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Raised PSA from 5.3 to 8.4

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User
Posted 07 Dec 2023 at 08:41

Good morning -  I'm very worried because my PSA has risen from 5.3 to 8.4 over the period of one year. For the record I'm 67 years old and otherwise in generally good health. 

I had an appointment with my GP yesterday and he did a DRE  which proved inconclusive.

I'm concerned now because the GP said he will refer me to a urologist but he was unable to give me any timeline of when that would happen and I'm concerned that stage 4  cancer might be present worst case scenario which means that there is very little that can be done. This is a scenario which happened to a former colleague of mine who was  given the all clear a year ago but who lo and behold this year was declared to have metastatic prostate cancer stage 4 inoperable and he is now on hormone therapy. 

User
Posted 07 Dec 2023 at 10:59

Thank you, Sir. 

Yes, I used to run marathons, best time, 2:30:40 (2 hours 30 mins 40 seconds). Back in 1980, wearing plimsolls, ASICS Tiger marathon shoes. I went to the USA on an Athletics scholarship. 

I thought running and being slim were assets, but it seems that prostate cancer does not respect BMI and other health factors and I have to live with this. 

Thank you for your support. 

User
Posted 07 Dec 2023 at 08:41

Good morning -  I'm very worried because my PSA has risen from 5.3 to 8.4 over the period of one year. For the record I'm 67 years old and otherwise in generally good health. 

I had an appointment with my GP yesterday and he did a DRE  which proved inconclusive.

I'm concerned now because the GP said he will refer me to a urologist but he was unable to give me any timeline of when that would happen and I'm concerned that stage 4  cancer might be present worst case scenario which means that there is very little that can be done. This is a scenario which happened to a former colleague of mine who was  given the all clear a year ago but who lo and behold this year was declared to have metastatic prostate cancer stage 4 inoperable and he is now on hormone therapy. 

User
Posted 08 Dec 2023 at 01:09

Never mind the PSA, being 67 is the biggest clue that you may have prostate cancer. Once you get above 50 year old your percent probability of having prostate cancer goes up roughly inline with age, so you have a 67% chance of having prostate cancer.

Now when you think about it that must mean an awful lot of your contemporaries have it, but they aren't dropping like flies all around you, and that is because for 80% of men with this cancer they will never even know they have it, they will live to a ripe old age and die of something else.

So the real question is have you got prostate cancer which is aggressive enough that it warrants treatment? That PSA is above normal, but it isn't very high, and the speed it has risen is not necessarily cancer related.

You now need to complete the diagnostic process, and then see what the doctors advise. Hopefully they will suggest Active Surveillance is enough, and you can live another 20 years, fully continent and having erections whenever you want.

You will find plenty of posts on here from men who were not well served by Active Surveillance, it progressed more rapidly than expected, and they needed treatment which may have been too late.

You will not find many posts on this forum about Active Surveillance being successful. That is because the thousands of men who are on it are, down the pub drinking as much as they want, and f****ing as much as they want, and see no need to post on a forum for people suffering from cancer or the side effects of it's treatment.

(This post is in no way meant to detract from those on the forum whose AS failed. It is to try and help the OP see that this forum does not reflect a statistical sample)

Dave

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User
Posted 07 Dec 2023 at 09:38

Hi 26.2,

with a psa at that level it is very unlikely that you have advanced metastatic cancer. It's not impossible, but as I say, it's unlikely.

On the other hand it's almost certain that you have prostate cancer and that's a big thing to get your head around Ahead of you will be evaluating the results of various scans and tests and with that, deciding what treatment will work best for you and how you're going to deal with it.

Keep the pressure on your Dr to move things along and don't hesitate to ask here about what the various options might mean for you.

Sorry to have you join the club but based on the information you've got so far you've caught the cancer early and you will have time to carefully choose what happens next.

Jules

User
Posted 07 Dec 2023 at 10:30

Thank you for your reply. 

User
Posted 07 Dec 2023 at 10:42

Originally Posted by: Online Community Member

Good morning -  I'm very worried because my PSA has risen from 5.3 to 8.4 over the period of one year.

Hello mate,

Nice to meet you, but it's a pity you've found yourself here.

It's been said thousands of times before, and difficult as it may be, try not to worry too much.

Everyone here has experience of prostate problems and they will all do their best to support, and where ever possible, advice you. My advice is takes things one step at a time, try not to get ahead of yourself or start pondering over things that may never happen.

I see your a marathon runner, I guess your user name refers to the 26.2 miles.  To run a marathon you must be strong, determined and resilient, use those assets to help deal with this 'possible' journey.

Best of luck.

Adrian

Edited by member 07 Dec 2023 at 10:52  | Reason: Additional text.

User
Posted 07 Dec 2023 at 10:59

Thank you, Sir. 

Yes, I used to run marathons, best time, 2:30:40 (2 hours 30 mins 40 seconds). Back in 1980, wearing plimsolls, ASICS Tiger marathon shoes. I went to the USA on an Athletics scholarship. 

