Most of the time.. Normal Range for PSA in men with regular size prostate (20ml -30ml) is between 2.0 to 4.0.In large and big men with prostate gland size 60ml to 80 ml the normal range of PSA can be even up to 8.0 . Famous Dr Mark Scholtz in one of his videos on Youtube talked about how normal PSA can vary in different sizes of prostate.
In general ,prostate size corelates with PSA well in men below age50. After age 50, most men start to develop benign hypertrophy of prostate, so the co relation is not fully accurate.
BTW..your formula to calculate PSA seems reasonable.
So despite being only being 40, considering my prostate size is 21CC so you would not be alarmed with a PSA of 2.4 ? Given the 3T MRI results as well of course.
I disagree with that formula. A man with 80 cc organ would have a cutoff of 80/10= 8 x 1.5 = 12 ...no, that is incorrect as far as an acceptaable PSA!!
The formula is not perfect. The cause of enlarged prostate can be many such as BPH, Prostatitis, excessive scar tissue , swelling due to inflammatory fluid etc.Formula is only valid in cases of normal prostates of various sizes. It still gives approximate PSA and is not precise. 80 ml normal prostate is rare but you can find in men who are 7 feet tall and huge living in tribes in African jungles. Normally ,we see size between 20 to 30 ml in most men. With age, the production of PSA declines so formula does not apply in men above age 65.
If the formula(where did you find it?) is correct only for "normal" prostates, then the use of PSA density must also only apply to men with "normal" prostates. Prhaps my Uro is incompetent....I have a 90 cc prostate which I assume is result of BPH.....so I guess I don't have a "normal" prostate, and thus my Uro should not have calculated my PSA density ......since that number would be meaningless if prostate is not "normal". Also, PSA may decline with age...but Kaiser uses a higher PSA cutoff for older ages? Ihave read articles about higher PSAs for older men....never seen anything about lower PSA for older men?
Well. I know a man who had ultrasound and his prostate size was 92 ml in his report. After 4 weeks being on Doxycycline for prostatitis , repeat ultrasound at 6 weeks measured size of prostate as 27 ml. It was mostly swelling and fluid. Abnormal prostates can cause lot of confusion because of fluid, hyperplasia, scarring etc. Multi-parametric MRI and PSMA Ga68 scans are the ultimate reliable tests.
Initial scare about him having a LARGE tumor in prostate subsided after antibiotic treatment. By the way, his PSA was also very high before antibiotics (it was 114)
I share the view of many that high localised levels of E2 in the prostate is the catalyst for PCa, and high T a long with a small dose of an AI can help prevent it.
Professor Edward Friedman has a fantastic book on this where he goes into great scientific detail.
Do you think given the PSA tests I have had and the normal 3T MRI that that would suffice for this year? I am going for a DRE next week with a urologist as I’ve never had one.
Have you heard of the Select MDx blood test ? I have the option to have this, but it might be unnecessary?
It is certainly not "the view of many" - just a lunatic fringe. I think you have drunk the koolaid. When you start listening to fringy folks on the internet, you don't want to talk to me. Good luck with your therapy.
You can harm yourself by holding all opinions as equal, and ignoring actual clinical evidence. When one doesn't discriminate between actual science and non-evidence-based conjectures, one is asking for trouble. There are rules of evidence. Ignoring them leads you down a dangerous path. The vast majority of fringy stuff was once fringy stuff.
Yes, I know Select MDx. There are a few non-PSA blood tests.
why are you so alarmed about PCa...many cases in your family maybe? You're young...enjoy life with your acceptable PSA and good MRI results. Has some urologist said something that has alarmmed you?
I think there is reason for caution when relying on such facilities for a very high skill level scan and radiologist reading experience. Buyer beware IMHO.
Nonsense in this case. The scan was operated at a hospital in manchester which is one of the few places to have a 3T MRI in the country. The radiologist report was thorough and detailed.
Taylor, you’re taking the right approach. You’re asking questions, considering all the data, sifting through alternatives, and pushing back. Try not to over-think (easy to do). I think you’re fine, nothing to worry about; you’re being vigilant. Above all don’t let anyone talk down to you, whether it’s arrogant dismissive doctors or imperious, cranky website members. Being patient and compassionate will serve you well.
