Sudden concerning rise in PSA

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User

Posted 22 Nov 2021 at 09:37

I’ve been on active surveillance since January 2020. Initial PSA 4.2 and remind around that for over a year. in May 2021 it rose to 5 and I have another biopsy. Results were that the lesion has only grown slightly and to continue active surveillance.

in October 15 it rose to 6.4 and asked to repeat four weeks later it is now 8.2.

but surprisingly I am rather shocked and quite anxious. I am first worried I am no longer suitable for HIFU and that it has turned quite aggressive.

This is particularly concerning apart from the anxiety around having an aggressive cancer because I’m not really suitable due to other conditions for radiotherapy and then definitely not radical prostatectomy.

User

Posted 22 Nov 2021 at 10:30

Okay - first thing to know is that the cancer doesn't usually change from one kind to another.

You were diagnosed with a small G3+4 where the 4 element was less than 5% - in almost all circumstances you will remain G3+4, it doesn't start to change into a G4+4 then G4+5 and then G5+5. So a rise of 20% in one month is not likely to be because the cancer has morphed into something else since May.

The second thing to know is that if the affected area had only grown a little between diagnosis and May this year, it is unlikely to have become extensive since then.

Having said that, it does seem that AS is not working for you because your PSA is not stable. It seems to me that it would be sensible to ask for a referral to a HIFU specialist now; due to your other medical issues, it might be that you can get HIFU on the NHS somewhere? You could also ask the urologist (or phone the PCUK nurses) whether any cryotherapy trials are recruiting at the moment.

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

User

Posted 22 Nov 2021 at 10:41

Thanks for that calming reply - i manage the anxiety of AS relatively well until recently and this has rather taken me by surprise

I am already under a consultant urologist HIFU specialist and they asked me to get the repeat PSA - am waiting for response to the new higher reading -

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