elevated PSA

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I'm 63 and I've been tracking my PSA for 10 years on a yearly basis.  The range has been anywhere from .7 to 1.9 with no real trend.  Today, my bloodwork came back and my PSA was 4.2.  I'm freaking out because I've never had any prostate issues and everything works like it is supposed to.  My doctor has told me not to worry about it and I'll be tested again in two weeks.

My doc then asked me if I've been riding a bike lately? Yes

Have I been lifting heavy weights? Yes

Did I have sexual relations the night before the PSA test? Probably.

She asked me about my urine flow and I told her that my start/stop is fine and that I will get up once a night to urinate maybe once every 3 or 4 nights.  If I don't drink anything after 9PM, the chances are that I'll make it through the night.  She was pretty amazed that at 63 I can sleep through the night.

So, any thoughts from anyone with this kind of experience?

Thanks,

John

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  • Posted

    When I was 29 (40 years ago), I had a stress test because my maternal grandfather died of a heart condition at 50 (he got sick at 29).  The doctor said he noticed something on the stress test and that I needed a thallium (nuclear) stress test which they scheduled for 2 weeks.  During that 2 weeks, I probably listened to my heart beat more than I ever did.  The test was negative.  Then I found out my maternal grandfather had rheumatic fever as a child (probably the cause of heart problems).  I started running marathons.  (slowly - wasn't disciplined for speed work).

    You'll get more informative responses on the PSA level..  But, my advice is not to sweat it.  Some guys have double digits.  I have BPH and the urologist also monitors the PSA (presently below 3).  If the blood test I had yesterday turns out to be higher than recent, I'll take another test.  Then I'll make a decision on what course to take.

    Wait until the 2nd test results.  Then read as much as you can and discuss it with your urologist if necessary.

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  • Posted

    John  If you answered yes to all of her questions  I would not worry about it.  That could be the reason to get a higher PSA.  I may be doing another one in a few weeks.  My PSA has all ways been under 0.7 The last one I had was 2.2  My doctor told me not to worry that will do it again in 6 months which is this month.  I see him next week If your not having a problem relax  Ken
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  • Posted

    Squats, lunges and sex can all cause PSA to rise temporarily. Don't lift the day before/of the test and don't have an orgasm either. My guess is that the next test will be in your normal range.

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  • Posted

    Okay, probably/hopefully the sex. 

    However, think about it, if it is cancer, what will you do?  Posting on a cancer site is a good start, but remember people don't always tell the truth - even anonymously.  At 63, if it is cancer, and you do nothing, you will die at 83.  A doctor told me this and he said not to do the hormones (ADT) until you have symptoms of it's spread... that means pain elsewhere, which I believe usually happens in year 18, so when you are 81.  

    Most guys run out and get surgery right away thinking "cut it out, be done with it".  However, statistics show that may cause urinary leakage problems and no sex again, sometimes even rectal trouble.  Radiation is no better.  And neither mean the cancer is gone, some 35% of the time. 

    So learn about what prostate cancer could mean, so that you make a wise decision. 

    Just don't do anything until you have researched this fully, if you are like most - doctors don't tell us what the ramifications are... and a surgeon will try to sell you surgery, while a radiologist will sell you radiation.

    If you have money (25,000.) to spend out of pocket, HIFU (high intensity focused ultrasound) is another choice.

    Fingers crossed it was the sex!  Stay well. 

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    • Posted

      This post is irresponsible IMO. 1) 95% of all prostate cancers never cause any problems - you die of something else before they ever grow enough to cause any issues. The can score them - after that only 1 or 2% need to be treated 2) Often PSA numbers are misleading on the high end. Many activities cause temporary higher numbers. Your second could well be back in the normal range. 3) Even if it isn't, PSA is a poor predictor of cancer. If the do a biopsy there is a good chance that you don't have cancer.

      All of the treatments leave you cancer free about 85% of the time, but all are almost always unnecessary. 95% of the time if you have prostate cancer, it won't bother you no matter how long you live. The only part of this post that was accurate was the permanent side effects part from prostate removal. In a good surgeons's hands, you only have a 10% chance of being incontinent - but be careful with statistics. I once asked a urologist how he defined continent and he said no more than 2 pads a day. To me, continent is "what's a pad for"? Impotence is almost assured at least on some level. About 50% can, after 1-3 years, get an erection with a pill. Almost no one can without.

      Wanna be that if you don't lift weights or have an orgasm within 48 hours of the next test your PSA goes way down? 