Hi there,I have the same situation. My father has Stage4, with 7 mets in hips, ribs etc. Hopefully, he is still having ADT after chemo and is more or less ok. I was really in panic 1,5 years ago, when he was diagnosed as his mother died young from ovarian cancer. So I decided that it is brca, so I am dying. :). It took me long to do psa last year and shit. It was 2,6 in 40 y.o. It made me panic again and I went to urologist for dre and ultrasound. Ultrasound did not show cancer, only prostatitis (I have it for years) and enlarged prostate (30 mm). I need to repeat the test now as it was half a year ago and I am very afraid. Probably will treat prostatitis in advance.
I agree with Tav. Talor, you are wasting your time and being paranoid pal!!! Let those in need use our medical services go find yourself a hobby and quit worrying!!!
That said, get a psa every year and get back to us if it hits 4 or higher!!!
Who’s Tav? Do you mean Tall Allen? It was Allen who suggested a PHI last year, so not sure what you’re about ?
I’m far from paranoid mate, but having being on the frontline with my Dads prostate cancer journey for over 20 years and understanding the family history role, I’m simply doing due diligence being a married father of two.
I did the same as heyfletch. Psa at 65 was 7. Watched it go 7,12,19,29 over 2 years. Forgot it . At 70 psa was 59. Prostate size 49ml. No symptoms. Forgot it again until 75. Psa 1350. Got first symptoms at 76. At 76 1/2 decided to take action. Body scan showed extensive metastasis throughout skeleton and minor in Lymph nodes. Treatment described as Palliative care consisted of Casodex, xgeva, Zoladex . Psa then 9000. Symptoms quite severe, bladder control, no more sex and weakness. In 3 months psa dropped to <.01 and strength recovering. Over 9 months virtually fully recovered. Except goodby sex. After 4 years and now 80 1/2 I am happy with my life. I am extremely happy after comparing myself with unfortunates that had disease in their 50s and have not had as successful outcomes using SOP.
That is an amazing story> if you had a Doc, did he/she think you were crazy? when you discovered the extensive metastasis, any regrets about passing on earlier treatments that supposedly might have made the metastasis much less likely to occur? I assume friends /family tried to pressure you? Seems you are also beating the odds on mortality for advanced cancer!!!
I have no regrets. I had 10 years of excellent health and a great relationship with my wife and we enjoyed cruising for 400 days.I don’t think my doctor and I communicated well as he didn’t warn me about rate of increase in psa. Later when we moved I saw that he had noted that I had refused any treatment. I thought I was just exploring alternatives. No pressure from family as they knew I always favoured alternative medicine and that I always had good health. I have a new neighbour 4 years younger than me. At 66 he went standard treatment. Had radical prostatectomy, radiation, chemo, which he didn’t tolerate well. He then went on ADT in opposite manner to me. He couldn’t tolerate Aberiterone but is ok on Enzalutamide. Now he has had radiation again. Hi sex life finished 9 years before mine. My decision seems to have been ok for me but everyone is so different so I wouldn’t recommend any one else to try. It could have gone terribly wrong for me but God has given me an extension for which I am extremely grateful.
Next PSA test get your free PSA tested for a more complete picture.
Starting TRT because you have low T symptoms is not a bad thing. Woman have been using hormone replacement for many years to improve their quality of life - why not us?
Taylor, let me repeat most of the sentiment here - you sound "perfectly normal" from your PSA and MRI results. The stuff with TRT is beyond me. What I would say - given your family history - what you did was reasonable, e.g. establish a PSA and MRI baseline (did you get a good 3T mpMRI with a PIRADS 2.1 score?). DRE is imho opinion not very informative but hey its just a finger up your butt, no major risk.
What can you do NOW that should benefit you? Get your BMI down, stop smoking, tidy up your diet, exercise. Diet of course can keep you and your family busy for the next 20 years or so - stop eating crap food, sweet drinks, etc. etc. If you want to get "fringy" you can try vegan or whatever gets you going.
