I'm now a 64 years old, but my PSA issues started eight years ago. On a routine examine, my PSA reading showed 5.2. Two months later it dropped to 4.3 then about a year later it went up to 4.9. My DRE were all good with my prostate being firm and smooth. Of course the urologist insisted I have a biopsy, but I declined. I told him I wanted to "watch and wait" and then I went on a gluten-free diet, started supplements, and juicing. I lost nearly 50 lbs in six months and my PSA tested at 3.6. I thought I was home free, so the strict diet when by the way side, though I continued to supplement with D3, K2, Magnesium, primarily. I continued to check my PSA level about every 3 months and I started steadily climbing from that 3.6 through 7.8, then this past January it jumped to 11.7. Over the course of these past 8 years, I've seen three separate urologist who all did the DRE and found my prostate smooth and firm and all indicated the only way know if it was cancer was to do a biopsy, which I declined. I might add, the steady climb of my PSA numbers were not uniform as one quarter it would register at 6.3 and the next time it would be 5.6. Four years ago it shot up to 8.3 then dropped back to 4.6 a year later. My most recent PSA number was this past week and it dropped from 11.7 to 9.7 in about 2.5 months. My question: is this how most of you have experienced your PSA number rise? Is it normal for PSA numbers to go up, then down, then up and back again?
PSA up then down: I'm now a 64 years... - Advanced Prostate...
PSA up then down
Cancer does not attack, retreat, attack again; on its own volition. In fact, when cancer, PSA will only but increase over time and do so with a degree of deadly precision. What we call the ‘rate of doubling’. While it may make sense to biopsy the gland to determine the cause of erratic and out of range PSA; one would not logically do so as to rule out cancer. Were I to guess, I suspect that you have a challenging case of BPH which may cause serious infection. I would also guess that your bladder may not be sufficiently emptying after urination.
Thanks for your reply. I read up on BPH a few years ago and I'm fairly certain the urologist tested for it and indicated it was not BPH or a urinary tract infection. It is true that I've had trouble emptying my bladder in the recent past, though that symptom has significantly improved with a bladder and kidney herbal I started on about three weeks ago. If I look at the rate of doubling, it's hard to tell from the vacillations of the reading, but here are my records:
1/19/2010 PSA reading 5.2
3/18/2010 PSA reading 4.3
9/2/2010 PSA reading 4.6
2/4/2011 PSA reading 4.9 Gluten-free start
4/2/2011 PSA reading 4.6
8/12/2011 PSA reading 3.6 Gluten-free end
5/31/2012 PSA reading 4.1
3/9/2013 PSA reading 5.6
7/25/2013 PSA reading 8.3 UTI infection
2/6/2015 PSA reading 5.8
5/14/2018 PSA reading 6.1 Gluten-free start
8/17/2015 PSA reading 5.7 Gluten-free
10/26/2015 PSA reading 6.3 Gluten-free
11/24/2015 PSA reading 4.6 Reduced Sugar
3/14/2016 PSA reading 4.7
11/8/2016 PSA reading 6.9 too much sugar?
11/16/2016 PSA reading 7.6 start gluten/sugar free
12/1/2016 PSA reading 7.2
2/15/2017 PSA reading 7.7
3/1/2017 PSA reading 9.1
3/21/2017 PSA reading 7.0
4/19/2017 PSA reading 6.7
5/10/2017 PSA reading 7.1
7/5/2017 PSA reading 7.8
9/6/2017 PSA reading 7.6
11/09/2017 PSA reading 8.7
1/31/2018 PSA reading 11.67 free PSA .95 free PSA % 8.1L
4/18/2018 PSA reading 9.7 (4 weeks on vitamin C,12,000mg)
Your free PSA number is good, correct? If so, al the more reason to watch more prior to biopsy. Particularly if the DRE is normal and you don’t have to get up at night. I did not leap at biopsy, either, even though in hindsight I am fairly certain to have been already metastatic at 4.9. A few months later PSA was 7.2, but free PSA was so low that it was a strong indicator of cancer. Endured the biopsy, had the surgery, looked clean at first then the lymph pathology was positive for mets PCA and PSA continued to rise long after surgery.
