Increase in PSA from 8 to 35

User

Posted 05 Sep 2020 at 19:03

My PSA increased from 8 to 35 in seven months and I am naturally concerned. I have been experiencing considerable pain while urinating and wondered whether this was due to prostatitis? On my visit to the urologist last week he performed a DRE and found nothing.

I have a 1 cm lesion on my prostate discovered in April 2019 during an MRI. There was no increase in size in the lesion on the MRI performed in Feb 2020. In April 2019 I had an ultrasound biopsy period that came back neutral.

Should I be preparing myself for some bad news?

Many thanks for your help

User

Posted 05 Sep 2020 at 20:28

An increase in PSA simply indicates that investigation is required. A PSA of 35 is quite high, certainly, but there have been many people here with similar or even higher PSA levels who've subsequently been given the all-clear. On the other hand it may indeed be prostate cancer. I'd suggest that your situation assuredly requires an MRI scan and probably a biopsy too. What is your urologist proposing?

Best wishes,

Chris

User

Posted 05 Sep 2020 at 20:41

It seems from your post that you had an image guided biopsy last year and samples of the suspicious area came back clear, you have recently had another MRI, you have seen your urologist again and he is happy. If that is the case then no, I can't see why you would need to prepare yourself for bad news. Did the urologist suggest that the lesion might be prostatitis? Has anyone suggested that you try some antibiotics?

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

User

Posted 06 Sep 2020 at 03:23

I would endeavour to establish cause of what is a considerable rise in PSA. If this can be determined and treated with anti-biotics or whatever and PSA falls, you can then take a more relaxed view. It does seem unusual for cancer to have caused such a rise at the sort of levels you report in such a short time. (With a higher level to start with the percentage rise would have been much less). If other reasons for the increased PSA have been ruled out and your PSA remains the same or increases, I would ask your GP to refer you back to your oncologist.

Barry

User

Posted 06 Sep 2020 at 05:54

What is an ‘ultrasound biopsy period’?

There are two types of prostate biopsies; TRUS, where a probe is inserted up your bum and samples taken through the bowel wall, and transperineal, also known as a target or template biopsy where the sample needles are inserted in the perineum, between your scrotum and anus.

Which one did you have? If you had either of the above, you are probably in the clear (for now).

Cheers, John.

User

Posted 06 Sep 2020 at 11:59

Hi Chris,

Yes, he is proposing an MRI and determinate upon the results a biopsy. They have rushed me in - I had the appointment on Thursday afternoon and I am having the MRI on Monday.

Many thanks for coming back to me.

Paul

User

Posted 06 Sep 2020 at 12:17

Hi Lyn,

Yes, the biopsy was performed in April 2019. I think the biopsy was target template. I was meant to see my urologist in feb 2020 he delayed the follow up conversation to September this year, due to Covid 19. The ! cm lesion hadn't grown in the period of ten months. When I saw him on the 3rd of September he re-did the PSA in the hospital that day - it dropped from 42 to 35 (the previous PSA was done on the 2nd September) He was somewhat concerned, to say the least, and he booked me in for an MRI on Monday 7th September. He is now talking about carrying out a fusion biopsy dependant upon the results.

The prostatitis didn't occur till yesterday (saturday) - so 48 hours after the second PSA test. I have previously experienced an inkling of the current pain I am now experiencing - I have a prostate volume of 109cc. But this is something quite different.

Thanks you for finding the time to reply to my post - it is much appreciated. This is the first time I have been on a forum like this and there seems like there is a lot of knowledge here.

All the best

Paul

User

Posted 06 Sep 2020 at 12:25

Hi John,

I had a target template biopsy (I think). The 1 cm lesion hadn't grown in 10 months (MRI April 2019 and second MRI Feb 2020), but my prostate had: from 103cc to 109. He said that the rise of 2 on my PSA (from 6 - 8) was probably down to this. But 8 to 35 is something altogether different - hence the panic.

Many thanks for coming back to me so quickly.

All the best

Paul

User

Posted 06 Sep 2020 at 12:37

Hi Barry,

I am English but I live in Ireland at the moment. The system is different here, I deal directly with my urologist so there is just a one time referral to a consultant from your GP and then you deal direct. I also have private health cover. Hopefully the MRI will put my fears at rest.

Thanks for replying so quickly - all the best

Paul

User

Posted 06 Sep 2020 at 15:01

Ah okay - that makes more sense. Even so, your prostate is huge so the PSA may still be in proportion to 'healthy' prostate function.

I think that regardless of the findings of this next MRI, I would want my man to have the biopsy - sometimes prostate cancer clusters simply don't show up on scans.

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

User

Posted 06 Sep 2020 at 15:42

Hi Lyn,

I agree wholeheartedly. I'm going to push for a biopsy. Despite the size of my prostate my PSA was never over 8 previously - hence my worries.

Thanks again

Paul

User

Posted 06 Sep 2020 at 15:52

Hi Lyn,

I'm also gaining solace that the DRE was negative: if it is cancer due to the huge jump in my PSA I guess he'd find something - nodules or whatever as it would be quite advanced with a PSA of 35.

Best

Paul

User

Posted 06 Sep 2020 at 20:05

No, it doesn’t work like that. If it was in the thousands you could be sure it was advanced but it is possible to have a PSA of 80 or 100 and no cancer, or a PSA of 3 and extensive bone spread. Plus they can only feel a small part of the prostate during a DRE and with such a large prostate there will be a larger unreachable proportion.

John had a PSA of 3.1, a small prostate at 22cc, soft at DRE and clear MRI. However, the cancer turned out to be in every section of his prostate and through to the bottom of his bladder. The op was unsuccessful and he needed salvage treatment 2 years later.

Be optimistic but assume nothing.

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

User

Posted 07 Sep 2020 at 16:29

I didn't realise that - v sharp learning curve. I've had the MRI today and was told they had good images. I looked at your profile - you've been through the mill. That said John's PSA looks great now - strength to both of you.

I let you know the result when I get them: the last four days have definitely been the longest of my life.

All the best

Paul

User

Posted 10 Sep 2020 at 16:19

MRI came back as stable no changes from Feb, apart form a 1/2 cm lesion that my urologist thinks looks like an ulcer. He believes that this may have caused the huge rise. I've already suggested a template biopsy, re your advice, and he seems happy to go ahead with this. Just need to finish the course of antibiotics and get PSA redone to see if there is a drop.

Thanks for your advice

All the best

Paul

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