PSA response to antibiotic

User

Posted 23 Oct 2023 at 06:10

Hello,

I'm 48-years old, with no history of prior illness.

My PSA jumped (doubled) from 0.75 (in August 2022) to 1.53 (in August 2023).

DRE (in August 2023) was normal: smooth, no nodules, no pain felt when doctor pressed on prostate to check for infection. Though I didn't have any pain or symptoms, the doctor noticed my prostate size has significantly increased during 12-months period, so he decided to put me on Doxycycline 100mg for 4-weeks, and recheck PSA after 5-weeks; ie, October 2023 my PSA came back 1.12 and %FreePSA was 33%.

I have a couple-of-questions to this group of experts:

First, was PSA drop from 1.53 to 1.12 significant enough to rule that prostatitis was the culprit? Is it fair to say prostate responded well to the antibiotic treatment? I ask because I'm still higher from my last year's baseline 0.75.

Second, has there been cases of finding prostate cancer at PSA 1.12?

Any input from you is greatly appreciated and welcomed.

Thank you again.

Omar

User

Posted 23 Oct 2023 at 15:16

A fluctuating PSA is a pretty sure sign that something other than cancer was the cause. With cancer your PSA goes in only one direction: upwards.'

There are VERY rare types of prostate cancer called "small cell" prostate cancer which doesn't secrete PSA, but with a PSA which is well within the normal range, and has dropped in response to treatment with antibiotics, there is absolutely no reason to suppose that you have any form of prostate cancer.

Best wishes,

Chris

User

Posted 25 Oct 2023 at 08:18

Omar, for a man in his 40 or 50s, a PSA level up to 2.5 is considered normal. Checking your PSA again in six months time sounds like a very good idea.

Chris

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User

Posted 23 Oct 2023 at 15:16

A fluctuating PSA is a pretty sure sign that something other than cancer was the cause. With cancer your PSA goes in only one direction: upwards.'

Best wishes,

Chris

User

Posted 24 Oct 2023 at 06:17

Originally Posted by: Online Community Member

With cancer your PSA goes in only one direction: upwards.'

perhaps, the trend with cancer is upwards, but PSA can still fluctuate from one test to another.

User

Posted 24 Oct 2023 at 08:32

Hi auriga,

At what age and PSA level was your onset? In other words, did you have symptoms or you tested one day and your PSA level was elevated? And at what pace (velocity) your PSA kept rising until diagnosis?

Do you have family history of prostate cancer?

Thanks,

Omar

User

Posted 24 Oct 2023 at 15:39

It might be unusual but my husbands PSA went from 3 to 20.15 in a year. This lead to scans more PSA tests and a biopsy.During this process he had readings of 5.9 and 2.8. So they think infection raised PSA. However biopsy showed cancer.

User

Posted 24 Oct 2023 at 17:06

My PSA started near 30 but fell to near 20 over the month I was being diagnosed. I suspect I had infection which fortunately led to investigation which then discovered cancer on the biopsy.

Dave

User

Posted 24 Oct 2023 at 18:55

Originally Posted by: Online Community Member

My PSA started near 30 but fell to near 20 over the month I was being diagnosed. I suspect I had infection which fortunately led to investigation which then discovered cancer on the biopsy.

same with my husband, without the suspected infection we wouldn’t have had the diagnosis. Now awaiting treatment which we don’t have a date for yet, the waiting is hard.

User

Posted 24 Oct 2023 at 21:05

Reading Dave's and Turkey2222's stories make me wonder if I should go in for biopsy, especially there was never an evidence for infection or urinary symptoms. My only observation was a slight drop in PSA (1.53 to 1.12) after a course of Doxycycline (antibiotic), which could've been (antibiotic treatment) a red-herring.

Thanks,

Omar

User

Posted 24 Oct 2023 at 21:19

Originally Posted by: Online Community Member

Thanks,

Omar

what does your doctor say about the need for that?

User

Posted 24 Oct 2023 at 22:36

Biopsy option wasn't brought up, but he wanted me to recheck PSA level in 6-months; ie, April 2024.

Thanks,

Omar

User

Posted 24 Oct 2023 at 22:44

Hi Turkey2222,

How old is your husband? Does he have family history of prostate cancer?

Do you know what's his %FreePSA?

Thanks,

Omar

User

Posted 24 Oct 2023 at 22:54

Originally Posted by: Online Community Member

Hi Turkey2222,

How old is your husband? Does he have family history of prostate cancer?

Do you know what's his %FreePSA?

Thanks,

Omar

hes 66

no family history

No idea of free PSA this year as tested here in uk, but last year it was0.68 ( tested overseas)

User

Posted 24 Oct 2023 at 23:03

Hi Turkey2222,

Can you please elaborate more on the 0.68?

0.68 was his Total PSA or Free PSA.

I was curious about his percentage %FreePSA, so the number should be a percentage.

Thanks,

Omar

User

Posted 25 Oct 2023 at 00:17

Hi Omar, I know my PSA was falling, but it was from a very high level. Your PSA is not very high. I think regular PSA tests to see what level it falls to and if it starts to rise again would be a reasonable way to monitor things. Of course if your urologist thinks differently then he is right.

No one in the UK knows their free PSA, it never gets measured here. I know it is supposed to help diagnosis, but our health service doesn't think it is worth measuring.

Dave

User

Posted 25 Oct 2023 at 05:00

Hello Dave,

Excuse me if I'm being extra paranoid, but I promise you that I'll be able to handle your brutal honesty :-)

Do you think PSA 1.12 is high for my age (48-years)?

Do you think PSA velocity (0.75 from last year) to today's PSA 1.12 is fast?

Thanks,

Omar

User

Posted 25 Oct 2023 at 08:18

Omar, for a man in his 40 or 50s, a PSA level up to 2.5 is considered normal. Checking your PSA again in six months time sounds like a very good idea.

Chris

User

Posted 25 Oct 2023 at 16:26

Thank you for the feedback, Chris :-)

Later,

Omar

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