Increase in PSA over 15 months from 3.9 to 6.4

......doxycycline, amoxicillin and no doubt other antibiotics

Ian,

3T MRI can help diagnose the possibility of prostate cancer.

Thomas

The first thing I would recommend is asking for a 'free PSA' test. This is, from what I understand, a more definitive evaluation as to the chances of actually having cancer.

You don't mention your age, but certainly our PSA numbers go up as we get older. I'm now 67 but about three years ago I also had a PSA number above 6.0. The urologist wanted to to a blind biopsy, but I declined. So he prescribed the free PSA test and the results showed that I did not have prostate cancer. Since then my PSA numbers have gone down. After my Rezum procedure the PSA numbers went down again. The latest result for me was around 2.4.

Certainly if you do have cancer, it might be a good idea to deal with it. But I think that proceeding slowly, as you are doing, is OK at this point.

Also, keep in mind that certain activities prior to testing, can cause elevated PSA levels. Bicycle riding, sex, as well as some other acivities, can cause the numbers to be higher than they are normally. Anything that causes some activity or irritation to the prostate can cause elevated PSA readings.

Definitely get a 3T MRI before doing a biopsy, That way, if there are suspicious areas on the scan, if you do opt for a biopsy it can be a targeted biopsy rather than a blind biopsy.

Also, take heart. My PSA went from 3.1 to over 11 over several years. Before I knew about 3T MRIs, I has two blind biopsies (both negative). Third time I had a 3T MRI which showed a suspicious area, so had a targeted biopsy which was also negative.

Finally, not sure about this, but doesn't prostatitis cause an increase in the PSA number?

Rich

Ian, I saw in another thread that you asked about using D Mannose for your prostate infection. Did you try taking it?

I realize that it's primarily recommended for UTI's, but evidently some feel that it also helps treat prostate infections.

Ian,

First of all, none of us are doctors but we have been through some battles and have gleaned a lot of knowledge and experience.

Secondly, you should be concerned over a PSA rise that quickly, but certainly not dismayed.

You've received good advice: get an MRI. It must be a multi-parametric MRI. The 3 Tesla magnet produces better resolution. By your name, I gather you're in the UK? My guess is that a higher percentage of imaging centers in the U.S. have 3T machines vs. the UK. Even so, a 1.5 T machine will still give you and your doctor important information.

As others have said, your prostatitis could be the cause of your PSA rise. PSA is not specific to cancer cells but to prostate cells. Inflammation of the prostate could raise PSA.

Request that they check your free PSA. If your % free PSA is 25% or higher, you have about an 8% chance of cancer at biopsy if you are under age 60. I think the number jumps to an 11% risk if you're age 61-70.

I don't know if the UK does the phi test or not, but you should ask for that. phi = Prostate Health Index. It was developed by cancer researcher William Catalona at Northwestern Hospital in Chicago, Illinois, U.S.

phi measures % free PSA and 2[pro]-PSA. These, combined with a negative MRI, give better ability to rule out cancer than total PSA alone or % free PSA alone (although % free PSA is better than only total PSA).

Also, the MRI will measure your prostate volume. You should know your PSA density (PSAD). Simply divide your PSA (total value) by your prostate size (in cc) to arrive at a ratio. For example, a man with a PSA of 5 and a prostate of 50 cc, will have a PSAD of 5 divided by 50, or 0.10.

If your PSAD is < 0.15, your chance of having cancer drops. Preferably, it should be < 0.10.

If you have the MRI, you'll be assigned a PIRADS score if any lesions are seen. If your PIRADS is 1 or 2, that is essentially a negative MRI and you can probably watch your PSA and not rush to biopsy. If your PIRADS is 4 or 5, you must do a biopsy. It could save your life. A PIRADS score of 3 is a tougher decision.

Before your next PSA test, avoid a DRE for at least one week, avoid ejaculation for at least 4 days, avoid bike rides for at least 4 days.

There are other things you can do, such as the PCA3 test, which is a urine test.

I'd imagine some of these blood or urine tests can get pricey. But they do give you/your doctor more information for decision-making.

Don't be filled with anxiety. PSA can rise for other reasons.

But, for the present, do not subject yourself to a random ultrasound-guided 12-core biopsy that just blindly probes the prostate. If the MRI shows a suspect lesion, they can overlay the MRI imaging onto the ultrasound and target the lesion.

God bless you going forward, Ian.

Michael

You should have a doctor write you an order for a 3T MRI from an imaging location neare where you live and then you should send it to an Interventional Radiologist who is specialized in Prostate cancer. It is fast, painless, and is very conclusive as to weather or not you need a targeted biopsy.

Miss diagnosis is the worse fault of the urological industry and needs to be addressed. I know that some talk is going on about a group starting a 501c3 foundation to work strictly on lobbing the American College of Radiology Association about a protocol for diagnostic procedures and teachings. If this is successful, it is the begining of the end of the hold and abuse of urology in regard to men and the deaths caused by horrible diagnosis failures.

This is analogous to the treatment women received in the sixties and seventies with regard to the hysterectomies that were handed out like pills by the OBGYN and surgical side of medicine. It happened, it was a sad thing, but it is just not acknowledged anymore. Now it is the mens turn in the barrel.

If you are in the states, I can personal message to you the two best and most specialized IR doctors that will review your MRI and advise you on weather or not you have PCa and give you their opinion on the options you have. One of them does not even charge you any money to review you MRI and tell you what the film shows. Both have this on the web with an upload protocol available. It's a lot better than 12 non-focused blindly inserted needles. That is sure to raise your PSA a lot more.

If you have interest, let me know and I will personal message to you there names.