Hi -- been on this rollercoaster, which I'm sure is familiar to everyone here, since a few days ago.
My recent history:
I'm 52 years old. Went for a general health checkup back in mid-2021 (aged 50) because I was getting concerned about getting up 2-3 times a night to urinate. DRE was normal. They gave me the whole talk about PSA tests being somewhat controversial with some, asked if I wanted one. I did. PSA level came back as 1.0. Went away reassured.
Over the following two years had annual DREs -- always normal. In fact two separate doctors commented that prostate was if anything "on the small side" -- which I found reassuring.
Last week (ie 2023) had another check up (I have private health insurance thru work) and another DRE which was normal - only to discover PSA had shot up to 9.7. A real bolt from the blue, cold bucket of water to the face sensation. I'm sure everyone's familiar with it. Not nice.
Urgent referral with urologist was made for the following day. He said we'd do an MRI followed in all likelihood by a biopsy. He did a DRE -- again all normal, he also commented that prostate is if anything a little small, also "maybe slightly firm on one side" but that was all. Also got me to do a urine flow test which seemed to show some kind of 'stop-start' issue with flow. Took another blood sample and also a urine sample and said he'd call when the results came back.
I spent the weekend Googling and managed to both reassure *and* terrify myself intermittently. I know there could be many causes, that the stats on PC generally are better than many other cancers... but also the fact that my prostate was described as 'small' yet was producing a PSA number so high -- which had spiked so fast -- really concerned me.
Urologist rang this morning to say my PSA has *dropped* to 6.5 and the urine test "to his surprise" shows some evidence of UTI (I haven't had symptoms beyond frequent peeing and *maybe* a very slight burning sensation about two weeks ago).
Urologist is sensibly v pragmatic and says he's "keeping an open mind", and that the MRI should go ahead as planned. He's prescribed antibiotics and we will retest PSA as well.
I'm clutching at any crumbs of comfort I can find obviously so I've taken this development as a "cautious positive". When I pressed the urologist (eager for as much reassurance as possible basically!) he said words to the effect again that he's keeping an open mind but I'm "maybe in a better position than last week".
To be clear, I'm not questioning whether the MRI is still necessary -- in fact I want to do it as soon as I can since I want as much clarity as possible. (Clarity is what we all crave). If I can avoid a biopsy then great, but again, if there's any chance one would be needed, I'm keen to do that too.
What I'm wondering is whether it's normal for a PSA to drop by so many points over a few days (the two blood tests were performed 3 days apart). Is this just a normal level of fluctuation or a sign of a reassuring fall? Could a mild UTI alone be responsible for the initial spike and then fall? Am I misguided to be clinging to positives here?
Sorry, I know there are many many possibilities -- just felt it helpful to discuss with people who've walked this path before.