If you choose to have a biopsy, i suggest do your homework in advance, get MRI guided if possible and be very cautious of physicians with high rates of infection. Also realize, that once that the little gland has been pulverized by 12 heavy gauge needles; it will never again operate the same—again. The procedure is among the more barbaric performed of routine nature in modern medicine.
My free PSA .95 free PSA % 8.1L . I have read quite a bit on the biopsy to know it does harm and is no guarantee of finding cancer even though it may be present. I am looking for a urologist that does color ultrasound, but so far nothing close to where I live.
Both misery..
The fluctuations from one day to the next happens, could be called noise in the test. What is concerning is your steady rise over time, what seemed you said “ In 3 month test ,steadily climbing from that 3.6 through 7.8, then this past January it jumped to 11.7. ” to me that is fairly close to a 3 month doubling time, and that is concerning when a cure is still possible.
I have 2 suggestions:
1] plot your PSA results along a time line. An upward trend, assuming there a discernible trend, would be due to PCa IMO. All of the ups & downs being "noise" from BPH.
2] since you are avoiding a biopsy, please get a 4Kscore test:
It is not yet covered by insurance, but you need to know what you are dealing with.
"The 4Kscore Test helps clarify the biopsy decision-making process by determining a patient specific probability for finding aggressive, Gleason score 7 or higher prostate cancer upon biopsy. These are the aggressive prostate cancers that always require medical treatment or intervention. The 4Kscore Test relies on the measurement of four prostate-specific kallikreins in the blood: Total PSA, Free PSA, Intact PSA, and Human Kallikrein 2 (hK2). The blood test results are combined in an algorithm with patient age, digital rectal exam (nodules, no nodules), and prior negative biopsy (yes, no) to give physicians a personal score for each patient. The 4Kscore Test predicts the risk percent score from <1% to >95% of a man having aggressive cancer in a prospective biopsy.
"PSA testing on its own has been shown to result in a high number of unnecessary biopsies. By providing information to improve decision making before ordering a prostate biopsy, the 4Kscore Test can help avoid an unnecessary prostate biopsy and its associated complications, and costs for men at low risk of having an aggressive cancer, while still identifying men at high-risk for having an aggressive prostate cancer. Depending on the 4Kscore result, Urologists can choose to either place a low-risk patient under active monitoring, or perform a biopsy on a high-risk patient.
"The 4Kscore Test has undergone extensive clinical research and laboratory test validation. The biomarkers utilized in the 4Kscore Test are based on over a decade of research conducted by scientists at the Memorial Sloan-Kettering Cancer Center and leading research centers in Europe, encompassing over 10,000 patients. The results have recently been replicated in a prospective blinded clinical study conducted at 26 urology centers across the United States on 1,012 patients. Based on the results of this clinical study, as many as 30-58% of biopsies are avoidable using the 4Kscore Test."
...
-Patrick
The see-saw pattern indicates prostatitis, which is also reflected in the firmness of the DRE. However, the continual rise in baseline PSA over time suggests there may be something else going on. There is a test called "Prostate Health Index" (PHI) that is better than just PSA or free PSA. If it is high, it would be prudent to have a biopsy.
Have a biopsy done, but insist they do while you're in LA LA LAND.
Good Luck and Good Health.
j-o-h-n Monday 04/23/2018 1:39 PM
Mine wasn't all that painful, but yeah, given a choice I always opt for La La Land.
