PSA

Workout, welcome to HW, hope you are just passing through.

Definitely not time to hit the panic button. Elevated PSA can be caused by any number of things, prostate cancer being just one of them. And it doesn't mean you have cancer, it just means there is something going on. It could be an infection. It could be that your prostate was stimuilated before the blood draw. Hopefully your Dr knew to do the DRE (digital rectal exam, aka finger up the ass) before taking blood (assuming he did a DRE). if not that could raise our PSA, Also if you had sex or rode a bike the day before, that would cause a rise.

When you see the urologist, he will likely retake the PSA, ask him about also doing a free PSA test (same blood draw). And possibly a PCA3 which is a urine test that would show if there was genetic material in the blood related to PC.
Also, as if it makes sense to do a round of antibiotics to see if it brings the PSA down. These are all things worth doing before going to biopsy.

Keep us posted, hopefully this is not anything to worry about.

Welcome to HW.

PSA isn't a test for cancer. It just means you need to get things checked out by a Uro. Lots of things rise PSA, PC will but it's low on the list. Before they even think about that, they want to check all other possibilities - BPH, infection, and so on. Only after all that is ruled out do we even think of the "B" word, biopsy.

What you should be asking your doctor is for a retest to confirm the reading and why is your PSA rising. Likely they'll also do a DRE. If infection (prostatitis) is suspected, you'll get some antibiotics to see if it comes down.

Even if the worst is proven eventually proven true, you'll have plenty of options for treatment. You won't like the options, but you have every hope of being able to complain about this whole thing for a few more decades.

Get it checked out, try not to worry (yeah, easier to say than do) and hang in there,
Andrew

Just saying hello and that you've got some excellent advice above--some of the most important being not to panic, since a high PSA can mean lots of things. I'm betting the uro gives you antibiotics and does a re-test in a few months. Good luck to you and do keep us posted after you've met with the urologist.

In my opinion, the uro should rule out the other, more likely causes of elevated PSA before rushing to a biopsy. A good DRE can be informative about enlargement, lumps or hardness which all point to different things. An ultrasound will give you a good size estimate for BPH diagnosis, PSA density, and can show obvious benign cysts or other lesions. Sometimes all it takes is 10 days on Cipro. Sometimes a few months on Proscar if your prostate is enlarged.

There's a better blood test called PHI. Your urologist may not give it. Call at the link below to get local uros who do give it. It's cheap, better than PSA and free PSA (it includes both), and is covered by insurance. Here's the link:

Prostate Health Index (PHI)

PCA3 is not covered by insurance before the first biopsy, and it can run you hundreds of dollars out of pocket, and is probably not worth that cost. Check with your insurance before asking for it or any of the several non-covered biochemical tests ( e.h., 4Kscore, Prolaris, Oncotype, etc.). I'd recommend you do the cheap, easy stuff first.

- Allen

Cycling is another thing that can raise PSA scores. If you were on a bike seat anytime within a couple of days of the test that could affect your score.

Hi Everyone. Thank you for all of the info you have given me. I had a follow up with my regular Doctor. I asked for a Urine test to see if I had any infection. The test came back negative. I asked him about what he found when he stuck his figure up my butt. He said it was smooth and normal size. He made me promise to keep my appointment with the Urologist.

I did meet with the Urologist. She retested for a urinary infection. Again, I did not have any infection. She felt my prostate and said it felt smooth and normal size. She did take a swab to see if I would have an allergic reaction to whatever they use during a biopsy if I need to go that path. She made me wait for a week before having another PSA test.

Finally, I had another PSA test. She called me with the result. She stated that my PSA number went down from 6.45 to 3.26. She also told me that the PSA level she uses for men my age (60) is 4.5 as the cut off. Of course she said this is just a number they used.

Her recommendation was to not do the biopsy and to keep up with my regular yearly physical with my Doctor. She stated that she already talked to my regular Doctor. My regular Doctor called and made the same recommendation. I am going to trust the Doctors and follow their advice.

I have a similar story. Mine had jumped up to 4.4 from low 3's. My Uro did a retest and it came back at 3.4, below the 3.5 threshold. So we passed on the biopsy. It hovered around 3.5 for over a year then jumped up again to 4.2. I waited 6 more months before another test to show it wasn't coming back down. I have regrets that I didn't act earlier. I'm not sure if it would've made a difference but my 50% Pca volume and +margins are likely attributed to the delay.

I also suggest that you retest in 3 months.

Wait a sec....did you tell you doctor(s) that you are on a bike seat regularly?

A bike seat (or horseback rining, or motorcycle riding, or any type of ejaculation) will "massage" a prostate and cause it to secrete higher than normal levels of PSA into the bloodstream. After any of these "events," the elevated PSA in the blood takes a few days to work itself out of the blood and back down to normal levels.

Did your doctors ask you if you did any of these things within a few days of giving blood?

Something to keep in mind next time...these "activities" will cause elevated PSA levels in the range which you are experiencing.

Hi Jack H and Paul 65, Thank you for the comments. My regular Doctor knew that I was a fitness instructor and he suggest that the jump to 2.06 PSA in 2011 was because I had started teaching cycling a lot that year. I was not teaching before that. Since I had no history of PC in my family and the finger test came back smooth and normal size. He did not have a problem.

He did ask me about my fitness schedule again after I had the 6.45 result. He did tell me about all of the things that could elevate it. My Uro doctor also told me. I abstained from all things but teaching my cycling class and she made me promise not to cycle on the day of the re test. The result was a drop to 3.26.

I racked my brain about what I did the day before the 6.45 result. I was not so good on the recall. I will try again in three months and see what the result will be.