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Psa levels.

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User
Posted 26 Oct 2024 at 10:35

Im 52 and had my first psa back in January 2024 and it came back 4.7 I agreed to have an Mri scan. This came back clear with a prostate of 27ml. I have since had 2 more psa tests April 5.4 June at 5.1. I am due another 2 psa tests to see if there is a pattern.

How much can psa levels go up and down and can you naturally have a higher psa level.

User
Posted 26 Oct 2024 at 15:52

Antman, I worked will a guy who often had a PSA of around 200, despite several biopsies, including template biopsies they never found any cancer. At the other end of the scale some prostate cancers give off very little PSA. 

Cycling,and ejaculating can affect PSA levels but some studies show the rise is for a very short time. There was a conversation on here about the time of day causing variations. There are also people on here who have reported seasonal variations. I have asked several consultants etc about fluctuating PSA levels and none of them can give a definitive answer.

Your PSA is reasonably steady, as long as it's not rising rapidly don't get stressed out. What have your medical team recommended. 

Thanks Chris 

User
Posted 26 Oct 2024 at 18:16

You are already above the limit for your age (NICE 3.5, BAUS 3.9, CHAPS 3.0, Europe 3.0). So I would say you should be getting regular PSA checks, and another MRI no more than a year after the last one, and sooner if your PSA continues rising. If you are a high risk patient (Black African or Caribbean, or father or brother has had prostate cancer), they should really be offering you a biopsy even though MRI isn't showing anything - it doesn't catch all significant prostate cancers.

I presume you've been checked for a UTI? Also, having COVID and some COVID vaccinations temporarily pushes up PSA for a month or so afterwards.

Your prostate isn't enlarged, so that doesn't account for higher PSA.

User
Posted 26 Oct 2024 at 19:09

I am having another psa test this week then again in months.  No family history and white .

Edited by member 26 Oct 2024 at 19:10  | Reason: Not specified

User
Posted 26 Oct 2024 at 21:12

Chris,

That is great that you have a baseline MRI that can be compared with a new one when that times come you need another. Small Variations in the PSA going up a little, down a little is normal but keep tracking the numbers for a trend every 90 days, especially if it begins to rise even slowly but rising. I don’t know if you have access to something called ExoDx or something similar. It is a non invasive urine test that assesses your risk of having clinically significant or high grade prostate cancer. The test works by analyzing prostate cancer specific genomic biomarkers that are highly expressed during tumor cell growth and found in the urine. If you have a low score it means even with cancer that the cancer is likely a lower risk prostate cancer or benign on biopsy. The results could then lead to the MRI or biopsy, or begin a careful active surveillance program. Since you have already had an MRI this might for your peace of mind determine yes or no the likelihood of any cancer cells, and if it does reflect some for you to watch your PSA real close and determine the appropriate time for another MRI. I was like you my PSA started jumping around in my case from a normal consistent number up, up, down, up, down but not by alot. My first MRI was negative and after continuing to watch my PSA for a year had the ExDxo test done and it exceeded the lower threshold. This encouraged my urologist to get another MRI and then it showed changes and then the biopsy. Google the test. In the states your Doctor orders from the company and they send it to your house. You provide the urine sample and return it to the lab. I would think if the UK does not have this specific test, they must have something comparable but by another name.

User
Posted 02 Nov 2024 at 14:01

Just got my results from my latest Psa it has gone up to 6.4. I spoke to a nurse about mri scan I had in January and was told my pirADS score was 2.  Next course of action is another psa test in January and a follow up appointment with Dr beginning of February. I am worried sick that I have prostate cancer. 

User
Posted 02 Nov 2024 at 14:53

I am sorry that you are facing such a worrying time. I am no medical expert just a partner to someone diagnosed with prostate cancer. However if you were my partner I think I would be suggesting a further MRI for the following reasons. Your PSA is high for a man of your age and your prostate is small so you probably do not have BPH. It is possible you could have some infection either prostatitis or a UTI but I assume your doctors have ruled out this possibility as a reason for your elevated PSA. My husband had a MRI which did identify one tumour but missed three others and these other tumours were not identified at biopsy either. They were diagnosed following his prostactomy. I suppose you could argue what’s the argument for further MRI if it misses some tumours but I think it is the best tool we have available at the moment.

I do know men with very high PSA who do not have prostate cancer but they tend to be older and have enlarged prostates. Perhaps that says more about my contemporaries being older now.

Wishing you all the very best.

 

Edited by member 02 Nov 2024 at 14:56  | Reason: Punctuation

 
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