Rise in PSA

[ironmanburg]

Hello everyone, I am 72 and have been on active surveillance for prostate cancer since I was diagnosed in August 2021 but probably had it prior to my first MRI in 2020. I have had 2 biopsies and 5 MRI's and countless PSA tests. The first bx showed 3 cores at 3+3 and 2 cores suspicious, confirmatory bx a year later showed 1 core at 3+3 and 1 core suspicious. My PSA has risen from 3.9 in 2018 to 12.7 and back to 11 this year. My previous MRI's showed a bladder outlet obstruction and BPH and one probable subcentimeter utricle cyst rated Pirads 2, the latest MRI report showed the probable subcentimeter utricle cyst as Pirads 3 (grew a bit) and didn't say anything about the bladder outlet obstruction or BPH. All surrounding areas were fine. When I saw my Urologist I brought this up and he had no answer for me other than to say I moved up to an intermediate unfavorable risk since my PSA was up. Said the size of my prostate was borderline enlarged anyway. I suggested that maybe riding my bike 5000 miles a year for over 20 years may have something to do with my rising PSA since the prostate may be in a constant state of proctitis and he had no answer. Of course, he suggested a prostatectomy which I am not going to do at this point. I have no other symptoms, I train and compete in Ironman triathlons, eat a Vegan diet, and get plenty of rest/sleep. My question is, has anyone else had a similar journey and where did you end up? Since this post, I have moved my care to Dr. Michael Poch at Moffitt Cancer in Tampa. I saw him on Monday and all signs point to me remaining on active surveillance and to have a PSA test that day and again in 6 months for a follow-up visit. My concern is that my PSA was 21,38 at the new testing site, up 10 points from 3 months ago. I just wanted to know if anyone else has experienced this after testing at a new lab? Thanks.

[Drianbrain]

Hi, I've been told by my urologist not to compare PSA tests from different labs. I had a PSA on 7/4 done by Quest =1.93 and one at the local hospital on 7/23, =2.90. The ones at Quest are always lower. But I'd ask your new urologist. Best Regards.

[ironmanburg in reply to Drianbrain]

Thanks. I did have a severe case of bronchitis and just finished up a round od antibiotics so maybe that had something to do with it. I guess the urologist wasn’t alarmed enough to call me.

[aceace12]

odd that its went up that high ....please get it checked out .. i am similar to all of you diagnosis and test results.. but my PSA has always been 4.0 or below

[RazorSaw]

I'm so curious about you, and maybe others with this story. My competitive cycling days are over, but all during my 40s, 50s, and into my 60s, I've been doing this kind of mileage on my bike. Road bike mileage mostly, but have had some intense mountain biking for past decades as well. Raced for 10 years.

PSA level of 2.4 in 2005/2007. Never had another checked till last month. PSA of 35, down to 33 3 weeks later when I got off the bike for 72 hours. I've not been diagnosed yet. Waiting for MRI, had first urologist appt 3 weeks ago. No sense of urgency from clinicians yet.

PCP, family medicine doc, has been treating me as BPH for about 3 yrs. Low dose of flomax has helped a lot with urination, especially nocturnal frequency. Otherwise, I feel great and have been active as usual. (well, recent knee issues are slowing me down a bit)

I just wonder if guys who have spent many miles on a bike saddle have a different physiology and perhaps are prone to enlargement without cancer?

I do have a thread of my own story going on here and will be adding to it soon. Due to lack of response and slow diagnostics in my home setting, I decided to go to Mayo clinic this week.