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Sudden increase in PSA from 19 to 39

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libralady13
libralady13

Hello, My husband will be 70 next month.  He has arthritis in the hip for some years,type 2 diabetes and last year was diagnosed with asthma/copd he on 3 different inhalers including one called spiriva.  The leaflet which comes with this inhaler stated to ask doctor if it is ok to use if you have prostate problems which my husband does.  We were told it was ok to use.  My husband started having regular psa blood tests back in 2002 and has had 2 biopsies and 1 MR1 scan.  His results have been as follows

May 2002 4.5

Dec 2004 7.2  had biopsy will was negative for cancer and was diagnosed with benign enlargement.  No treatment.

Dec 2009 17.5 another biopsy same results but suffered a bad reaction to the antibiotics.

Jul 2010 and Jul 2011   14.4

Feb 2012 21   This time because of the antibiotic reaction had an MRI scan which show enlargement but no convincing evidence of cancer.

Sept 2013 19.6

Feb 2015 19.6

Feb 2016 39 Gp is referring back to hospital.

My questions are is level of 39 likely to be cancer or could it be benign enlargement.  If I remember at the 2nd biopsy the doctor did say that there were some areas of inflammation.  I think he may have prescribed anitibiotics, but can't be sure.  Also the inhaler that I mentioned which is caused Spiriva could that have anything to do with the rise.  I would appreciate any views I realise you are not doctors.  My husband is not unduly worried but I as an anxiety sufferer am worried sick.  Thank you.

 

1 like, 26 replies

26 Replies

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  • craig84609
    craig84609 libralady13

    Posted

    He can have the 4k blood test to see how likely it is to be cancer . But with what you said I would stay away from biopsy. No need if nothing is found in other screens.
    • craig84609
      craig84609 libralady13

      Posted

      It is a new test that can tell how likely it is to be cancer, but keep in mind that the meds he is on can cause this so I know it is difficult but try not to worry so much. Most prostate cancer is slow growing and may never be an issue. Look up the test online and there is a lot of good information on this subject.
  • gary97183
    gary97183 libralady13

    Posted

    Hi libralady13,

    There is some correlation with Spiriva and spikes in PSA. 

    With his past its probably just more inflammation. 

    I would get another MRI if you are worried, but at age 70 and if the MRI does not show cancer. I would forget about PSA already. 

    • libralady13
      libralady13 gary97183

      Posted

      Thank you Gary97183.  Not sure where you are, we are in London.

      Our gp will make an urgent nhs referral to see the urologist.  Incidentally the gp referred him back to the hospital last year only to be told by the clinic doctor the psa is the same as last year 19.6 I think. We only need to see you if if goes to 24 or more, hence this latest referral.

      I have been trying to get my husband to be more healthy for the diabetes and the lung problems.  I am wondering if there are any do and don'ts diet wise for prostate problems.

    • gary97183
      gary97183 libralady13

      Posted

      Hi libralady13,

      I am in sunny Hawaii.

      Basiclly eating more healthy for the prostate, would be eating more greens and less red meat, sugar and dairy. Take a supplement BETA-SITOSTEROL and Quercetin for the inflamation.

    • libralady13
      libralady13 gary97183

      Posted

      Hi Gary97183 and craig84609  

      My husband spoke to gp this morning regarding the spiriva and spikes in PSA and was told spiiva does not cause this and to carry on taking it.

      I have found a couple of patient comments saying it does or they can't get a clear answer from anyone.  I just don't know, but what I do know from years of being on various medication, is that not only do doctors differ in their opinion as to whether drug causes a certain side effect, some refuse to believe that a particular drug causes a side effect experienced by a patient.  It does not help if you are on several medications either.  The gp said he should get a hospital appointment though in 2-4 weeks.

      I have been trying to educate myself on prostate cancer is case it is bad news.  Every article or comment from patients seem to think that is level 38 (not 39) not that is makes any difference, is very high and definitely cancer and possible advanced.  I know that he has had high levels for quite a few years but I m still very worried.  Also because of treatment he has asthma/copd and has daily cough and slight breathing problems but stable now on inhalers.  He is also overweight and despite me trying to encourage him to lose some weight he does not seem interested.  His diet is not too bad as he has diabetes but I think it is the beer which needs to go at least until he has lost weight.  I don't know what else to say.  As said before I am a worryer.  He is not and just puts things out of  

      his mind.  Sorry to have gone on a bit. Feel better for having a moan.

