58 years old with a PSA of 5 what sho... - Advanced Prostate...

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58 years old with a PSA of 5 what should be next move?

math33 profile image
23 Replies

My friend at work is 58 years old with a PSA of 5 and his Urologist wants to do a biopsy, he doesn't want to.

I ask him to get his entire history of psa scores and check his doubling time. Is there any other test he should have before deciding?

5 is a large number for his age.

Larry E.

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math33
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23 Replies
GP24 profile image
GP24

It is above 4 but I think if your friend does not want a biopsy he can wait for the next PSA test. Let him do watchful waiting for now.

medicinenet.com/prostate_sp...

Tall_Allen profile image
Tall_Allen

He can ask for a Prostate Health Index (PHI) test. It helps eliminate benign sources of PSA, and might spare him an unnecessary biopsy.

will hes stupid not to get a biopsy then no i don't want to. thats why men die much earlier to find out what his psa is or where are the mets, how many if hes stupid not to then let it go. his numbers will increase the mets will spread and he will die. the problem with men they are stupid. oh i have a lump in my leg, then they remove his leg, oh i have a lump in my stomach then they remove 50 feet of his intestines. he's old enough to make that decision let him him decide on his own.

charlie

in reply to charlesmeyers1964

I waited too long myself . Can’t recommend that to anyone ...

dmartinaog profile image
dmartinaog

I'm 57 and have been monitoring PSA and having DRE every year for 12 years. I was told that I had a slightly enlarged prostate and not to worry. I should have been concerned and insisted on a biopsy. PSA was always under 4.0. Mainly it stayed around 3.0

In January it went to 4.1 in may it was 5.0. I got the biopsy done and found out I am a Gleason 9 and had a complete RP, ripped out by the roots. My prostate was 95% tumor. It was everywhere and I was left with positive margins, a total crap show down there. I'm 4 months post op and went to undetectable in November and now its .2 after the second Lupron shot. I'm going to MD Anderson tomorrow for the week to see what they can come up with fo me.

Tell him to get a biopsy as soon as possible and don't put it off.

tfly59 profile image
tfly59 in reply to dmartinaog

I'm with dmartinaog. I'm 59, my PSA was around 3.1 two years ago GP Dr. suggested monitoring the PSA, went up to 3.8 summer of '18. He then suggested I see Urologist, who did an exam and suggested I get a biopsy, received call three days later on 11/22, turned out to be Gleason 9. I started on a 6 month Study at MD Anderson on 12/13. Study has me taking Lupron, abiraterone, prednisone, and apalutamide. RP at end of Study. I would suggest at the very least getting an MRI of Prostate. Biopsy only way of being positive of Prostate status.

pakb profile image
pakb

There really is not an age/PSA number correlation. Lots if older men have a lower PSA and younger can have higher. My husband was diagnosed at age 49 with a >677 PSA. A PSA of 5 can be very aggressive... or not.

His Gleason score and if he has metastasis are more important. If they find he has prostate cancer (psa increase can be due to things other than cancer) Those two numbers will show if his is aggressive.

But I would not wait to investigate. It may just be something other than cancer but investigate in case. Waiting will not be good if it us cancer.

Well, first of all, your friend is very lucky to have you!

Five years ago at age 53, discovered PSA 8 from a regular scheduled physical. The Urologist performed a biopsy, which resulted in Gleason Score (GS) 6. This score, at the time was debatable for actually declaring it cancer.

Consequently, the Urologist, which also a surgeon, suggested Radical Prostatectomy (RP) immediately. After some research, learned, Urologist Surgeons are trigger happy and typically over treat with possible early stage prostate cancer diagnosis. So, decided to "Active Surveillance", although, unfortueately lapse with the "Active" discipline.

Then, at age 58, diagnosed (3 months ago): Advanced Prostate Cancer, Metastatic Stage 4, PSA 1000+, the Pelvis MRI looks like a Supernova...

Was fortunate 5 years ago of being cancer curative, now no chance for a cure. I just needed to focus a bit more 5 years ago, discovering this forum back then - would have made a universe of difference with my life now.

in reply to

Looking back in the rear view mirror sucks . If I woulda coulda shoulda .? Boy I fed up . How the sleeping going? Hope your sleeping like a baby . Take it easy NYMets! Peaceful nights hermano...😎🎢

in reply to

Hola Amigo,

Yes,, I'm finally sleeping better, just got more active, working out and staying busy. Then the late night falls, take some Melatonin gummies and bang out like a baby!

But, not always, some nights just can't get into the zzz's, it's obviously the racing mind, anyway, much better sleeping overall.

It's gotten freaking hot up here in New England area, time to burn off some fat..

Cheers

in reply to

😴

j-o-h-n profile image
j-o-h-n

Tell your friend to have the biopsy... I understand that they can perform it while you're under anesthesia. If I had to do it again I would insist it be done while I was under anesthesia... Doctors want to do it cold turkey in their facility. Again tell him to get it done under anesthesia. <===<<< If doctor doesn't want to, see another doctor.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 01/27/2019 12:54 AM EST

Shooter1 profile image
Shooter1 in reply to j-o-h-n

Just anesthetic jelly up butt and then biopsy. Wasn't bad at all.

RalphieJr64 profile image
RalphieJr64 in reply to j-o-h-n

I definitely agree. Get the biopsy, and make sure you're out. Very painful and bloody. Well mine was.

in reply to RalphieJr64

😫

j-o-h-n profile image
j-o-h-n

My Urologist used a salvaged WWII bazooka...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 01/27/2019 10:32 AM EST

in reply to j-o-h-n

Was his name JOE?

j-o-h-n profile image
j-o-h-n in reply to

ugotit...His initials were G.I.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/26/2019 11:46 AM DST

Reply

in reply to j-o-h-n

Was that upper GI? Or lower?

j-o-h-n profile image
j-o-h-n in reply to

Give me a minute.... I'll ask him.....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/29/2019 5:15 PM DST

My psa was 4.2 when I had my biopsy. The tumor was outside the capsule of the prostate against my rectum and in the nerve bundle. Have the biopsy in the hospital and have it fast. Zero reason not to.

My psa was 4.25. Gleason 8, Inoperable tumor. Find out ASAP what is going on.

Looks like I’ve repeated myself. It really pissed me off to have missed the earlier chance at getting it out of me I guess.

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