In the meantime, keep track of the new developments like Sentinel. If it holds its apparent promises, it could substantially reduce the need for needle biopsies and help a lot with staging decisions. Imaging will continue to get better. Get a new MRI when you PSA hits 4 (which is still not "high") and verify that you get it down by an imaging center and radiologist with prostate experience.
And enjoy your life!
p.s. I have two sons in their 20's. Given their family history (me, my dad who is 90 but had PCa diagnosed at 82), this is more or less my recommendation to them. But they will also make their own choices ...
You didn't mention what your testosterone level is. I would not use T therapy. Don't mess with your hormones. Get a T test and begin doing back squats. Use a weight that you can rep around 20X. The breathing squat type is good. At the top of each rep take an extra breath. Deadlifts using a weight you can rep about 20X. If you can cleans to overhead presses. You will be surprised at how difficult it becomes. At the end of three months get another T test. These exercises will stimulate your body to produce the maximum amount of hormones including T that it can given age, genetics and diet. I think that you will be surprised when you compare your testosterone results between the two tests. Raising your T artificially may eventually make it difficult for your body to make it's own T.
Diet! Most of us on here have cleaned up our diet. processed meats, charred meats, free range, grass fed, organic are all things to consider. Foods that prevent cancers as opposed to an Italian sub with the delectable, processed meats! You might read about "The Blue Zones".
Is there a contrast agent used when you have a MRI? Gadolinium is usually in contrast agents. The gadolinium in contrast agents is bonded with a chelating agent yet it seems that amounts of the gadolinium remain, some more than others. After five MRIs I had heavy metal testing. My gadolinium level was 23X that expected to be found in the population that hadn't had a MRI. Did you know that Chuck Norris' wife, Gena, nearly died after two MRIs in one week? The Japanese, during autopsy of cadavers to determine if gadolinium is retained in the body, found that two regions of the brain retained gadolinium. The info is on the net. I had my chelation therapy just before it was found that gadolinium was a concern. Let's just say that gadolinium is a concern --read about it.
As you are 40 years old I think that perhaps your mind is dwelling on the worst case scenario. Try lifting but learn proper form first and foremost. I trained a young couple, some neighbors last summer. It is hard with COVID19 to find a gym. I took them through 10 to 12 free weight exercises including the multi-joint lifts and then we broke the workouts into upper and lower body days before they started on their own. Exercise and diet will go a long way to giving you the optimum level of health that you can achieve. Try my suggestions if you wish and get a T test three months after you begin lifting and PSA test with it. If you are lifting really heavy stop lifting a couple days before the PSA test. It would be fine to do pull ups, chin ups and dips as there is little abdominal pressure created when doing these exercises and there should no effect on the PSA number.
I think that every man on here would trade situations with you in an instant!
I found it useful to plot using Excel the log 10 of your PSA versus days from first test. and also to calculate the PSA doubling time. The 3 tests you've got establish an excellent baseline. Using Excel, you can estimate how long it might take for your PSA to do double. Any big deviation from the log 10 trendline or abrupt shortening of the doubling time would set off the alarm bells. With your family history, you might consider getting some germline tests.
Warriors in our PCa Support Group think in terms of PSA doubling time. prostaidcalgary.org
Have you experienced a DRE yet? A couple of those will cure your anxiety...It's good to check your PSA on a yearly basis (especially since your Dad has Pca), but here in the States they recommend it at 50 years old not 40. But hey whatever sinks your sphinx.....
I would do the same... but I would also LIVE and LAUGH as much as I can. 40 years old? Hmmm I have dandruff older than you..... Give my regards to your DAD and keep him laughing.... Before you get your first DRE tell the urologist that you want him to use two fingers. If he asks why? Tell him you want a second opinion.....
Of course there's the gourd or cucumber method used by urologists with short fingers...So while you're in the waiting room before the doctor steps in, make sure you see a jar of used vaseline on the shelf...
Oh geez silly me..... I forgot to mention the Pineapples are used in Phase II...not to worry they use the ones in cans.... and I do mean " the ones in cans".....
