PSA at 39 years of age: Apologies if... - Advanced Prostate...

Advanced Prostate Cancer

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PSA at 39 years of age

taylor123 profile image
33 Replies

Apologies if there is an issue for posting this in here, and fully understand if it gets removed. It's just I have posted in here many times, and really value the members opinions who post.

So my Father has PCa, I decided last year to have yearly PSA tests myself.

My first result in August 2018 was 2.1.

My result from yesterday was 2.2. (15 months later)

I just turned 39 start of November, and even though the normal range is 0-2.5 I am mindful of the family history.

Do you think a free PSA test would be helpful now? Maybe even a scan?

I am awaiting the results of my T, E2 and SHBG levels.

Thanks in advance.

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taylor123 profile image
taylor123
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LearnAll profile image
LearnAll

Its good to be vigilant specially when you have a family history of cancer. Normal value of PSA is 0 to 4.0. Your PSA seems in middle range and fully stable around that.

I would monitor PSA every 3 to 4 months to see if there is upward trend. Until then, I would not go for more complex tests and scans etc.

taylor123 profile image
taylor123 in reply to LearnAll

Thank you, yes I think I am going to have a check every 4 months to try to establish a baseline.

LearnAll profile image
LearnAll in reply to taylor123

Taylor'

The truth is that Prostate Cancer does not erupt overnight. Mine took 6 years because my primary doctors office did not inform me about my high PSA.The cancer must have been brewing for last 10 years. , I found out only 6 months ago when I had urinary symptoms and got diagnosed.

In 2014, Primary doctor ordered PSA and it came out 42, . I was not informed. Then, in 2015, it was 65,...then in 2016 is was 78...then in 2018..it was 160 ….Nobody called me from doctors office in all these years. And I did not have any symptoms, so I thought everything is fine. I was walking 4 to 5 miles a day, in Gym 4 times a week, working full time. No complaints at all.

Then ,In May 2019, I suddenly developed severe urinary tract Infection and that's when I was admitted to hospital (my first hospital admission in my entire life at Age 61 yrs . In hospital, my PSA came at shocking 830 prompting all kinds of tests and scans etc Diagnosed with AdenoCarcinoma of prostate with multiple bone mets.

Casodex (bicalutamide) was started immediately and PSA dropped to 249 within 15 days on Casodex. Casodex was stopped and Lupron and Zytiga were prescribed.

It has been total 6 months and 15 days and my PSA is 0.6 and ALP is 59. No symptoms.

So Taylor, do not be nervous ..nothing will happen overnight..

If you really wants to be on top of things, my suggestion is : Check 4 tests every 4 months

(1) PSA (2) ALP (3) CRP (4) LDH

Chart a graph to see any pattern .. and I believe you will not miss it.

tom67inMA profile image
tom67inMA

My PSA bounced between 2 and 2.5 in my late 40s, and in 13 months jumped to 216 at age 50 and I had metastatic cancer. My dad had a PSA around 10 and no cancer. PSA isn't the greatest test, but it has its place. Scans are expensive and usually involve some amount of radiation, so are probably overkill.

As much as nobody likes an old fashioned DRE, it is an easy way to check for abnormalities in the prostate gland, and I never had one until after I had symptoms.

Be on the lookout for any symptoms like blood in urine or semen, reduced semen volume, and slower urination. If you have any symptoms, then you have a good reason to insist on a closer look by your doctors.

It's good to be aware of what's going on in your body, but don't be paranoid about it. Develop a healthy lifestyle of good diet, exercise, a social support network, and reasonable stress levels. It will all help prevent cancer, and if you do get cancer or some other disease it will improve your prognosis and quality of life. Enjoy the time you have, anyone could be hit by a meteor tomorrow, either literally or metaphorically.

taylor123 profile image
taylor123 in reply to tom67inMA

Oh my goodness. So sorry to hear that.

Did you ever have any symptoms at all when your PSA was around 2-2.5?

Did you ever track Testosterone and E2?

I fully subscribe to Ed Friedman's take that PCa is triggered by localised E2 in the prostate gland.

tom67inMA profile image
tom67inMA in reply to taylor123

Yeah, I had the symptoms I mentioned. Generally I had the symptoms of aging a bit earlier than normal. The tint of blood was a bit concerning but it couldn't be cancer because my PSA was low last year. Oops! Had T tested in my early 40s, was in normal range.

"Prostate cancer" is a catch all term for any cancer starting in the prostate, and there are certainly many distinct types and causes. Mine is a rare form called intraductal carcinoma. I also had a bladder tumor and some family history of cancer, so probably my cancers were partly caused by some genetic defect, though I haven't had reason to get genetically tested yet.

Magnus1964 profile image
Magnus1964

Bounces like yours are normal. The changes could be caused by irritations, infections etc. But with your family history be vigilant.

taylor123 profile image
taylor123

Many thanks. All noted.

Yes i have tested for T, E2 an SHBG as well at the same time.

Just waiting for those results to come back.

I am very much likely to start TRT soon to keep my T levels high with perhaps a very small dose of an AI if warranted.

LearnAll profile image
LearnAll

Nalakrats, But ..my total T was 650 at the time of diagnosis....Does T always correlate with PCA ?

taylor123 profile image
taylor123 in reply to LearnAll

High T can mean a lot of aromatase is going on, and that is the issue, in my opinion.

Tall_Allen profile image
Tall_Allen

Ask for Prostate Health Index (PHI) next time (in about a year).

taylor123 profile image
taylor123 in reply to Tall_Allen

Thanks Allen, would you also suggest a yearly ultrasound to monitor prostate density?

