Rising PSA, no cancer detected (yet) – seeking shared experiences - Worried about symptoms

User

Posted 04 Aug 2025 at 07:53

Dear community,

I'm a 50-year-old male (born 1975) with no family history of prostate cancer. Over the past two years, my PSA levels have been rising:

April 2023: PSA total 1.03 ng/mL

April 2024: PSA 1.36 ng/mL

May 2025: PSA 3.96 ng/mL, free PSA 0.538 ng/mL (ratio 13.6%)

June 2025: PSA 4.16 ng/mL (confirmed), free PSA 0.565 ng/mL

Parallel test (other lab): PSA 3.91 ng/mL, free PSA 0.92 ng/mL (ratio 24%) → methodologically inconsistent

Digital rectal examination (DRE) and ultrasound were both unremarkable.

Urinalysis showed no bacteria – thus no current sign of infection.

I had an mpMRI (May 2025): PI-RADS 2, no suspicious lesion but signs of past prostatitis.

A PSMA PET/CT (June 2025) also came back negative: no suspicious uptake in prostate, lymph nodes, or skeleton.

Vitamin D was low but is now in normal range (47.3 ng/mL 25-OH and 47.3 ng/L 1,25-OH).

CRP stable around 0.6 mg/L.

Testosterone levels are normal.

No urinary or erectile issues.

Relevant history:

Severe Stevens-Johnson syndrome mid-2024 (due to NSAIDs)

COVID in Sep 2024

Brief corticosteroid therapy Oct 2024

Important note:

My PSA increased by 2.8 ng/mL over 13 months – which translates to an average rise of ~0.22 ng/mL per 28 days. This exceeds the threshold sometimes cited for “biological activity” and might indicate an active process in the prostate.

Current approach:

I'm currently pursuing a conservative, supplement-based strategy:

Sulforaphane (broccoli extract)

Omega-3 fatty acids (high EPA/DHA)

Astaxanthin

Quercetin

Vitamin D

Zinc

No antibiotics or alpha-blockers so far.

My urologist is cautious but not alarmed. Next PSA and free PSA check is planned for late August or early September 2025, along with a follow-up mpMRI.

My question to you:

Has anyone here experienced a steadily rising PSA with negative imaging and no symptoms?

How did you proceed?

Did a biopsy eventually become necessary?

How did you weigh the risk of overdiagnosis vs. delayed action?

Thank you for reading – any shared experience or advice is appreciated.

Mario

User

Posted 04 Aug 2025 at 12:03

Originally Posted by: Online Community Member

Hi Mario,

I'm sorry that you appear to have prostate problems and have had to join us, but welcome to the forum.

Your first post is extremely detailed, well done.

I see that you're only 50 years old and live in Austria. I'm surprised with such a relatively low PSA and negative imagining results that you have had a PSMA scan. Was this done privately? In the UK the NHS would not have given anyone a PSMA scan with your diagnosis

You are probably aware, that other non cancerous prostate and urinary condition can elevate PSA levels. You mention previous prostatitis. Is your prostate enlarged. Both conditions can cause a PSA rise.

Based on the information given. I think you consultant's recommendation of a further PSA test and follow up MRI is the right way forward. I'm surprised though that they'd do another MRI so quickly when your first was only done in May 2025.

You ask, how do you balance the risk of over diagnosis vs delayed treatment? Do you mean the balance of over treatment and delaying any action?

In your position, I'd be very happy to accept your consultants advice. You have no visible lesions and a pirads 2. I doubt any hospital in the UK would consider any sort of radical treatment at this stage. IF later it becomes more likely that you do have PCa, you'll have a biopsy and dependent on the results of that, further treatment may be deemed necessary.

Good luck mate, and please keep us updated.👍

Hi Adrian,

In Austria, if you're enrolled in one of the mandatory public health insurance plans, you can opt for additional private coverage or pay out-of-pocket for extra services. This means, in principle, you can undergo any medical examination—as long as it's either approved by the insurer or paid for through other means.

I assume it's not too different in the UK?

At this point, I don't have any symptoms, but unfortunately, as you know, with PCA that doesn’t mean much. I’ve also sought a second opinion from internationally recognized experts. All of them agree that there’s currently no reason for concern and that there's over a 90% chance that it’s simply prostatitis.

However, the continuous rise in PSA is quite striking, and due to my allergy, I can’t take ibuprofen or similar medications.

The next PSA/fPSA measurement will be crucial. I plan to follow it up with another mpMRI to better detect any changes. In the meantime, I’m looking for similar cases—otherwise, mine is fully documented and might help others down the line.

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Rising PSA, no cancer detected (yet) – seeking shared experiences

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