Very similar to my PSA but I got the biopsy which I will never get again as they did not let the freezing take before they did it. I also had an MRI which was better. They found what they said could be medium risk. Could be is not good enough for me. Your Psa history over time is slow rising so it may not be an aggressive cancer but it could be a low risk form. I still like my sex life and do not want any of the ongoing complications of surgery or Radiation so I am doing the diet and supplement rout and keeping the alternate therapies such as laser, electro, and photo dynamic therapies in my hip pocket if things get nasty. So far I am doing well. Many would disagree with me but check out Chris Wark's website. The main issue for me has been psychological. I have also been working on faith and attitude. A smile and a good appreciation of life is powerful . Ultimately you must do what is good for you. We can only say what we are doing which may or may not work. Good Luck!
Well it's good to see that you're not keeping your rocket in your pocket. Give her HELL...
Good Luck and Good Health.
j-o-h-n Monday 04/23/2018 7:54 PM EDT
I was diagnosed 24 years ago 3+3 bilateral at the age of 49 years 11 months. I opted watch and wait as the surgeon informed me that even though I no longer had a prostate there was a 35% chance that it would return. I lived symptom free for over 21 years but when it decided to go it went. Psa peaked at 5664 May 2022. Now I’m doing well but that could change at any time. If I had it to do over I would have started adt before Psa hit 900 and symptoms began. Prostate is still intact, no surgery or radiation. I get monthly Lupron injections and take low dose abiraterone with food. You must choose your own path. The path I chose is for someone who wants to live life to the fullest and not afraid to die. I had my doubts through the years and some may say that I took years off my life and they may be right but we’ll never know. Why, because this group consists of plenty of guys who follow SOC and yet here they are. Best wishes and God bless.
I agree with getting the biopsy and an MRI-guided biopsy is a good idea. Yes, the MRI is no fun and there are other things I would rather do than get a biopsy, but it's better to know than find out too late.
My PSA was up and down though slowly rising. The DREs were fine and I had two negative biopsies. Long story short, my urologist failed to diagnose, but we hear what we want to hear. By the time my PSA was 11+ a friend suggested I see another urologist. He ordered an MRI, identified the lesion, did another biopsy guided by the MRI, etc...
Please consider an MRI and/or biopsy. A little inconvenience and discomfort now may save you a lot of trouble later.
Good luck.
To mtjag, Do you have any urological conditions also or discomfort?
Lulu700 I've had some issues on and off for the past eight years but they come and go. For instance, about 4 years ago (when my PSA was lower) I had some pain urinating and a few times with painful ejaculation. Interestingly enough, I was up for surgery and they found a UT infection and put me on antibiotics to clear it up, then did the cath for surgery, I didn't have that problem any longer. About a year ago, I was having trouble starting and stopping but that cleared up as well. Recently, my stream seems to be better and I seldom need to get up in the middle of the night for a bathroom break. I am taking a herbal for kidney and bladder support now over the past month or so and am also on supplements of high doses of Vitamin C, D3, and K2. In the past six weeks, we are juicing every morning and cutting out sugar and eating more fish, fruits and vegetables. We use only coconut or olive oil in all our food preparation and limit our outside dining. Most of these changes are recent since about early March.
Guys, one other thing to let you know is that I had a DNA test done in January and while it showed a high genetic risk for Alzheimers and Parkinson's there was no markers for cancer or things that lead to cancer. Having said that, my diet has been pretty much typical of the Western culture for most of my adult life with lots of red meats, alcohol, breads, sweets, etc. Never smoked. I stopped drinking when I was 43 and started taking some supplements when I was 57 years ago. After a six month diet with juicing, eating much better and supplements, my PSA dropped into normal range. However, I didn't follow through and went back to a standard diet with just some supplements. I am giving the diet with supplementation another run in hopes that will have the same impact it had 5 years ago. I am weary of a biopsy thought I would be in favor or other less harsh methods such as the 4K Score as mentioned above or a color ultrasound. The problem here is that no one offers those within 150 miles of my location, though I will seek that out in the next two months.
Thanks for all of your insight and help. I wish you the best.
docrok; 15 year update. Rising PSA, Pet Choline Acetate Scan test results Mayo Clinic, Minnesota. 
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