Need your expert opinion about this PSA

OK, after a few years of my "suggestions," my son, who is 36 years old, finally got his PSA done.

His result is 1.29.

Keep in mind his father, paternal grandfather, and maternal grandfather all had PC.

Looking at my own records, my PSA was 1.20 at age 49 (my first such test).

He was told his is fine and anything below 2.5 is fine.

I will concur in the sense that there is nothing to be done now, but he should continue doing his PSA maybe every few years.

But what is your opinion about this result.

Mel

Mel. First, I am no expert and the number of posts you represent in comparison to mine make you far more of an expert than me. Here goes an unprofessional opinion. PSAs (plural) over time that indicate a significant upward trend are cause for concern no matter how low they may be.

My GP told me year after year that I was doing great because I was less than 4. The realty is that I could well have had PC 5 to 10 years prior to the telling biopsy. That said I could have caught this beast with only a G6, fewer cores, no PSAv, and no PSAD issues.

Just an opion.

How big is their estimate for prostate size?

You can recommend a 2nd opinion. You didn't say but I would believe that the first testing and reading was done by a primary care physician. I would believe that depending on whom he would see in the urology world would probably be as divided on the screening/baseline as the discussions here. I know quite a few guys in the 30's that did have a PSA in this range get biopsy with PCa being found. They were mostly treated with RP as well.

Thus the conundrum. Further testing and biopsy could in fact lead to immediate treatment even if a cancer found would fall under Epstein Grade 1 (6 or less) and be ideal for monitoring. The problem is that I doubt many physicians would recommend it still for a man in his 30's.

Every single year!! Because of family history because early detection gives best chance for cure and because this is the the silent but deadliest cancer!
I don't know of any man who would want to be where Dave and I are .Stage 4 metastic prostate cancer. Psa at diagnosis 80 last months 2,389 prognosis May 6 th 2-4 months All because the nurse practitioner wouldn't do a Dre exam wouldn't check the box off for psa . Told Dave at 57 to young to worry about prostate cancer! Following year syptomatic was told things are age related! , We would give anything if we could redo this horrible death sentance. We are the stongest supporters of PC screening there is .For the love of heaven its only a blood test no worse than knowing your hemoglobin level!

IMHO
Have him get a guided biopsy, I think it's called 3T MRI

He has been told that his result is normal (they said anything under 2.5).

It is hard to know how to proceed. I do not want him to go through the heck of worrying about PC all the time.

I think my stance will NOT be to get a biopsy, but to get regular PSA tests and jump on it if we see that it is rising.

Mel

"I think my stance will NOT be to get a biopsy, but to get regular PSA tests and jump on it if we see that it is rising"

I think that's right. His number is on the high side for 36. Test at not less than one year intervals, and if it's rising, particularly if it's rising at a geometric rate rather than linearly, get a biopsy.

Mel,

I agree. The current guidelines for someone his age is that under 2.5 is normal. I would watch his PSA annually. Who knows, even if it is PCa it could be slow moving and low grade. His PSA could stay low for 20 years.

You can say what you will about the family history, but your son is a product of you and your wife. He may not have all the genes that you got and definitely not the combination of genes that you have.

I would just watch his PSA every 6-12 months and avoid treatment as long as I could at his age. Treatment will really mess up his life at such a young age. It did mine.....