PSA rapid rise to 20, no explanation.

I am still awaiting a response from the urologist regarding my questions re diagnosis. I was having a blood test on Monday for something else and asked my GP to include a PSA test which they kindly did. It has stayed the same, so still at 15, but at least it hasn't gone up in the last 3 months, but still no explanation as to why it is so high. It is now 7 months since my biopsy, so if the elevation was as a result of the biopsy, then I would have expected it to have settled down some by now. I spoke to the urologists secretary today and advised that if I didn't have a response by Monday that I would be raising a complaint, lets see if that stirs any action. I expect not.

Hi everyone, I seem to have found this discussion just like Mint.

I have very similar PSA trend and levels as OP - Billy. Latest reading from this week is PSA of 20.

I've already had three biopsies, and two MRIs. The history was Biopsy (#1), repeat Biopsy (#2) - found pins, MRI, Biopsy (3), MRI (#2).
I asked my urologist if realistically, the PSA results mean that I likely have something, but it's hasn't been found yet. And he said not necessarily; no doubt trend is a concern. 

Next step is MRI #3, and based on what the MRI sees, probably Biopsy (#4).

Edited by member 08 Nov 2017 at 21:19  | Reason: Not specified

BillyB: good to hear that you're doing well. Thanks for your update.

Quick update from me. my PSA has gone up steadily over the last five years or so. It did level off at about 11-12 for about one year, and then started going up again to 14,16, and 20. I had three biopsies already (two biopsies to start, and then a targeted biopsy in June 2016 based on MRI results), and I had already had two MRIs (one in early 2016, and another one after the targeted biopsy). And just had my third MRI early this month..

Just discussed results of my third MRI with the doctor, and it's still negative. There is no change in the area of interest over the course of three MRIs. So rating is unlikely to have cancer.
Also, I'm pretty much symptom free. Around the time the PSA scores were increasing to 20, I did notice more symptoms such as needing to urinate more frequently. But now it seems back to normal.

So while I was fully prepared to hear that they found signs of PC (and I would consider it as good news that it was caught very early when it is most treatable), I'm still negative after three biopsies and three MRIs.
I will continue to see the urologist regularly, with updated PSA tests. And depending on PSA results, more MRIs may be in order. Of course, they all say that PSA is not a test for PC and high PSA doesn't mean you have PC. But if my PSA continues to go up, they continue testing until they find something or until I'm too old to worry about it. But hopefully, PSA stops going up.

That post is two years old Barry :-/

Hi

I have got BPH and it has never been diagnosed  properly just the symptoms. My PSA was 0.4  for years and rose to 0.9  four months ago. Now after seeing my GP  for a referral he had another PSA  and it came back at 21.9  in four months. Is this a fluke or can it go that quickly.  I asked for another test the next day in case of a faulty result. Am awaiting the result 

Assuming that infection has been ruled out and they found no evidence of PIN (a sort of pre-cancerous state)?

I think if this carries on, you might consider pushing for a bone scan as well. There are a tiny number of cases worldwide where secondary prostate cancer has been diagnosed even though there was no primary cancer in the prostate. If you were my dad or brother, I would also be asking them to check for other conditions that can raise the PSA such as breast cancer and thyroid problems.

Edited by member 16 Jan 2019 at 15:48  | Reason: Not specified

I had 4 MRI and 3 biopsies. MRI only shows PIRAD 2 and some PINS. But since PSA pretty much had a steady increase over the last 5 years (from 8 to 24.2), a fourth biopsy was done and Gleason 6 found.

The next decision then is what to? active surveillance or treatment? My regular urologist was on medical leave, and the younger urologist who was covering said two somewhat opposing things. At the 2nd last appointment, he said active survelliance might be difficult due to my small prostate (last biopsy only managed to hit 7 cores due to small prostate). Then at my last appointment (after bone scan and CT scan come back clear) he said their protocol is not to treat Gleason 6 (i.e. wait to see if it gets worse).

I was not entirely comfortable with the somewhat contridictory statement (AS would be difficult, but don't treat gleason 6), and got a 2nd opinion at the top cancer center in my country (Princess Margaret hospital in Canada). The head of the department saw me, and said that while the "normal protocol" is AS for Gleason 6 (and Princess Margaret is one of the centers that was involved in coming up with the protocol), there are just too many unexplained things in my case. And since I'm only age 57, he recommends treatment.

I agreed. Non-stop increase in PSA, with a small prostate. 5 of 7 cores finding Gleason 6. Very possible there is higher grade elsewhere. I expect to have another 30+ years, so 10 year survival rates aren't good enough. I'm healthy now. Will get it treated. Have decided on Robotic Surgery. Waiting for surgery date. Likely to be in December.