High PSA test

[Goncountri]

Husband has always had normal PSA test and this last one Dr said was 23. We thought maybe they missed entering the . point after the 2 so we had a second one done on our own to be sure there were no mistakes. Appointment has been made for follow up with neurologist next week. Seems like a 23 is off the charts with no symptoms to back it up. Does this indicate a pretty solid case of cancer that may have already spread outside of the prostate and that’s why the high number. Any help to understand this high number would be appreciated

[Tall_Allen]

No. It can be a prostatitis or a bad case of BPH. A large sudden jump like that is often prostatitis. Did he feel anything? What did the ultrasound show? Why a neurologist?

[LearnAll]

There are many causes of high PSA and prostate cancer is one of them. I would certainly repeat PSA 3 or 4 times to accept the high reading and then proceed accordingly ..get a digital rectal exam and other tests .

Sometimes, the old fashioned digital rectal exam can provide great clues...if prostate is rock hard, possibility of cancer goes up but if prostate is soft, boggy and tender ,cancer possibility goes down. Ask urologist to do digital exam..

[Goncountri in reply to LearnAll]

Yes he had the old fashion finger check, Doc said everything felt good.

[whatsinaname in reply to Goncountri]

The "old fashioned finger test" usually cannot reach ALL parts of the prostate. Really don't know why this outdated, primitive "test" is still used.

Btw, three surgical oncologists performed the DRE on me before my biopsy and declared that they could not detect anything amiss.

My 16 needle biopsy showed cancer in 14 cores with a Gleason score of 4+4=8.

So much for the "old fashioned finger test".

[Goncountri]

Is PCA same as PSA, I keep seeing both

[JamesAtlanta in reply to Goncountri]

PCA is the abbreviation used for ‘prostate cancer’. And PSA is a test that is used as an indicator that someone might have PCA. They are not the same thing. As Tall_Allen says, there are sometimes other reasons for a high PSA.

The ‘normal’ range for PSA is between 0 and 4. Above this requires more investigation. This number can go into the thousands.

Hope this helps!

Best,

James

[LearnAll]

If digital exam did not reveal hard prostate or a palpable nodule..this is first piece of good news...but investigation must continue.

[timotur]

I was PSA:23 at dx, negative-DRE, asymptomatic, and later, biopsy was G7 (3+4). Do a free-PSA test, if <10%, then do a 4KScore, and if that is >10%, get a MRI/targeted-biopsy.

[Fairwind]

Time for a biopsy, it's as simple as that...PSA's can go into the hundreds without any symptoms..

[Currumpaw in reply to Fairwind]

Hey Fairwind,

Make that an in bore, biopsy with a mp 3.0T being used for imaging. No unnecessary "exploring" with a biopsy needle which can cause irreversible damage to a man's prostate.

It is time for the "antique" TRUS and Artemis biopsies to be set aside.

The in bore biopsies today dramatically reduce the number of cores needed to be taken as long as whoever is doing it is experienced and competent.

Currumpaw

[j-o-h-n]

Relax and take a few deep breaths... We've all been there.... The only advice I would give you right now... is if he will be getting a biopsy of his prostate, then make sure you ask the doctor to put him under sedation. It's not a pleasant test and why put him though the uncomfortable test. Most urologist don't like to do it under sedation. But insist upon it...

It is good that you're on top of your situation but don't eat your heart over it.... Now take some more deep breaths.... and -

P.S. Your age? and location? Info voluntary

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 07/14/2019 2:04 PM DST

[JimVanHorn]

In the last eleven years I have had three prostate biopsies and they hurt really bad unless you are put under light anesthesia. These biopsies saved my life and the answers they give direct your future therapy. I had a second opinion before I chose my therapy and I would recommend that to you. Make a decision based on your life and what seems logical for you. PCa is usually slow growing, but putting off your decision for a long period of time can change the outcome as well.

[cesanon]

Digital exams and even biopsies can miss things. Next step in my opinion is an MRI, which is also safer than a biopsy. Find a medical oncologist with a heavy or an exclusive prostate cancer practice.

A no brainier next step if your MO can point you to the right Doc is a simple inexpensive and noninvasive color sonogram. It Should be done by someone experienced in using it for prostate cancer diagnosis.

Tall Allen is pretty knowledgeable. He may very well be right. He is probably likely right. I just think you should error on the side of early intervention.

Also you need to insist on high frequency psa testing. Personally I would insist on a few weekly tests to start with. Then move to a few monthly tests.

The psa doubling rate is what will separate cancer from other alternative causes. If your psa is stable or only slowly rising, you can take some time to think, educate yourself, and get some second opinions.

If your psa is doubling every month, you don't want to waste time fumbling around waiting on the scheduling convenience of particular docs.

[Jesusheld]

I had a rapid increase in my PSA. It turned out to be BPH, but my docs too their sweet time (5 months) determining that I didn't have PCa. Now, I'm on two different Anitdepressants! Please take his mental health seriously and sell counseling! Remember, it's likely nothing life threatening. STAY CALM! ASK FOR MENTAL HEALTH HELP SOONER THAN LATER!!

[Goncountri]

Well he had a second PSA and we had to become loud in the waiting room after the staff refused to give him his results over the phone. So we showed up and then get told Dr will call us. NO we will wait! She finally says oh since they are signed off on I can give to you. This is Saturday and they had results since Thursday. New results were 3.36. Oh my husband could have destroyed something at that point. How could let him continue to think he had the cancer. We are still following up with urologist tomorrow just to be sure. Sure will like to get a copy of first report to see if Dr mis read or if it really said 23. Thank you all for all your advice . Prayers for all and hopefully everything turns out good for us also.

[Hidden]

23 isn’t super high . We have some members in the thousands . I think you’re catching this sooner than later . Don’t jump to the worst conclusions .. pray for the best results with a biopsy.. Its normal for most humans to panick thinking about cancer . I did the same . Thought I was dead on the doorstop . Over four years later ,I’m still here . No symptoms is great .. If possible see a prostate cancer specialist ..... hopefully its bph or prostatitis .. no reason yet to think that it s out of the prostate ... stay positive ... no matter what you’re told ,You two can deal l with it ,as we all have ..,Stay strong together .. The fear of not fully knowing is tremendous.. Sorry that he in this position . But you should soon find out the low down .. How old is your husband?? Keep his spirits up ...