

@Stevev...

'Do I insist on 'tests' or just monitor?'

Having tests will provide good information - and enable you to be better informed.

Getting those tests might be a problem.

Too-much of NHS appears oriented toward budget rather than care, and hence availability is either restricted and/or resisted.

Paying for private tests is worth considering.

In terms of 'appropriate tests'... consider a more-detailed PSA variant, PROMIS-standard mpMRI, and template biopsy.
Together, they should provide accurate info. (And the total cost-to-NHS of all of 'em is about the same as treatment for a broken arm/leg.)

PSA, DRE, TRUS biopsy, and non-PROMIS-standard mpMRI aren't that useful.
And the ability/experience/attitude of consultant surgeons varies greatly.

 

Edited by member 06 Jul 2018 at 09:41  | Reason: Not specified

User
Posted 06 Jul 2018 at 09:42

Stevev,

 

I would encourage you to have a DRE and seek a referral to a urologist - just for peace of mind. 

My first PSA came in at 4.2 (a little higher than yours) and my GP asked me to come in. She did a DRE and found nothing untoward. She did though  refer me to a urologist. He also performed a DRE and confirmed the GP's assessment. He went on to say there as an 80% chance of it not being PCA and gave me two choices... I could have a follow up PSA test in six months time or have a biopsy. I chose the latter and unfortunately found myself in the other 20%.  In hindsight, I'm glad I made the choice when I did although, because the initial PSA result was moderately low, I don't think leaving it six months would not have made a jot of difference to my treatment choice and outcome, in my case the likely rise just confirming further investigation was needed.

Flexi

 

 

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User
Posted 05 Jul 2018 at 12:11
Steve,

Many men who have PCa are fit and don't have any symptoms. Did you provide Your GP with a urine sample to see whether you had a urinary infection which is a frequent cause of an elevated PSA? Did your GP do a DRE (feel your prostate with a finger through your rectum to help ascertain whether you had a very enlarged Prostate (another contributor to raised PSA) or to feel whether it was hard/soft/irregular/lumpy? This easily done things should be investigated before more involved tests are done.

Barry
User
Posted 05 Jul 2018 at 12:27
When I had my first PSA test aged 55 It was 2.2 and I was told that under 4 was ‘normal’ for my age. Fast forward 7 years to my next PSA which was 13.9, the Urologist I was referred to said he would have insisted on regular PSA tests after the 2.2 reading but conceded “I do meet a lot of men with prostate cancer”.

Bear in mind, ejaculation, any kind of prostate stimulation such as cycling, horse riding or something more exotic can have a short term effect on your score, so it’s best to abstain from such things for a couple of days before your next blood test.

I trust you have nothing to worry about.

Cheers, John

User
Posted 05 Jul 2018 at 13:41

Thanks John & Barry for your replies.

I certainly abstained from everything before the re-test and will see what the GP says.

I had a urine test as part of the health check and that came back as normal.

I agree it's likely the GP will want to do a DRE bit I've had colonoscopies in the past so guess not to bothered about that! If my wife puts up with smear tests I have no excuses for that test!!

User
Posted 05 Jul 2018 at 15:25
The annoying thing for me is that Her Loveliness had a total hysterectomy three years ago, and yet she still gets invitations for cervical smear tests despite her cervix being long gone into a medical incinerator.

In contrast, I was neglected for those seven years between PSA tests, and a GP refused to do a DRE, saying ‘We don’t do that these days’, and I ended up with Tommy the 15mm Tumour and a (so far) post-operative limp dick of diminished stature. If I had been diagnosed much earlier, who knows what my outcome might have been. Anyway, still breathing, still smiling.

Cheers, John

User
Posted 06 Jul 2018 at 09:40

@Stevev...

'Do I insist on 'tests' or just monitor?'

Having tests will provide good information - and enable you to be better informed.

Getting those tests might be a problem.

Too-much of NHS appears oriented toward budget rather than care, and hence availability is either restricted and/or resisted.

Paying for private tests is worth considering.

In terms of 'appropriate tests'... consider a more-detailed PSA variant, PROMIS-standard mpMRI, and template biopsy.
Together, they should provide accurate info. (And the total cost-to-NHS of all of 'em is about the same as treatment for a broken arm/leg.)

PSA, DRE, TRUS biopsy, and non-PROMIS-standard mpMRI aren't that useful.
And the ability/experience/attitude of consultant surgeons varies greatly.

 

Edited by member 06 Jul 2018 at 09:41  | Reason: Not specified

User
Posted 06 Jul 2018 at 09:42

Stevev,

 

I would encourage you to have a DRE and seek a referral to a urologist - just for peace of mind. 

My first PSA came in at 4.2 (a little higher than yours) and my GP asked me to come in. She did a DRE and found nothing untoward. She did though  refer me to a urologist. He also performed a DRE and confirmed the GP's assessment. He went on to say there as an 80% chance of it not being PCA and gave me two choices... I could have a follow up PSA test in six months time or have a biopsy. I chose the latter and unfortunately found myself in the other 20%.  In hindsight, I'm glad I made the choice when I did although, because the initial PSA result was moderately low, I don't think leaving it six months would not have made a jot of difference to my treatment choice and outcome, in my case the likely rise just confirming further investigation was needed.

Flexi

 

 

User
Posted 06 Jul 2018 at 10:15
Interesting views on this.

I'm thinking because I'm lucky enough to have private healthcare via work that maybe I should ask for a referral to a Urologist and sit down with them and have a discussion?

Not sure how I find out who is a good urologist I can refer to, read some reviews somewhere I guess.

Personally I'm more of a better to be safe than sorry sort of guy rather than wait and see.

User
Posted 06 Jul 2018 at 11:47

I would ask for a private referral to a Urologist, who should then refer you in the first instance for a multi-parametric MRI scan at 3T resolution. Hopefully that will put your mind at rest.

Here’s a list of some of the top peer-respected Urologists in Britain. I am over the moon with mine, he’s the one at the Royal Surrey County Hospital.

Britain’s Top Urologists

 
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