Your Psa rise is from 2.1 to 2.4 over 27 months. From that, using school boy math, you could work out what the Psa doubling time is, but your Psa doubling time is a number of years. Here at this website for mainly advanced Pca, its not uncommon for Psa rise to be 100 times in 7 months, like mine was from Nov 2019, to July 2020, from 0.32 to 30, when the effects of Xtandi and maybe effects of 4 doses of Lu177 wore off, so I had a very small doubling time. I was diagnosed at 62 in 2009 with a Gleason 9, inoperable, and the ADT + EBRT worked for awhile, but unless I get something else to work soon I could be dead in a year or two.
Its good you came here because you will learn why you just do not want to let the doctors dither about and not treat you with an effective RP BEFORE any Pca spread occurs everywhere else, so that the only side effects you should have with treatment is that you have temporary incontinence, and mild ED, and you won't need to be chemically castrated by ADT, and you should have no problems with RT side effects or side effects from successive other things like I have had, such as chemo.
What you want seems to be some conformation that you do have Pca, and get the darn PG removed with as little nerve damage as possible, and without a surgeon leaving any PG tissue behind even if it has no Pca, because over time that may develop Pca because it has same DNA of the rest of your PG.
If you dad had Pca, or brothers had Pca, its highly likely you will get it even if you have no Pca now, so why not beg the best surgeon you can find to remove your PG?
There's a doc in Sydney's St Vincents Hospital who in 2014 was charging usd $21,000 to remove PG and he was the only one I heard about who said he could spare all the nerves that wrap around the PG. Most docs doing RP cut 1/2 the nerves or maybe all nerves which causes huge damage to continence and total ED.
With your Psa above 2.1, you could have a PsMa Ga68 PET / CT scan and if there is a tumor in your PG that is larger than about 2mm dia, it may show up. CT now might be useless, but MRI could be used. I don't know about MRI to PG because I have never had one for PG. I have had them for knees and hips, and they really do show a lot.
A many of 40 who will never ever have any trouble with his PG, Psa of 0.7 is about right, and at 60 its about 1.0. I have a cousin of 75 with Psa at about 1.1, and its been constant for years.
But he takes a long time to pee, so I bet his PG is swollen.
My PG at diagnosis was about 3 normal volume, and during attempt to remove PG, Pca was wrapped around the PG capsule and docs could not see what they had to cut into so they took biopsies, and cut off seminal vesicles, and then sewed me up with poxed up PG left in place. I had ADT and EBRT which didn't work.
So you have a splendid opportunity to avoid the huge expense of never ending treatments that work for a while, then don't work at all to slow down the Pca progress or kill Pca cells.
Meanwhile, this here castrated man of 73 went for a 79km cycle ride early today and averaged 24.5kph in hot humid conditions. This is better than most other men my age can do even with a "full bottle" of testosterone. The ride was mainly on main roads in Canberra in Australia where I live, and it was early Sunday morning, with minimum slow downs for traffic lights and other delays, so I know I am about as fit and healthy as I could be, and I would not be much better if I had no Pca.
But you are 40, and I bet you might prefer to remain a Hot Rooster and not want to be turned into feather duster and maybe your partner would prefer that as well. Many men in this group have had to say goodbye to Rodger right after beginning of Pca treatment. I didn't have any partners after I turned 59, and most females are so ruined by their menopause that sex after 50 is definitely not as good as a nice long cycle ride. And the ladies don't like those either. So at 62, I accepted the prospect of never ever having sex again. But last week I cycled a total of 245km.
So work hard to find the truth about your PG, do not dither.
I must now eat dinner or I starve. All the best Taylor123,
Interesting, So , my son age 47 PSA is 2.4. My father and older brother had Pca. (brother died of stroke at age 72 ,dad had heart attack and died at 72. I am soon to be 80. ). So I mentioned he get pro active about his PSA and yep he does think he has a concern. Tough guy. Is there any resource I can get to show him to be concerned. He for some time does not eat read meat and follows a good diet plus many supplements. I was diagnosed at age 59, PSA of 6.2.What literature might I recommend and get for him to be aware. Also, what might he do do to avoid this demon ?
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