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PSA keeps rising

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User
Posted 13 Mar 2022 at 19:25

Hi,

I’ve posted here before. My PSA has gone from 1.8 in October to 4 in December, 4.9 in February and now 5.9. 

No infection, small prostate (29 cc) and no BPH.

I had mpMRI with Pirad 4 last year but negative biopsies (atrophy and inflammation). I’ve also had high grade bladder cancer but am currently NED. I’m 50 and have a strong family history of prostate cancer.   

I have a cystoscopy check for my bladder cancer this week. Just wondering if anyone has any ideas of what I should push for next, if anything? I’m really worried now. 

User
Posted 14 Mar 2022 at 01:43
Another MRI and targeted biopsy
User
Posted 14 Mar 2022 at 15:29

What sort of biopsy did you have?   A 12 pin trans rectum standard or 24+ pin transperineal?    Pirads 4 is a likely cancer present, the biopsy might have missed it, your psa was much lower then so it will have been smaller.

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User
Posted 14 Mar 2022 at 01:43
Another MRI and targeted biopsy
User
Posted 14 Mar 2022 at 15:29

What sort of biopsy did you have?   A 12 pin trans rectum standard or 24+ pin transperineal?    Pirads 4 is a likely cancer present, the biopsy might have missed it, your psa was much lower then so it will have been smaller.

User
Posted 14 Mar 2022 at 15:59

Thanks for your reply Peter. It was a targeted transperineal biopsy so 6 needles in total (3 from each lesion). I asked afterwards if it was normal to take so few as I’d read 12 was the norm but didn’t really get a clear answer why. 

User
Posted 14 Mar 2022 at 16:03

Thanks francij1. My GP says wait another 3 months, which worries me. It seems the threshold for MRI and biopsy is pretty high. I will ask the urologist I meet at my check up tomorrow. 

User
Posted 15 Mar 2022 at 15:46

Thanks for your responses. I had my cystoscopy today and the urologist told me my PSA levels are concerning but my bladder cancer now looks like it could be back and that is more urgent. So I have an operation in the next couple of weeks to remove the new lesion and if it’s the same aggressive type as before, bladder and prostate etc will be removed. Not feeling very happy today😕! 

Edited by member 15 Mar 2022 at 16:19  | Reason: Not specified

 
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