  • libralady13
    libralady13

    Posted

    Hello You will see from my post above my husbands record of psa readings and tests.  Is there anyone out there has been in a similar situation and found out that their high psa reading was not cancer.  I realise it is a high reading but as you can see he has had high readings for around 13 years.  Everything I have seen on line seems to say that a reading this high is definitely cancer and posssibly advanced.  I am an anxiety sufferer and am finding this very hard to cope with unlike my husband who can just forget about until his clinic appointment comes through.  Last night I hardly slept for thinking that he has cancer.  He will be 70 mid March and we have some family celebrations planned.  I feel like everything is on hold and he not even seen the consultant yet alone any biopsy or mri scan.  I know I must calm down but it is so hard.  My husband is the type of man who does not like having to give up anything he likes.  It has taken my ages to sort his diabetic diet out not perfect by much improved although he will not give up his beer, I am concerned that if it is bad news he will not cope with any treatment.  I appreciate that any treatment given will depend on the result of any biopsy etc.  Radiotherapy and hormone treatment seem to have awful side effects.  I am not sure if at 70 with breathing problems (Asthma/copd) ,Diabetes and being overweight if he would be a good candidatefor surgery either.  Hew coughs a lot daily so might that hinder recovery (urinary problems).  Any experiences you can give would be most welcome.  It is so hard waiting for an appointment to come through.  Our gp said that it would take 2 to 4 weeks to hear from the hospital.  This was from February 3rd.  Thank you.
    • gary97183
      gary97183 libralady13

      Posted

      Hi libralady13,

      I PSA was always high and was always told to get a Biopsy. The past ten years my PSA went from 4 to 11 up and down and was told it could be cancer. A few weels back my PSA came back at 15 and repeated at 14.

      My doctor said I should geta MRI to check on whats going on. My MRI came back showing two masses 70% cancer.  

      Had a Biopsy on the two masses came back zero cancer, just inflamation.

      So to answer your question PSA does not mean anything, just measures inflamation and when there is inflamation your body produces more to fight the inflamation.

      I would get the T2 MRI before he has another Biopsy. No reason to go poking around without knowing were to poke. At age 70 and if he goes on with a biopsy and if they find something as long as his gleason score is low, like 3+3 or 3+4 I would pass on the surgery like my dad did he is now 94 and has Prostate cancer it does nor affect him. Surgery has many side effects.

       

    • libralady13
      libralady13 gary97183

      Posted

      Hi Gary97183

      Thank you for your reply.  It has reassured me somewhat.  I think even before you replied I though he would ask for an MRI scan first of all although I expect the doctor will want a biopsy done.  I don't know how old you are but one thing we did ask about somewhere along was whether vascectomy could cause prostate problems.  We were told no at the time but I have read that there is ongoing research on this subject.  What I do know is that round 6 months after the surgery he suffered terrible pain which has to be treated with anitobiotics.  It was something to do with congestion and I believe it is something which can happen.  I suppose that could tie in with inflammation.  I will try and calm down and wait until he sees the doctor.  It is the waiting which does not help.  2015 had been a difficult year for us with him being admitted to hospital and having the asthma/copd diagnosis plus other family illness and things going on.  I do hope 2016 will be healthier and quieter.  Thanks again.

       

    • libralady13
      libralady13 gary97183

      Posted

      Hi Gary just to let you know my husband has a urology appointment next Wednesday 24th.  This is just for consultation, will see what tests are ordered hopefully MR1 first and then biopsy if really necessary.  Will keep you posted.
    • libralady13
      libralady13

      Posted

      Hi Gary,  Just to let you know my husband saw the urologist this morning at our local hospital.  He said that as the psa had doubled for 19 to 38 he would not be happy just to leave it (my husband as you know is not keen on another biopsy).  What was decided is that he have an MRI scan in the next couple of weeks and then a targeted biospy.  His previous mri in 2012 showed no convincing evidence of cancer but a nodule which they said might just be from the enlarged prostate and that a targeted biospy was a possibility.  As you know he decided against it.  His psa stayed around 19 until this Month when the test came back at 38.  He looked at his notes and said he had been noted that there was prostatitis and that could be the cause of the rise but equally it could be cancer.  Trying to be upbeat but it is hard.  My husband as usual does not want to know about it or talk about it.  So these forums are good for me to find out information and let off steam.  I am glad he is having the MRI done first.

      I did mention to the doctor about the spiriva but he seemed to think it would not affect the psa.  Who knows.  There are those who say that their psa has risen since starting this inhaler.  Just like you we are hoping that it will be just be inflammation he has no symptoms other that urinary ones from the enlarged prostate.  The doctor when asked seemed to think if there was cancer found he would have radiotherapy rather than surgery.  Well we will have to just wait and see.  The mri should be done soon and then he will see the doctor again in 4 weeks to see about the biopsy.  In the meantime he will celebrate his 70th birthday with a family lunch.  So we have something tyo look forward to plus a new grandchild in June.  Thank you for sharing your experience and for your advice.

      Will keep you posted.