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  • Posted

    John, I would advise you to stop freaking out. All of the questions she asked you can effect a person's PSA and you answered yes to every one of them. Refrain from each of those activities 48 to 72 hours prior to your next test and see what happens. I'm guessing you'll score a lot better than that 4.2 that has you so worried. It sounds to me like you have a pretty level headed Doctor.   

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  • Posted

    You are lucky indeed as you describe yourself. PSA values can vary as I understand due to activities, so I would wait and take more tests before doing anything else. Next time, pay attention what activities you did the day before. 
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  • Posted

    At 60-69 <4 is considered normal, however 48 hours before a test you should avoid the activities you describe for this rather blunt instruments sensitivity to have a result that would suggest firther investigation. Ask for another and avoid anything that might artificially raise it. Let us know the result.

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  • Posted

    "American doctors are too aggressive re PSA levels." - words from my Canadian urologist. My PSA varies between 12 and 14. Biopsy showed nothing malign. PSA no longer used as a guide in other parts of the world. I would distrust a medical system governed so hugely by the profit motive.     Paul in the Great White North

     

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  • Posted

    Hi John,  all of the advice you got above has some merit, but take a breath and absorb it.  I was in a similiar position like you, ten years ago. My PSA was like yours and one year it went up just like you.  My Urologist suggested we wait and retake my PSA. It remained same so he suggested a biopsy. It showed cancer in three areas. Immediately started treatment. Lupron shot, external radiation and I elected brachertherapy( implanting radioactive pills). Ten years later still cancer free, however I developed urethal stricture so research and determine what’s best for you. The key my Urologist told me was any time your PSA double within an year you should be concerned and keep an eye on it. Don’t delay it’s not how low the number is. 
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  • Posted

    Here's some info:

    My urologist says he had a patient who had a PSA of 8,000. with no symptoms.

    There's a doctor on the web who says he had a patient with a PSA of 21,000. who also had no symptoms.

     

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  • Posted

    Thanks to all.  I'll post again in a couple of weeks after the next PSA test results.  I'm also going to request a DRE from my family doctor.  If I have any concerns, it's off to my urologist for further discussion.

    On a related note, a friend of mine rushed into a prostate removal after he had elevated PSA numbers about 15 years ago.  He regrets it big time now.  He uses several pads a day and has other problems that he doesn't want to talk about.  He believes that he should have taken more time to let things set in and that he should have went for a second opinion.  He told me to take my time and not to panic.

    Thanks again,

    John

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  • Posted

    John,

    I took all the over 50 tests at the age of 55, at the urging of my mother. That was ten years ago. My PSA, which I always heard about when I was younger, was 3.9. Now, 10 years later, it has crept up slowly to 8.0 last summer, 2017. I have had two negative biopsies, over the last 7 years. One year, my PSA dropped down, so the doctor said to wait another year. In 2013, I had the PS3 genetic proclivity exam, which came back .3, very low, and yearly rectal exams,  with a prostate MRI last summer. Everything has come back negative. I missed my half year appointment. I do have BHP, and have developed incontinence within the last few years. Now I know what "nature calling" means, even in the city. However, other teachers in and around my age bracket have to visit the men's room rather suddenly, so I am not alone here. The one factor I have heard about rising PSA is that they are a bit more concerned if it rises sharply in relatively short periods of time. However, even this does not necessarily guarantee any serious condition. Yes, I am 65 and still teaching. Kids have always used the excuse of going to the restroom to get out of class, now I do too.  

         However, I am curious if some of you have developed incontinence over a period of time as well? The world is really one big bathroom now. Take care. 

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    • Posted

      Not incontinence, Gary, but extreme urgency that requires strategizing and some means of control - that is where CIC comes into play. Without it, in my case, the sole option was surgery to alleviate complete retention - a state where incontinence is impossible. BPH leads to greater and greater retention not to be alleviated by an accidental episode of incontinence should such occur. Incontinence from all the reports is more a concern as a side effect from  the various medical procedures.   Best, Paul
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    • Posted

      I believe you are right, Paul. Extreme urgency is the term I was looking for - not incontinence. It does require strategizing and some means of control, such as watching what beverages one drinks and the amount. Urgency has slowly crept up over the last few years, concurrent with enlarged prostate. This is most likely my situation. Thanks for the correction and subsequent comments.

      G

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    • Posted

      You may well have overactive bladder along with BPH and one may not relate all that much to the other. The good news is that both are treatable. Incontinence can't be solved with CIC or anything else non medical. If your urgency problem is from overactive bladder, I would try a course of myrbetriq. It works well and few have any side effects. If its from BPH, I would look into one of the less invasive treatments (not TURP, Holep or Greenlight). I get doing CiC rather than undergoing a procedure, but if it were me I'd draw the line at peeing myself.

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