Tall_Allen profile image
Tall_Allen in reply to taylor123

One is enough for PHI

Great job being on top of it due to your family history ....My father and his brother both had pc . I wish that I had payed attention . I waited until stage #4 ..almost too late .. I say check the Psa every year.. more important is living healthy as possible to try to ward PC off in the future . You’ve found a great resource of support and real time info here at hu . Welcome young man . Scott

LearnAll profile image
LearnAll

I did read in an article on pub med that total T less than 350 at diagnosis indicates worse prognosis whereas high Total T (above 700) indicate less aggressive PCa

Happy Thanksgiving ! Celebrating with Cauliflower in shape of turkey .

LearnAll profile image
LearnAll

interesting ! thanks.

TNCanuck profile image
TNCanuck

Stay vigilant in monitoring. The "0-4 is normal" is a very general guideline, but the real "normal" range is lower for younger men and higher for older men.

taylor123 profile image
taylor123 in reply to TNCanuck

The range my Doctor gave for my age is 2-2.5

TNCanuck profile image
TNCanuck in reply to taylor123

So glad he's aware of age-appropriate PSA levels. Many doctors are not, unfortunately. They depend on the lab to tell them what's normal.

taylor123 profile image
taylor123

Wowzers. I have never head of this before.

Do you have any links for further reading? I speak to Ed Friedman quite a bit, and would love his take on it.

Have you been subject to the Digital Rectal Exam too? My PSA was only 2.7 when a suspicious DRE finding got me sent for a biopsy. Gleason 8 at age 66.

taylor123 profile image
taylor123 in reply to

Wowzers. So was your PCa confined to the prostate ?

Does your PSA not correlate to your PCa then?

Because a PSA of 2.7 at 66 seems fairly ideal.

in reply to taylor123

Confined to the prostate at time of diagnosis as far as they could tell. I was steered toward external beam radiation but chose full gland, as opposed to focal, HIFU. Biopsy revealed tumor activity on right side only but surgeon's advice was to do full gland to be more thorough and more likely to zap it all. Some PC doesn't produce a high PSA reading, making PSA alone inadequate as a screening method for prostate cancer. I was undetectable after the procedure but three years later PSA has ticked up to 0.6. I will get an Axumin scan when PSA exceeds 1.0.

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

Okay taylor.... take a deep breath.... Now check your psa at least twice a year (here in the U.S. higher than 4.0 = biopsy) and a Digital Rectal Exam (DRE). Make sure you get a copy of the blood test and keep a chart of your psa score. Any unusual issues with your urine or it's flow see a urologist as soon as possible. Make sure you use the same laboratory for testing your blood (sometimes results vary from lab to lab). Give your Dad my regards and my best wishes. Keep laughing.... and live your life...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 11/28/2019 10:30 PM EST

taylor123 profile image
taylor123

My T came back as 577 and SHBG at 45.

Meaning Free T is at 10.2 ng/dL (1.77 %)

E2 not back yet.

taylor123 profile image
taylor123

Sorry this took so long.

My recent T was 663 ng/dl and my SHBG at 48, giving me a free T of 0.391.

My most recent E2 was 62.4 pmol/L

taylor123 profile image
taylor123

Thank you Nalakrats.

Each year that goes by I believe more and more that Oestrogen is the devil. A hormone of chaos no more.

Do you pay any dividend to Progesterone at all?

I have just ordered some AI's to have on standby.

Now I was always put off them because I believed too low E2 would cause heart and bone issues... however I am not so certain anymore.

I think high T, high progesterone and low E2 would be the way to go.

Maybe also keeping DHT in check as well, although I know low DHT can cause nasty side effects in men.

taylor123 profile image
taylor123

Hi again, please note my E2 is actually 16.9 pg/ml.

In the UK, it is given in pmol/l

Chugach profile image
Chugach

Good for you for being proactive. Your numbers seem fine, I wouldn’t worry about it yet. I had an exam at 40 and everything was fine, but by 46 I was stage 4. I didn’t even know about PSA test, as it is not often recommend to those under 50. As you know it is not diagnostic if you have a prostate. I would suggest only PSA yearly or every 6 mo at the most and not worry about it if it is under 4

taylor123 profile image
taylor123 in reply to Chugach

So you had a DRE at 40 but no PSA at the time?

Chugach profile image
Chugach in reply to taylor123

Correct

timotur profile image
timotur

Taylor: if you don't already, find a good Uro, don't rely on a GP for guidance on PCa testing. My Dad gave me that advice 20 years ago, and I ignored it, while my GP was talking down the PSA test back in 2010, eight years later I was stage-3. Don't worry about a PSA < 4.0, but keep track of the trend, most important is the doubling time (PSADT). If you ever see that drop to < 12-18 months, it's time for more diagnostics such as free-PSA, PHI, and /or 4K Score tests which would indicate your risk and possible need for a biopsy. Otherwise, forget about it and enjoy life.

lowT163 profile image
lowT163

screw 0 to 4. Mine was cancerous at 1 .4 but they decided the lump was a nodule. One year later at 4.2 it was out of the prostate against my rectum. You need a Psma scan. Pay for it and get it done. I’m sure insurance won’t pay. Psa of 2 would bother me at your age. I was in a group getting radiation at MD Anderson that had 2 guys 43 years old with big problems because they were not diagnosed in time. One was a doctor. His was out by a millimeter.

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