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Son's PSA 4.5 age 46...

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Posted 7/11/2018 4:38 PM (GMT -5)
Information please my son's psa has been going up for about 2 yrs... he saw urologist Tuesday he checked his prostate it wasn't enlarged...he has been on an antibiotic for about 6months for a bacterial infection .and he has had blood in his urine too....I have 2 uncles that passed away with prostate cancer...and I have battled this prostate cancer myself with metastatic prostate cancer now.... I was diagnosed at 58.the urologist is doing a breakdown of his blood ...I think checking his free PSA to see if a biopsy is needed....the Dr did say he didn't think it was prostatic because he has been on the antibiotic for so long ....any ideals....please...
Posted 7/11/2018 4:57 PM (GMT -5)
Prostatitis often doesn't respond to antibiotics and is difficult to treat. Often it just clears up on its own. An UTI or other problems could raise his PSA, so that is a possible reason for a higher PSA.

More diagnostic work is needed. The PHI test (prostate health index) might be a better blood test to get. Still getting the free PSA is a good step along with retesting his PSA

The only thing you can say for sure is that his PSA is higher than normal. How many PSA tests have been done? You really need to see how the PSA is responding over time. Is it going up, swinging between extremes, steady? A rising pattern with a low freePSA would be an indication that a biopsy is needed. Your having PC is an added risk factor.

You've got a mystery there and he needs a little more testing to know for sure if a biopsy is needed.

Still, if it is PC, now's the time to find out and to deal with it early.

Andrew
Posted 7/11/2018 5:17 PM (GMT -5)
Thanks ..In shop...I'm of the same opinion....better safe than sorry...and the urologist he is seeing did my surgery... not sure of all the breakdown on the blood he was doing but he did tell my son he was going to do several test.
Posted 7/11/2018 5:41 PM (GMT -5)
Ask for a PHI (Prostate Health Index) test specifically. Don't leave it to the urologist.
Posted 7/11/2018 7:53 PM (GMT -5)
He's regular MD didn't check his PSA when he had the UTI because he said it would make his count not accurate....so as soon as it cleared is when he checked his PSA. Also in 2014 he decided to get it checked ( PSA) and it was 1.9. I felt like that was a little high then..I'm going to mention the PHI TEST TO HIM AND SEE IF THAT WAS ONE THE DR WAS GOING TO DO IF NOT THEN GET DR TO DO ONE...THANKS FOR ALL THE GREAT INPUT..
Posted 7/11/2018 8:43 PM (GMT -5)
Remember no sex, bicycling, heavy exercise, for a couple of days before test. - Good Luck to him.
Posted 7/11/2018 8:49 PM (GMT -5)
You son might benefit from a visit to a URO for a followup and second opinion on needing a biopsy.

Andrew
Posted 7/12/2018 1:08 PM (GMT -5)
Just my story so you have some comparison. So I'm 52 and just got done with robotic surgery two weeks ago. In June of 2016 my PSA was 3.9. I was told no big deal and just monitor it every year. Well, I was living out of the country for a couple years and got it checked again (3/18) and is was 6.9. My Dr. referred me to a urologist (Dr. Robert Gaertner in St.Paul). He asked if I had had prostate cancer in my family (no) or breast cancer on my mothers side. (yes) after that he recommended a biopsy. He said if he had know my history he's have biopsied at 3.9. He's done 1000's of robotic surgeries , so has seen a lot I guess. Biopsy came back with three lobes positive (10%,10%,90%) and Gleason 6. Because of the 90% he recommended surgery which I did. This was two weeks ago and I've had no incontinence and am already able to have a partial erection (both nerves spared). In my post op today he said my end score for the cores was 3+3,4+3, and 3+4, which means one part was getting pretty nasty. So I would think with that family history a biopsy would be in order, but darn it Jim! I'm an engineer, not a doctor. It's all relatively easy and very little pain. The surgery was easy and after day 3 I was feeling great. Catheter is no big deal either. Doc said this surgery is much easier when you are younger, fyi. Take care and God Bless! Mike
Posted 7/12/2018 2:48 PM (GMT -5)
Based on my experience I would have your son take this seriously.

My father had prostate cancer at 61. Thankfully he's still kicking at 90. I'm now 61 and just had a successful prostatectomy. It was only a few years ago that my PSA was running 1 or 2. Then it got into the 3's and once to 4.2 and they suggested biopsy. I asked if I could have time to change my diet and check it again. I did and within a few months I was back down into the 3's. So I ignored if for another year. Then it jumped to 4.4 and I agreed to do the biopsy. It was positive with 50% 3+4=7 in one quadrant. So I decided to get the prostatectomy done quickly to get on with my life.

But here's the thing ...

The biopsy on the prostate they removed was aggressive 4+3! So, either they missed something or it progressed that fast in 45 days. I often read on these forums that ... my PSA was "low", 4.5.. something like that. For the average person that may be low but not for someone with a family history. I believe if there is a family history the numbers are less important, at least my experience proves that out.
Posted 7/12/2018 8:14 PM (GMT -5)
Thanks everyone we are waiting on his urologist to call back with the blood test results..but I've told him to push for a biopsy...the urologist said his prostate felt ok but that doesn't mEan anything tho.
Posted 7/13/2018 8:25 AM (GMT -5)
As has been said a number of issues other than PCa can cause the symptoms you are describing but an increase in PSA from 1.9 to 4.5 in 4 years could definitely be caused by PCa. Wild fluctuations or very fast increases are usually something else.

The biopsy is not such a great big deal so I would go for it myself.

Roger
Posted 7/13/2018 1:13 PM (GMT -5)
Hi deer hunter,

I've been reticent to post because I'm not a PCa survivor. No two stories are exactly alike, but mine is similar to your son it sounds.

I had my first PSA and Free PSA tests at 44 after nagging my primary care doctor to start a baseline. My Total PSA came back at 2.9 and Free PSA at 15%. I was referred to a uro who decided to do some watchful waiting as my Total PSA was only just above the age-adjusted threshold.

Fast forward 14 months and my latest test shows Total PSA is now 5.2 and my Free PSA has dropped to 7%.

My uro said it could be a "blip", but he also said the rise in Total PSA and the halving of Free PSA concerned him and offered me a biopsy.

I have that biopsy on August 15th (my healthcare system doesn't work as fast as in the U.S. -- I'm presuming you're in the U.S.).

Having just turned 46 and the thought of having a biopsy for prostate cancer is very scary. I guess it's scary at any age, but I have a young son and statistically, half my life left. Maybe your son is in a similar situation with children to consider.

Given your son's age, I would go for a biopsy. Hopefully, it's nothing too serious. But it's also the way to find out if it is something serious and nip-it-in-the-bud before it gets out of hand. (I get that the biopsy process isn't perfect).

And I just want to add that having a dad who supports him and researches things on a forum like this is golden!
Posted 7/13/2018 5:59 PM (GMT -5)
Deer Hunter,

I agree wholeheartedly with Geekything; Your family history (in and of itself) would seem to warrant a biopsy post-haste. I am a 66-year old high-risk patient myself, and a father of two boys, ages 40 and 44, and I wouldn't hesitate to recommend a biopsy if such were the case for either of my two sons.
Posted 7/14/2018 11:35 AM (GMT -5)
My PSA was nearly identical to your sons at the same age.

The PSA jumped from 3.8 to 4.7 within a 10 month span.

I hope the best for you both. Take care!
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