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Is there a scale for PSA scores?

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User
Posted 20 Dec 2023 at 14:52

Is there a scale for scores that helps people understand how good or bad their level is? As a newbie I would like to know where my PSA score of 11.7 sits. Thanks

User
Posted 21 Dec 2023 at 17:54

For your age the normal PSA should be around 6 and generally the severity of the cancer rises as the PSA level increases and depending on the source of information PSA over 10 (some consultants think over 20) may indicate that the cancer has spread beyond the gland but I don't think you should jump to conclusions. It is early days for you. There are many other factors to be considered before you can get an accurate diagnosis and then think about your treatment options. I was about your age when diagnosed 12 years ago. The treatment options have improved considerably since my prostatectomy. Your  prospects are very good.

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 21 Dec 2023 at 19:16

Made me laugh, thanks

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User
Posted 20 Dec 2023 at 15:08
Medium. More than 20 would be high risk.

But, prostate cancer isn't that simple so without a biopsy you don't really know.

User
Posted 20 Dec 2023 at 20:31

People talk about risk in different ways. If you've only had a psa test and not a DRE or MRI then under 10 will be lower risk of actual cancer. 10 to 20 medium risk and over 20 higher risk and higher risk of spread.

PSA by itself is very unreliable. It can be inflammation in many cases, even up to psa 400.

After more tests psa still has the same boundaries but it is used to categorise whether you should get treated as low risk or slow growing or high risk faster growing

So it gets more complicated see below for one way to look at it. There are other ways.

 

Note the below is American. It was the best my first search showed and I've cut bits out.

 

Risk Groups

Your prostate cancer doctors will use your test results to determine your risk group, which is a way categorizing the overall severity of a case and applying evidence and experience to inform your treatment options. There are 3 general risk groups 

 

  1. Low risk: Tumor is confined to the prostate, and the PSA is <10 and grade group 1 (Gleason 6). 

  2. Intermediate risk: Tumor is confined to the prostate, the PSA is between 10 and 20, or grade group 2 or 3 (Gleason 7). This category is often divided into a “favorable” and “unfavorable” intermediate risk.

  3. High risk: Tumor extends outside the prostate, the PSA >20, or grade group 4 or 5 (Gleason 8 to 10). There is also a subset of very aggressive tumors is called “very high risk” in which the tumor has extended into the seminal vesicles (T3b) or the rectum or bladder (T4), or there are multiple biopsy samples with high grade cancer.

These risk groups are not perfect indicators.

Edited by member 20 Dec 2023 at 20:41  | Reason: Not specified

User
Posted 20 Dec 2023 at 23:09

As an indication that the above rating can be wrong, at age 73 I had a psa of 9 which rose to 10 around the time of my treatment but my diagnosis after testing was G9, locally advanced with some invasion of seminal vesicles and three nearby lymph glands. High risk, locally advanced.

Based on psa alone, using the above guide, I would have been low risk but a biopsy and a PSMA PET scan quickly changed that.

Jules

Edited by member 20 Dec 2023 at 23:10  | Reason: Not specified

User
Posted 21 Dec 2023 at 03:23

As has been stated PSA of itself is an unreliable test particularly as a diagnostic tool. There are different types of PCa and some produce more PSA than others. Another variable is age where the range increases with age, There could be an unusual situation where a man with a PSA of 3 or less has PCa but a man with a PSA of 80 doesn't. PSA is a rather more (but not inflatable) indicator after treatment where base figures and other tests/scans provide a base following which subsequent PSA tests help show how treatment worked and the pattern of increase can often help learn whether cancer is still within the Prostate/Bed or elsewhere.

PCa and it's treatment is complicated. Furthermore despite similar statistics, treatment may vary from man to man as individually offered as appropriate and an individual making a choice where given choice. I recommend you read or obtain the 'Tool Kit' from this charity that will understand more about the disease. https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100

 

Edited by member 21 Dec 2023 at 03:23  | Reason: To highlight link

Barry
User
Posted 21 Dec 2023 at 14:08

Peter, thanks for your reply. I've had two PSA test three weeks apart which went from 11 to 11.7. Seems everyone wants to give me a DRE as I have had four now. Had a MRI and at a meeting with a consultant he said it is important to have a biopsy, but no date yet. Since that meeting I have read some of the great articles on this site and realise I was not told what my T was after the MRI. Should they have let me know?

User
Posted 21 Dec 2023 at 14:24

Originally Posted by: Online Community Member

Had a MRI and at a meeting with a consultant he said it is important to have a biopsy, but no date yet. Since that meeting I have read some of the great articles on this site and realise I was not told what my T was after the MRI. Should they have let me know?

Hi Derek.

As I understand it, your MRI scan should give a radiological cancer staging. Your biopsy is usually guided by the MRI scan. The histology of the biopsy will give you a Gleason score, and could as in my case, detect cancer unseen by the scan. The MRI and biopsy results will give you a cancer staging which combines both. 

I would have thought they'd informed you of your MRI cancer staging.

Edited by member 21 Dec 2023 at 14:31  | Reason: Not specified

User
Posted 21 Dec 2023 at 17:48

Originally Posted by: Online Community Member

Seems everyone wants to give me a DRE as I have had four now...

Many years ago when I was young a friend of mine who was in his 60s said, "I've reached the age, where whenever I walk into a hospital, someone wants to shove something up my arse"

I guess we've all reached that age now.

Dave

User
Posted 21 Dec 2023 at 17:54

For your age the normal PSA should be around 6 and generally the severity of the cancer rises as the PSA level increases and depending on the source of information PSA over 10 (some consultants think over 20) may indicate that the cancer has spread beyond the gland but I don't think you should jump to conclusions. It is early days for you. There are many other factors to be considered before you can get an accurate diagnosis and then think about your treatment options. I was about your age when diagnosed 12 years ago. The treatment options have improved considerably since my prostatectomy. Your  prospects are very good.

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 21 Dec 2023 at 19:16

Made me laugh, thanks

 
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