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When is a PSA level 'raised'?

User
Posted 29 Sep 2022 at 11:17

Hello everyone,

I've been having 3-monthly PSA tests for a while now since it was flagged up as 'raised'.

Went for an MRI January 2021 - nothing found.

Since then the levels have been:

April 21 - 3.89

July 21 -  4.19

Nov 21 - 5.58

Feb 22 - 5.09

May 22 - 3.74

Aug 22 - 4.93

So, fluctuating.

I have no symptoms other than these raised levels. The urologist seems happy to continue with these 3 monthly tests. He did think my cycling to work might be affecting it, but I refrain from cycling well before any test, and in any case it's not 'vigorous' cycling and is a short distance.

Should I be concerned? I forgot to say that I'm nearly 61.

Edited by member 29 Sep 2022 at 11:51  | Reason: Not specified

User
Posted 29 Sep 2022 at 11:53

Hi it may depend on your age but i had a PSA 2.19 with no real symptoms apart from microscopic blood in sample at 70 so had more investigations.

John.

User
Posted 29 Sep 2022 at 15:23
If you had prostate cancer your PSA would be steadily increasing. Fluctuating levels like this may indicate another prostate condition, but it doesn't look like one would expect from cancer. Monitoring it with 3-monthly testing seems like a good course of action.

Best wishes,

Chris

User
Posted 30 Sep 2022 at 15:42

In November 2021 you would have been worrying that the next one will be 7.   But it went right down and still hasn't reached its former peak.

Once you start on this it can ratchet up so you're convinced you need treatment when looking back you'd decide you didn't. 

The three months testing sounds thorough. 

If it was me I'd also be wondering why and whether there is some inflammation that could be treated.  There are men who get very high psa due to inflammation.  Cheers Peter

User
Posted 30 Sep 2022 at 19:27

My husband had a PSA done 9/6 and his level was 81.2 referred to urologist and new test was done today, level is now 87.1 CT scheduled for this afternoon. Is this considered a rapid increase? This is all new to us. 

User
Posted 30 Sep 2022 at 19:39
It would be a good idea to start your own discussion thread rather than posting in someone else’s.

Best wishes,

Chris]

User
Posted 30 Sep 2022 at 19:50

 Sorry thanks for the instructions.

User
Posted 25 Oct 2022 at 21:45

Your case seems similar to mine with the difference that currently I am 52 y/o.

19/05/2015

PSA 6,26 (posible infection, positive semen culture, bacteria  sensible to ampicillin, first course of this type of antibiotic)

30/06/2015

PSA 2,55 (still positive semen culture, new round of ampicillin stronger, instead of 500 mg each 8 hours, 1000 mg each 6 hours)

20/08/2015

PSA 2,58 (semen culture negative)

26/05/2016

PSA 2,23

01/06/2017

PSA 2,44

17/05/2018

PSA 2,99

07/05/2019

PSA 4,27 (semen culture negative)

12/06/2019

PSA 2,68

13/07/2020

PSA 4,93

03/08/2020

PSA 4,63

03/09/2020

PSA 4,45

16/09/2020

PSA 4,54

07/10/2020

PSA 5,85 (after course of antibiotics -cefuroxime- although I suggested the urologist to have ampicillin, he refused and prescribed cefuroxime instead)

21/10/2020

MPMRI - findings: post-inflamatory changes in peripephal zone. 

Two months later course of antibiotics -ampicillin- (although negative semen culture) prescribed by my general doctor as I wasn't able to obtain an appointment with my urologist.  I had blood in my semen and a small fever. At the beginning I thought it was covid. (It started with fever and the blood in the semen showed two days later). 

20/04/2021

PSA 3,64

17/11/2021

PSA 3,59 - I though it was less than 4 because in september I had another course of antibiotics - ampicillin- because a non-related small surgery in other part of my body. 

27/04/2022

PSA 4,28 (back again over 4, although I had strange sensations in my penis, probably infection again, although negative urine analysis and negative semen culture)

Taking into account the size of my prostate in the MPMRI on october 2020 (41,73 cc), the psa density at this time was less than 0,15. My urologist told me that acording to the density charts with the result of my MPMRI, he thought that my chances at this time of having prostate cancer were less than 1 out of 10-15. He told me that there is even a study where they say 1 out of 30 when psa density is less than 0,15 with a clean mpmri.

Taking into acount this, he prescribed PSA measurings every six months.

Last one six months ago, I thought he was going to prescribe another mpmri, but as the free psa went up to almost 20% he prescribed again psa measurements in 6 months (almost now). He told me again that he thinks it is chronic prostatitis.

Now crossing fingers hoping PSA less than 4 again (hopefully) in next bloodwork... (I plan to measure again in two weeks time).

Lots of symptoms, much worse since when I had blood in the semen in december 2020, (namely the caliber became very thin) the rest of the sympthoms similar, weak stream, many times going to the bathroom... and never improved since then. Let's hope that it is prostatitis and nothing more.

Good luck.

 

Edited by member 25 Oct 2022 at 22:17  | Reason: more information

User
Posted 21 Nov 2022 at 11:33

Hello again.

Well, I had another PSA blood test last week and await the result (last was 4.94)

I received a letter from the NHS even before the test saying that my telephone appointment to discuss the result would be on 29/12/22 which seemed far too long to wait.

Incredibly that appointment has been cancelled and re-scheduled for (wait for it) 22/2/23 - next year!

Surely this can't be right?

If the level is raised again the urologist said I'd be offered a repeat MRI. Thing is, we're not even going to discuss that until 22/2/23 and if it is raised then I'll have to go on a list for the MRI, then wait 2-3 weeks for the result, then if there is anything there another wait for a biopsy and the result of that.

Is anyone else experiencing these long waits?

Hopefully last week's result will be lower and I'll continue on 3-monthly tests.

 

User
Posted 21 Nov 2022 at 13:59
Given that your PSA is fluctuating rather than steadily increasing, it seems unlikely that you have prostate cancer, so your referral is presumably going down the "routine" pathway rather than the two-week urgent one for cancer. Waits of several months are entirely normal for routine referrals, I'm afraid. I was referred for a non-cancer urology condition in August, had an appointment for 21st Dec but now that's been cancelled and no new appointment yet. Just the way things are, unfortunately.

All the best,

Chris

User
Posted 29 Nov 2022 at 14:21

Well, after all that my last test went DOWN to 3.94. 

Go figure.

My PSA level goes up and down like the Assyrian empire.

I'm guessing an infection. Thanks for the responses though - always re-assuring.

I'll probably remain on 3-mothly tests.

User
Posted 29 Nov 2022 at 18:18

Great news, fingers crossed it will remain low for you and antibiotics will clear any infection 👍

User
Posted 12 Dec 2022 at 10:51

Hello, my psa has fluctuated over the past 3 years so on active surveillance every 3 months atm. Next blood test tomorrow in fact! Frustrating as hell living from one blood test to the next waiting for bad news. 
However consultant does not think it’s PCa standard mri and mp mri negative. Had an episode of AUR a couple of months back but go over that quite quickly and been fine since.

I totally understand your thoughts on this, but like me you are now in the system.

best of luck

 
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