Confusing results

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Hi

?Really hoping someone can shed some light on what seems like positive but somewhat confusing results..

?50yo and have been symptomatic for some years now - hesitancy with urination, weak flow, stream all over the shop etc..

?Went to the Doc with what I thought was a UTI in January. Had a course of ABs which seemed to help with that and a couple of weeks later had a full blood workup. Based on my symptoms, the Doc also ordered an Ultrasound.

?Results were prostate vol 60cc and Total PSA at the time was 3.73. radiographer also noted some tissue heterogeneity in the prostate. No other PSA related tests were done. Had a follow up DRE which was normal. Doc ordered a repeat PSA + Free PSA to be done a month later in Feb.

?Well it's May and I've just had that repeat test done smile My expectation was that that PSA would probably be the same or close to - had no idea what to expect with fPSA but was obviously hoping for a high number. The results were tPSA 1.04, fPSA 76.9%.

?Now as I said, those results are great right? Without medication, tPSA is less than 1/3 of what it was and fPSA is through the roof..BUT, ..WHY?

?Prostate is still enlarged, symptoms haven't changed - and with all the reading I've done the fPSA just seems too good to be true..(?) So, ...I'm one part relieved and one part thinking "Hang on, this doesn't make any sense.. Is it possible they've screwed up the assay..?" Particularly with that fPSA result, which just seems to be waay outside of the reference ranges I've seen for much younger guys with normal prostates(?) - I think that is the one that is confusing me most...

?

Anyhow, current GP advice is "watchful waiting" and repeat in a year. Very happy to move on for now and do just that but would appreciate some other informed opinions on those results. Do they seem right? Am I confusing myself for no good reason? Do tests even get screwed up these days (is that even possible with all the tech, checks and balances that must be in place..?)

?TIA, Brent.

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8 Replies

  • Posted

    My prostate is 125 cc ( i'm pretty sure cc and gr are interchangable regarding size if prostate ) Any was when that measurment was taken my PSA was .8 PSA can very based on what you did prior to the blood draw. Sex Infection I think strenuous activity. Others will be along that know more that I. If you have week flow you may want to consider daily cialis if its covered by insurance or if you can afford it.

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  • Posted

    Oh I'd stay away from flowmax or other drugs if possible

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    • Posted

      uncklefester, yeah, my GP did start reeling off a list of drug options to help with symptoms, but I think I'll be avoiding any medications for as long as possible.. 125 cc, bloody hell.. And here I am worried about 60 ! Appreciate the advice and all the best.

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  • Posted

    Google, What is the difference between PSA and free PSA? But your results are good.
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    • Posted

      Actually, I suspect I've probably been second guessing things as a result of too much googling; so much info out there and it doesn't help that some of it is contradictory.. As you say, the numbers are good and for the moment I'll keep the hell away from Google and just take 'em at face value. Cheers..

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  • Posted

    Well my psa after or still during acute bacterial prostatitis was 16.92 then a few days later 9.66. For reasons I never fathomed neither GP nor uro tried ciproflaxin on it. But the first test the free PSA was 5% and the second time 4%. Both alarming and so was the 3t MP mri scan result at 4 out of 5, a bad score, but it was still just inflammation. The acute phase with sudden massive LUTS symptoms had been preceded by similar to what you said for years so although the acute phase receded over 2 or 3 weeks, I said yes to holep. I too am 50, my prostate was 22 cc. Inward obstruction is possible even from a small one. Post holep the PSA was 0.66. Didn't test free PSA post holep. I asked at final appointment, how come my free psa was bad given no cancer in biopsy or holep samples ? Oh he said all the alternative tests to PSA are dodgy too, if any were more reliable obviously that would be used for everyone instead of PSA... anyway your score is nice, anything above 20% on free PSA is good. You should perhaps just relax and be pleased, think how it feels to get bad scores like I did !!

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    • Posted

      Thanks for the advice and yep, I think you're dead right about not reading too much into the PSA tests as they seem to fluctuate so easily.. Would have been useful to know that beforehand and saved a lot of unnecessary stress. Pretty sure my Doc's plan was to go straight to a 3T MRI had the results not come back as good as they did, but can gladly put all that on ice for now..

      Thanks again and all the best with your own situation, Cheers.

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  • Posted

    Psa can be high for many reasons, e.g. recent dre, recent intercourse, NO recent intercourse, infection, etc. etc.

    If possible, get a 3T MRI, which will more accurately tell what is going on.

    Do not let them do a biopsy unless it is guided by 3T MRI, and NOT THROUGH RECTUM, WHICH CAN GIVE YOU A REAL CASE OF PROSTITUS.

    Neal

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