I thought running and being slim were assets, but it seems that prostate cancer does not respect BMI and other health factors and I have to live with this. 

Thank you for your support. 

User
Posted 07 Dec 2023 at 13:30

Originally Posted by: Online Community Member

Thank you, Sir. 

Yes, I used to run marathons, best time, 2:30:40 (2 hours 30 mins 40 seconds). Back in 1980, wearing plimsolls, ASICS Tiger marathon shoes. I went to the USA on an Athletics scholarship. 

I thought running and being slim were assets, but it seems that prostate cancer does not respect BMI and other health factors and I have to live with this. 

Thank you for your support. 

running and being slim may not stop you getting Prostate Cancer but as sure as hell will help you through any treatment if you ARE diagnosed with PCa. So, keep it going,  keep as active and fit as you can…and be kind to yourself.

And Good luck with your journey, you’ve come to the right place for advice😊

Derek

User
Posted 07 Dec 2023 at 14:12

Originally Posted by: Online Community Member

Yes, I used to run marathons, best time, 2:30:40 (2 hours 30 mins 40 seconds). 

Wow that's quick. Less than 6 minute miles for 26 miles. I used to jog 5 miles a day to keep fit, but couldn't run one sub 6 minute mile.

I agree prostate cancer seems to affect the fit the same as the unfit. There are many fit people on here, including several keen cyclists. 

 

User
Posted 07 Dec 2023 at 14:33

Hi 26.2

I ran a marathon 5 years ago (nowhere near as quickly as you!) and by the looks of things I had this thing growing merrily inside my prostate at the time! It is no respecter of age or fitness, but as Adrian said, you clearly have a strong and determined mindset when needed, so hopefully that will help you deal with the coming weeks of tests/scans/ifs/buts & maybes.....

Good luck, and keep us posted on your progress.

Ian.

User
Posted 07 Dec 2023 at 14:35

Thank you. 

User
Posted 07 Dec 2023 at 14:44

Thank you for that. 

As I'm a recipient of NHS West Yorkshire, hopefully the GP request (yesterday, Dec 6,  2023) to get me to see a Urologist will be done in a timely manner, lest the cancer spreads, if in fact it is cancer - not confirmed yet...but huge red flag with PSA evolution 5.3 -8.4 over past year. Alarm bells and doctor agreeing that those numbers are indeed of concern. 

How high can PSA go for BPH? 

 

By the way, I've been suffering with nocturia since 2014! Learned to live with it. Sometimes 4-6 times per night....One urologist in France (where I used to live) said it might be "nerves." 

Side note: I've noticed in tropical countries (Thailand/Philippines) on holiday, much less trouble with nocturia. Climate, sweating, or less stress? 

User
Posted 07 Dec 2023 at 20:50

Hi 26.2 

I'm sorry that you find yourself here, but glad that you found this site.  There are some very knowledgeable people here who can guide you through every step of any future tests that might be imminent.

The G.P.'s digital rectal examination is not that accurate.  I had a PSA of 13.4 and the G.P. could find nothing untoward, but sent me to Urology because of the PSA score.

You will probably have an M.R.I. scan and a biopsy before they can confirm whether it is cancer or not.  I was lucky in that I had both tests within 2 weeks of referral to Urology but it may depend on your local NHS Trust's waiting list.

I know it's easier said than done, but until all tests are completed, try not to focus on it too much, because it's all "ifs and buts" at this stage.  Try to distract yourself with pleasant activities or just keep generally busy.

IF the tests indicate that you do have cancer, the next stage would usually be for the medical team to offer you a choice of treatments.  That can be a hard decision to make.  Once again, there are plenty of people on here who have experience of every type of treatment, so it's a great place to get more informal information than is usually offered in the official information sheets.

Best of luck to you.

JedSee.

  

User
Posted 07 Dec 2023 at 21:28

Thank you for your informative reply. Hmm, PSA 13, sounds high, but I'm at 8.4, and velocity is concerning, from 5.3 last year. That's a huge factor. Double time velocity. 

I have some reservations about the digital rectal exam based on what happened to me yesterday with the doctor as it was inconclusive and rather unpleasant and the doctor made a remark that my reaction was excessive to the DRE (yes, I'm sensitive). I have reservations because it seems almost pointless based on my experience and the experience of others. Would not an MRI be a more accurate way of spotting potential problems in the prostate? For people of a nervous disposition the DRE exam is really an ordeal in my humble opinion,  or maybe I'm just being a wimp? 

User
Posted 07 Dec 2023 at 21:38

I received a letter the next day after my DRE consultation with my GP so I'm assuming it is  serious and basically the letter from NHS is telling me that Urology at one of the hospitals in my area will contact me in the next two weeks. This has got to mean that it is estimated that I'm a serious case. 

At least I estimate that I'll get to the bottom of this soon and then based on the Gleason score the treatment options will manifest themselves. 

Any recommendations for Dr Walsh and his well-known  prostate cancer book? 

