BPH with PSA of 9.7
Posted , 13 users are following.
Hubby is diagnosed with BPH. His PSA has been high for 5 years or so, ranging from 4-7ish. He has BPH, and had a biopsy a couple of years ago when his psa was at its highest of 7.3.
Doctor said he would eventually need surgery for BPH, but he should wait as long as possible, due to possible side effects.
But his latest PSA came back 9.7. Is this more worrisome for possible cancer again, or just a result of his prostate growing even more?
Experiences with BPH and a PSA this high?
0 likes, 21 replies
Howard31850 mamadeesix
Posted
For men with very large prostates the PSA number is not very helpful when diagnosing cancer. The range of 4 to 10 cited when talking possible prostate cancer is for normal size prostates around 30 to 40 cc. What is more diganostic is the PSA density which is computed by dividing the PSA number by the prostate size. Numbers less than 0.1 are considered good when worrying about cancer. In my case my PSA number is around 15 and my prostate size is about 300cc ( ten times normal!). So my PSA density = 15/300 = 0.05 which is very good.
Another indicator for prostate cancer is the Free serum PSA which should be greater than 18% though there is some uncertainty whether this applies to BPH patients.
The best test is still the oldest - the simple DRE - since most cancers appear near the surface of the prostate.
Over the years I was subjected to 3 very unnecessary blind TRUS biopsies because my urologists did not understand BPH and were alarmed by my high PSA numbers. Many millions of unnecessary biopsies have been performed for this reason and have left prostates butchered up and infected.
An excellent diagnostic tool is the 3T-MRI with dynamic contrast ( ask for Dotarem only as other contrasts have been implicated in dementia). This will show clinically significant focal lesions that can be targeted for biopsy if they appear suspicious.
The rule of thumb is that there is the same probability of having prostate cancer as our age. So I am 70 which means that if enough biopsies are done there is a 70% chance that at least microscopic cancer cells will be found. But so what! Microscopic cancer cells, that are contained within the prostate may never become important over our lifetimes. This is the problem with blind biopsies - if some cancer cells are seen what do you do about it? Perhaps order an MRI to follow up and see if there are significant lesions that can be selectively removed w/o affecting the whole prostate.
mamadeesix
Posted
So doctor called and said he wants to repeat the psa in 4 months. Will figure out a plan, based on that number, I guess.
nick67069 mamadeesix
Posted
PSA number can be misleading. Some say that trend is more indicative of something going on in the prostate. PSA in general reflects size of the prostate, but not always. I have prostate about 70-75gr and PSA range between 15- 18 and sometimes spikes to 24. Dr wants to do biopsy , but I opted for 3T scans. I had one 4 years ago, one last year and I just had one in January with no indication of cancer. Bottom line high PSA does not necessarily mean cancer.
john74625 mamadeesix
Posted
Is your husband retaining ? I had PSA has high as 7.3, ,stones from retention will cause the PSA to go up . I had a TURP with a little better performance. I started CIC and had the best results! PSA down to 4.3 , no stones! , I wish I had just stated CIC before the TURP . CIC for 3 months now . no regrets!
andrewcalgary mamadeesix
Posted
I had FLA with Dr.Karamanian 9 months ago for PCA and BPH, results are excellent, PSA dropped from 10.3 before to 0.6 at 5 months, 0.9 at 9 months, BPH symptoms disappeared IPSS dropped from 25 to 1, urine flow is excellent, I was Gl4+3, had 3TMRI's before, start with 3T MRI and send CD with images to Dr.K for review, no ED, fully continent