PSA Increase

[boxmk]

PSA was at 4.92 three months ago. It is 6.99 today. Have had cancer for 2 years with a Gleason of 3+3. No treatment other the active surveillance. Next appointment with Urologist is in January. Any suggestions?

[Hidden]

I suggest an appointment in December.

[cajun1949]

I agree with martingugino...

[Wings-of-Eagles]

I would skip the Urologist, and get thee to an Oncologist/Specialist sooner than later. This PSA jump is what your active surveillance was designed to see! And now is the time to take action, and new treatment.

[AlanMeyer Moderator]

I think the increase in PSA could be a growth of the cancer, but doesn't have to be. Even when we have cancer, we can still get prostatitis (infection and/or inflammation of the prostate) that causes the PSA to rise. In fact, from my own experience, I think that digital rectal exams that are not carefully done (I've had some brutal ones) can cause prostatitis.

Now about what to do.

Is your Active Surveillance something with a plan, or is it just "Well, let's just watch it for a while." Here's what I mean by a plan: What PSA level should trigger what new actions? New actions could include an MRI of the prostate, more frequent PSA tests, other kinds of blood tests, maybe another biopsy, and possibly treatment. With a plan you're not just drifting from appointment to appointment and wondering when something should be done. No plan is perfect, but at least it will give you some guidance about the future.

Wings-of-Eagles suggested going to an oncologist/specialist. I think there's a great deal to be said for that. There are urologists who specialize in prostate cancer and are real experts, but most are not, they're generalists on all aspects of urology and PCa is just one of their concerns. Real specialists are often found at the big teaching hospitals. See: cancer.gov/research/nci-rol....

Good luck.

Alan

[boxmk in reply to AlanMeyer]

Thanks Alan. So much to consider but the best suggestion is to have AS with a plan. Which I currently do not have.

Take care!

[boxmk]

Maybe the wrong decision but having another PSA done at end of month and seeing Urologist in January. Thanks for the advice.