In summation. December 4, 2023, was the blood draw for PSA and the following day I called the surgery and found out that the PSA was 8.4 (up from 5.3 last year, ouch!),  and then the next day December 6, I visited the doctor for the DRE,  and the day after that, December 7, 2023, I got the letter from NHS. I must confess I'm very impressed by the speed at which the NHS is operating at least in my case at this present time.

I'm also on the waiting list for an inguinal hernia with NHS since January 2023 coming up to almost one year but I guess the NHS does not deem that to be an urgent situation. Fair enough I have to be philosophical about the whole thing. I used to live in France and things move much more swiftly there but I'm not complaining as I live here now and so I shouldn't complain. 

User
Posted 07 Dec 2023 at 21:54

Any recommendations for Dr Walsh and his well-known  prostate cancer book? 

Yes I would get a copy of the latest/5th edition, very informative and thorough. It could wait though till after Christmas.

Follow thru on any scans, tests etc offered.

P.

Edited by member 07 Dec 2023 at 21:59  | Reason: Not specified

User
Posted 07 Dec 2023 at 22:05

Originally Posted by: Online Community Member
How high can PSA go for BPH?

Not out of the question with your nocturia but only the tests will tell.

Being fit and slim is a huge help, if you've got to deal with cancer.

Jules

User
Posted 07 Dec 2023 at 22:41

Thank you for the advice and even though I can't run anymore because of my age and problems with my hip I still do a lot of exercise every day comprising swimming cycling and walking. In addition my BMI is around 21 so in the normal range. 

One of the main concerns I have is that if I'm diagnosed they will recommend hormone therapy and from what I have learned hormone therapy is really something I don't want to do with all the side effects and it seems really unnatural to me even though I know that the objective of hormone therapies are  to reduce or nullify the testosterone which cancer feeds on. 

User
Posted 08 Dec 2023 at 00:20

Originally Posted by: Online Community Member
if I'm diagnosed they will recommend hormone therapy and from what I have learned hormone therapy is really something I don't want to do

If you have cancer and if it's locally contained you could be offered a prostatectomy with no hormone therapy.

There can be marginal situations where a prostatectomy comes with the risk of leaving something behind in which case it's onwards to radiotherapy and probably some hormone therapy as a secondary treatment.

Sometimes, where cancer has moved outside the capsule and even into lymph glands or bones a prostatectomy might not be the best option for staying alive and a choice won't be an option. Then, it's radiotherapy/hormone therapy.

Let's wait and see but please don't pre-judge your course of action without knowing what you're up against [or not up against]

Jules

User
Posted 08 Dec 2023 at 00:58

Originally Posted by: Online Community Member
How high can PSA go for BPH?

Potentially, up to about 60 - 80 depending on the size of the prostate 

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

User
Posted 08 Dec 2023 at 01:09

Never mind the PSA, being 67 is the biggest clue that you may have prostate cancer. Once you get above 50 year old your percent probability of having prostate cancer goes up roughly inline with age, so you have a 67% chance of having prostate cancer.

Now when you think about it that must mean an awful lot of your contemporaries have it, but they aren't dropping like flies all around you, and that is because for 80% of men with this cancer they will never even know they have it, they will live to a ripe old age and die of something else.

So the real question is have you got prostate cancer which is aggressive enough that it warrants treatment? That PSA is above normal, but it isn't very high, and the speed it has risen is not necessarily cancer related.

You now need to complete the diagnostic process, and then see what the doctors advise. Hopefully they will suggest Active Surveillance is enough, and you can live another 20 years, fully continent and having erections whenever you want.

You will find plenty of posts on here from men who were not well served by Active Surveillance, it progressed more rapidly than expected, and they needed treatment which may have been too late.

You will not find many posts on this forum about Active Surveillance being successful. That is because the thousands of men who are on it are, down the pub drinking as much as they want, and f****ing as much as they want, and see no need to post on a forum for people suffering from cancer or the side effects of it's treatment.

(This post is in no way meant to detract from those on the forum whose AS failed. It is to try and help the OP see that this forum does not reflect a statistical sample)

Dave

User
Posted 08 Dec 2023 at 06:42

Thank you, Jules. Will keep these options in mind. 

User
Posted 08 Dec 2023 at 06:45

60-80 seems huge for PSA, but based on DRE, I don't think my prostate is that large. 

How is prostate size measured? 

Thank you. 

User
Posted 08 Dec 2023 at 06:52

Thank you for your interesting reply and I will certainly keep those things in mind. Yes, I understand, for example,  that a Gleason score of 6  is not really of concern and  people with that score may go on active surveillance. I also understand your point about people on active surveillance getting complacent and not posting here anymore and that makes perfect sense although as you do suggest that might be a mistake for some people. 

Even if I'm fortunate enough to be the so-called victim of a low-grade cancer where active surveillance might be an option I will make sure from now on in to monitor my PSA at least twice a year and consult if the PSA shows a rise  which is deemed a concern. Unless mistaken,  it seems that the PSA is the monitoring system which best suits patients to assess the progress of this disease -  prostate cancer. 

 

Thank you, Sir. 

Edited by member 08 Dec 2023 at 06:53  | Reason: Not specified

 
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