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Posted 6/21/2024 1:09 PM (GMT -5)
Well Ive been on this site for for a few years and been watching my PSA increase
Never had PC that I know of
Just got this year's results back 3.63 up from 2.16 last year and 2.49 the year before.
This happens a day before my wife and I are to leave for vacation …
I’ve had an enlarge prostate for years
I’m 65 yrs old .. I believe he said my prostate was 55 ??
This doesn’t look good and I wish I had waited … oh well

Post Edited (cvc) : 6/21/2024 11:10:11 AM (GMT-8)

Posted 6/21/2024 1:35 PM (GMT -5)
cvc, your PSA level still is not abnormally high for a 65 year old man with an enlarged prostate. So I don't think you should worry too much. Having said that, there is a slow and steady progression upwards over the years. Have you had a scan lately? That might be the next step to see if there are any suspicious areas. Probably not and I'm guessing you are just fine.

Jim
Posted 6/21/2024 1:45 PM (GMT -5)
Jim
Thx for the reply.. slow and steady I get , but this is 1.5 jump in a yr
Dr just got on the phone with me after I badgered his nurse 😂
He said he isn’t worried at all , it also isn’t his prostate ..
He said he will restest in a month right before my DRE at his office …
He said something about a biopsy IF he feels it warrants it .
Isn’t there other tests or blood tests before jumping into that ?
Can I be knocked out IF we go that route ?
I need a couple shots of whiskey
Posted 6/21/2024 1:48 PM (GMT -5)
Jim
and I’ve never had a scan … nothing but PSA and DRE
Posted 6/21/2024 3:27 PM (GMT -5)
cvc, you might find this YouTube video from Dr. Scholz to be interesting.
https://www.youtube.com/watch?v=qnhhvl7e7sa&t=188s

If you and your doc are still concerned after the next PSA test, the logical next step is a multi-parametric MRI done at a center of excellence.

The answer to your question about anesthesia during biopsy is yes...that can be done. My biopsy was done under IV anesthesia because my urologist didn't believe in causing any extra pain and wanted to take his time.

Jim
Posted 6/21/2024 3:52 PM (GMT -5)
What is a center of excellence ?
I’m near Syracuse NY but have been advised to ask for a second opinion at Strong in Rochester NY
Any comment ?
Thank you
Posted 6/21/2024 4:52 PM (GMT -5)
https://www.cancer.gov/research/infrastructure/cancer-centers/find/roswellpark

Not sure you need to go to a top cancer center quite yet as you don’t have a first opinion yet. Your Uro probably knows the best place locally to get a prostate MRI after your physical evaluation.

Enjoy your vacation….
Posted 6/21/2024 8:19 PM (GMT -5)
So I guess my biggest question / fear is …
If the PSA in 30 days isn’t normal or still elevated .. what would you guys recommend ?
A different blood test than the PSA ?
Biopsy ?
MRI ?
Thank you for the kind words
Posted 6/21/2024 9:06 PM (GMT -5)
PSA density is helpful. It is your PSA divided by the prostate size which is usually determined from scans. Let’s say yours is 55 / 3.63 = 0.066 which is less than the typical >0.10 criteria which is good. There are PSA tests that can provide more data such as free PSA which you can ask about. There are a few more steps (DRE) before they typically order the MRI and go to biopsy. Back to your vacation now….
Posted 6/21/2024 9:56 PM (GMT -5)
My biggest concern was the 1.5 in one yr jump
Not sure I understand your density info but I caught you said “ good”
Thank you again
I’m not looking forward to the 30 day wait for retest
Posted 6/29/2024 1:21 PM (GMT -5)
Years before I got PCA my PSA was always high because I had a very large prostate.
Not sure when it was decided to have a biopsy but around 2018
Mine was lower grade but sorta high volume cancer and I'm well over two years post SBRT PSA 0.09
Posted 6/29/2024 3:04 PM (GMT -5)

cvc said...
My biggest concern was the 1.5 in one yr jump
Not sure I understand your density info but I caught you said “ good”
Thank you again
I’m not looking forward to the 30 day wait for retest

Mumbo's wise words:
Uncertainty is the name of the game here with PCa
Posted 6/29/2024 4:54 PM (GMT -5)
Best thing is to just relax and continue to investigate. If you don’t think your current doctor is doing enough then call another doctor for an assessment. We comparison shop on everything in life, but medical. Terrible in my opinion. Get another assessment. If it is different you might want to follow it. If it confirms what your current doc says, then be more confident and relax.

For most men your age an increase of 1.5 in a year is probably meaningless. Most often it signals infection, inflammation or enlargement. For a 60 year old man with a 55 cc gland it is probably to be expected. After all you don’t know what the size was a few years ago. As your prostate enlarges, your PSA will go up.

And if you are going to drink, I suggest a good mellow bourbon.
Posted 6/29/2024 5:38 PM (GMT -5)

JNF said...
Best thing is to just relax and continue to investigate. If you don’t think your current doctor is doing enough then call another doctor for an assessment. We comparison shop on everything in life, but medical. Terrible in my opinion. Get another assessment. If it is different you might want to follow it. If it confirms what your current doc says, then be more confident and relax.

For most men your age an increase of 1.5 in a year is probably meaningless. Most often it signals infection, inflammation or enlargement. For a 60 year old man with a 55 cc gland it is probably to be expected. After all you don’t know what the size was a few years ago. As your prostate enlarges, your PSA will go up.

And if you are going to drink, I suggest a good mellow bourbon.

I’m 65 … and the Basil Hayden and Old Forrester is tasting gooooddd
Posted 6/29/2024 8:10 PM (GMT -5)
Right on……
Posted 6/30/2024 4:49 AM (GMT -5)
cvc: If you're going to seek a second opinion, be careful to not fall into a trap of confirmation bias. If a doctor tells you that you shouldn't be concerned, will you believe him/her?

You can likely get a prostate MRI in Syracuse. And, if the MRI has shadows of concern, the step after that is biopsy, guided by the MRI findings. Then, and only then, do you need to think about treatment. Not until.

In your current situation, you don't need to worry about finding a center of excellence. Really. You need to decide, first and foremost, if you trust your urologist.

Keep sipping that bourbon. Have you tried Angel's Envy?
Posted 6/30/2024 7:30 PM (GMT -5)
Are you aware that a PSA blood draw after a DRE will have elevated results? You should wait 24hrs before having the blood draw.
An ejaculation will likewise produce an elevated result.

If none of these apply, then just sip your bourbon. If they DO apply, then sip your bourbon - with a big smile on your face.
Posted 7/1/2024 3:53 AM (GMT -5)
As others say, you should be diligent watching your psa. But, also and maybe more important, you should not let the psa worries change something in your life as your vacation plans or to become a cloud over you. At your current psa level, PC maybe on the horizon, but it is not something that requires your urgent attention. Do not let PC worries be your main concern in life because there is a high probability it will take years before it requires any action, if it ever does.
Posted 7/1/2024 8:45 AM (GMT -5)
Worried Guy, always great to hear from you.
Michael
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