My PSA and Me

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Does anyone else have a PSA that goes up and down in the same way as mine does? And what do people think about such a large variation? Many thanks.

Age in Dec 2011 - 50

Dec 11       5.7      

Dec 11         7                        Biopsy 1 core out of 12     3 + 3

Apr 12         1.7

Aug 12       1.5

Dec 12       2.1                      Biopsy  0 cores out of 12

May 13     2.4                  

Aug 13      1.5

Mar 14      1.7

Aug 14       1.7

Jul 15         3.2

Sep 15       3.3                     MRI small focus found.

Jan 16        5.7

Mar 16      2.8

Apr 16      5.3

July 16     4.9

Aug  16    8.1

Sep 16     10.2

Nov 16     3.9

Jan 17      6.1     Now age 54

As you can see, in the past it has risen dramatically and then falllen dramatically. Don't really know what to make of it.

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18 Replies

  • Posted

    Good morning Sam.  First of all can I ask why are you having it done so offen.  I have mine done onces a year.  When I was 47 I was told I had cancer asnd they wanted to do surgery.  I told them no.  He did more test and a 13 needle biopsy all came back clearn.  It was a prostate infection.  Is your doctor checking you this way.  2014 I had a PSA of 7.0 .  2015 PSA 4.0   2016 PSA was 0.7  I will be have another one in March.  Do you have any other problems  Also I don't know if your doctor told you or if you read.  You should not have any kind of sex at least 2 days before a PSA because it will change the results.  Take care and I hope they find the problem.  Ken

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    • Posted

      Thanks for that Kenneth. The reason I have it done so often is because they keep suggesting I need radical treatment but from all the research I've read, I don't believe that this is the best advice, especially because of the fluctuating PSA leve.

      I'd have thought you would have had another PSA test more quickly after the 7 to see if there was a trend. I wish I had only been tested much less but when you have a high score you feel comforted by then getting a much lower one (hopefully).

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    • Posted

      I have a very good Urologist and he did not feel that I needed another one because I was not having a problem.  I will be having both done in March the regular and the free.  If you are not having a problem.  I would not let them mess around with my prostate.  Just be care full  Ken
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  • Posted

    There are a dozen reasons why your PSA can vary.

    1. Did you have recent sexual activity prior to the blood being drawn?

    2. Was blood drawn after a DRE or before?

    3. Is there ANY signs of infection?

    4. What is the free PSA ratio?

    5. Did the same doctor arrange for all of teh tests?

    6. Did the same lab run the tests?

    7. Did the lab use a differnt test kit? (There are cheap trst kits and expensive test kits. Guess which are less accurate.)

     

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    • Posted

      Hi Bobby, thanks for the reply. Yes the tests were all NHS and legitimate. I think on the 10.2 result I had sex within the 48 hours which was a bit silly I know.

      I don't have any symptoms although boy do I suffer from piles which itch and then scratch (unpleasant I also know) which may antagonise the prostate?

      I feel as though on any given week I could have a PSA ranging from 2 - 10 !

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    • Posted

      Get the piles fixed. Life is much better without them. Less straining.

      I am in USA and cringe at the thought of NHS. Too many friends have told me how they lost their parents to cancer or heart disease waiting for treatment. It is almost as bad as the VA system in the USA.

      There are some top urologists in Spain and Belgium as well as New York City. Spend the money out of pocket and take care of yourself. Do not rely upon government or insurance companies to tell you what the best treatment is.

      Good Luck. Life is too short to suffer.

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  • Posted

    My PSA last year, 29th April 2016, was tested at 16.92, free PSA 5%, bad result.  Re-done 2nd May 2016, 9.66, free PSA 4%.  Expensive 3-Tesla multi-parametric MRI Nuada Clinic, off Harley Street, came back 4/5 suspicious area but unable to rule out inflammation.  Biopsy showed 13 cores no cancer, no PNI but chronic inflammation.  6 grammes of material from centre removed via HOLEP also no cancer, no PNI but chronic inflammation.  2 months after Holep, PSA was 0.66 in mid August.  2 months later one more test, October, 0.66.  No more tests now for 2 years as 0.66 from my remaining 10gramme of outer prostate tissue (that's all I have left of my little 22cc prostate = 22 grammes, before the op) is fine. 

    I don't know if that helps, but I guess the key point there is I went down from 16.92 to 9.66 in just about 4 days, proving that when you have prostatitis, it goes all over the place.  No bike riding or sex for a week before any of those tests, although my 'uro said that really only boosts it by +1 at most, often less - not by loads.   So maybe prostatitis could make yours fluctuate a lot, too. 

    Both those tests done at same private hospital, so was the 0.66 in August, so one can't blame slightly different test media (assays)

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  • Posted

    Sailor Sam, I plotted a chart of date vs. PSA, attached (the trend is obvious even from the tiny thumbnail at the bottom of this reply), and there's an obvious trend with accelerating PSA velocity.  In 2015, was that an mpMRI?  I'm wondering what happened with the Gleason 3+3 biopsy found in 2011.   There's probably no way to know if that's the same spot found in Sept 15.  In any case, if not done before, an mpMRI is in order, and if the PI-RADS score (1-5) is 3 or higher, than an MRI-guided biopsy would probably be strongly recommended.  Random biopsies are now obsolete.

    My own PSA (now, I'm 75y.o.) has gradually increased from 6.2 in 1999 to 8.5, currently, with a peak as high as 14 in 2015, when I had my mpMRI.  It dropped back down to 8.5 a month later.  I've had other, smaller peaks, over the years, but not as wild as yours.  

    If I were you, I'd have an mpMRI immediately to fully evaluate the possibility of significant PCa.  However, I'm an engineer (as my motivation to plot a graph, supports), not a physician or medical scientist, and I only have experience with my own prostate.

    Good luck!

    Harvey (in S. Calif.)

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    • Posted

      Harvey, thanks so much for taking the time to do that. It gives it a new perspective. I have a appointment with the Doctor at the end of Jan and will definitely ask for another MRI, and guided biopsy. 
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    • Posted

      Good luck.  You will probably be able to look back on it all as an interesting experience afterwards.  But it is good to check it out.  Don't worry too much in the meantime. 

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    • Posted

      Hi Waffalobill,  It is unknown what caused my PSA to go so high.  I had no symptoms, no presumed infection and took no antibiotics.  I had changed nothing in my diet or lifestyle.  It just zoomed up and then zoomed back down.  

      The only hint of a possibility is from a biopsy I had in 1999, in whch was found "prostate tissue with focus of benign crowded glands," with a Note that read: "Stains for high molecular weight cytokeratin are positive in a patchy fashion in some of the glands." This report came from a renoknowed pathologist at Johns Hopkins, Jonathan Epstein.  

      My biopsy slides had been sent to Hopkins for a second opinion after the local pathologist, in a first opinnion, claimed:  "Atypical small acinar proliferation," which is jargon for: I don't know what this is. That same pathologist wrote that my right core biopsies were "Benign prostatic tissue with chronic prostatitis," but that claim was not repeated in the Hopkins opinion. 

      Also, I should mention that i don't, and never have taken any ongoing medication for anything, only short-term antibiotics when called for.

      And I exercise a lot, every day--always have, although I'm not a gym rat.

      Harvey.

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