    • libralady13
      libralady13

      Posted

      Hi Gary,  Mri Scan done 2 days ago.  Now waiting for follow up clinic appointment.  Have been googling a bit too much I think.  I can never find anything about psa at around my husbands level without it saying advanced pc.  It seems that some  people seem to think over 4 and it's definitly cancer. Most stories I have read seem to be of patients with pc with level under 20 or over 100 or even higher, quite confused now will have to wait for the appointment to see if biospy is needed. 
    • craig84609
      craig84609 libralady13

      Posted

      The PSA test is a flawed one at best. It can't diagnose cancer with certantee. If PSA is a 4 I would say there is a strong chance of no cancer being present. Some have had a PSA test below 2 and have had cancer while others have shown PSA well over 4 with no cancer found. The decision to do a biopsy should be carefully weighed as biopsy can cause permanent damage and even lead to sepsis. In someone of marginal health biopsy is not usually done as it can cause problems for someone who's health is fragile. Most cancers of the prostate are slow growing so may not ever pose a problem. I hope everything turns out ok.
    • libralady13
      libralady13 craig84609

      Posted

      Thank you for your kind words Craig.  My husbands psa which has ranged for 7 to 19 gradually rising over  13/14 years this year doubled from 19 to 38, hence the referral to the hospital.  He has had 2 negative biopsies in 2005 and 2010 plus mri in 2012 as I mentioned in my original post which is why we are worried.
    • libralady13
      libralady13

      Posted

      Just an update on my husband.  Good news mri scan results no sign of cancer and consultant feels the rise in psa to be down to his very large prostate.  I must say that I would not rule out spiriva as being partly to blame but not according to the consultant.  He has been given tablets to shrink the prostate and will have another psa test done in 6 months. He has been told to double the result to give a correct level as the tablets will shrink the prostate and the lower the psa.  We are very relieved.

      I would like to thank you for your input and wish you well for the future..

    • libralady13
      libralady13 gary97183

      Posted

      Hi just an update on my husband,  Good news mri shows no sign of cancer.

      The consultanty thinks the psa rise is down to him having a really large prostate.  I do think though that maybe the sprivia might have played it part in the rise, although not according to the doctor.  He has been given tablets to help shrink the prostate and will have a psa in 6 months.  He has been told to double the level to take into account the effect of the tablets.  His 2nd psa test was down from 38 to 30.  

      Thank you for your advice on the forum.  I wish you well for the future.

    • craig84609
      craig84609 libralady13

      Posted

      Good thing for the MRI. Now no more worries. BPH is quite common and can cause PSA scores to rise high. That is why one can't rely soely on PSA to detect cancer. I am happy for you both.
    • libralady13
      libralady13 craig84609

      Posted

      Yes thank heavens he insisted on an MRI scan first.  Thank you for your good wishes.
    • gary97183
      gary97183 libralady13

      Posted

      Great news. I am glad everything worked out fine. The sprivia is the only reason why it would ihave increased so much. 

      I talked ro my doctor the other day, he said they no longer are doing PSA test unless the patient insists on them. 

      Wishing you well

       

    • libralady13
      libralady13 gary97183

      Posted

      Thank you.  That is interesting about the psa test.  In a way it has caused us needless anxiety over the years where we would have been none the wiser with the same outcome no cancer just large prostate.

      I agree with you about the spiriva as it is the only thing that has changed over the last year.  

      Best wishes to you as well.

    • libralady13
      libralady13 gary97183

      Posted

      Hello Gary Don't know whether you still log into this site.  You might remember me the wife of a man with history of high psa over a 15 year period but negative biopsies and mri scans.  Last year you might remember the MRI was fine and he was started on finasteride to reduce the size of the prostate with regular psa monitoring.  Fast forward a year a lot has happened not least a move of house 200 miles away to be near daughter and family.  Both myself and my husband have had health problems (added to those we already had) since January of this year I have had heart scans and colonoscopy both which turned out fine.  My husband also a colonoscopy again fine plus other problems with low iron and protein in urine.  At a a result of a kidney MRI scan he was referred back to urology.  Obviously they know nothing of his prostate history thankfully I kept all the relevant paperwork.  He has had a bone scan which was negative apart from usual degeneration as you age.  An MRI scan showed a suspicious area he is now waiting to see if he is suitable for a biopsy under a general or epidural rather than the normal prostate biopsy.  What I wanted to ask was this.  I see that you had an MRI which showed 2 masses thought to be cancer and which turned out to be inflammation.  Did you have the MRI scan graded I think it is called PI-RADS score which is graded from 1  to 5.  He has scored 4 and they seem to think it is cancer.  Naturally we are shocked and worried especially as it is only just over a year from the last MRI which showed no problems.  The latest scan also shows pelvic lymph nodes enlarged.  I still have my doubts about the Spiriva inhaler and have read on line of a few people saying it increases psa and others saying it increases your chance of PC.  I have asked the specialist nurse if she could do some research for me.  He is now 71 and ok but does have trouble breathing at times coughs a lot and has diabetes.  I assume that he would not be offered surgery but either radiotherapy or hormone treatment.  If you could offer any advice or anyone else reading this I would be grateful.  I realise until we have a definite diagnosis it is hard to comment but I would like to be prepared for what is ahead.  It will be me who had to try and sort things outs as he is not really interested,  I have been nagging him to lose weight to no avail.  It gets me down I have my own health problems as well.  I do try and support him but I can only do so much.  Thanks for reading this.

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