New and looking for additional thoughts/information

[bigtrev46]

New here, not an official member, but have some concerns over symptoms and PSA results etc. Will apologize up front for the lengthy post.

For several years, I've had urinary and ED issues, along with back and pelvic pain etc. Although I consider them somewhat mild, they do cause me concern. (even though all the new ED and BPH commercials make one feel that its a normal process for aging etc!!.) I'm 49 years old, in great health and run 25+ miles a week and other than my Coors Light, I maintain a good diet and very active. I had several bouts of symptomatic prostatitis over the years, but never had a PSA during the symptoms, but from 2001-2012, all PSA tests hovered around 1.5-1.6.

I retired after 30 years in the US Military in 2014 (maybe the cause of my back pain and I have several jacked up discs between L3/S1), and thought I had a PSA test on my exit, but cannot find any records. Fast forward to Feb 2017, I had a PSA of 2.24. My PCM recommended waiting 6 months and I went back on 20 Sept 17 and found my PSA had climbed to 8.53, which resulted in immediate referral to the Urologists. The Uro put me on two weeks of Cipro, but wanted to repeat the PSA just in case. One week later (after starting Cipro) I got my results back at 7.79 on 26 Sep. We waited until 23 Oct 17 and did another PSA which was 6.15. A small decline over the course of the month, but my Uro wasn't impressed, so he scheduled a biopsy for 17 Nov 17, but asked me to do yet another PSA, this time including a free and total. So on 7 Nov, we drew blood again and the results were a PSA of 5.9 with a free/total of 9.3%.

So besides from being quite worried about all of this, especially with my high PSA and low free/total %. I'm hoping someone here can help explain this rapid rise and very small decline after antibiotics. I've scoured the internet over the past several months and see a lot of conflicting information. On the one hand. my PSA shot up rapidly and the antibiotics seemed to stop the rise, but on the other, the drop seems insignificant to me.

Summary:

Baseline PSA over many years of 1.5 (last checked in 2012)

3 Feb 17: PSA 2.24

20 Sept 17: PSA 8.53

26 Sept 17: PSA 7.79 (after starting Cipro)

23 Oct 17: PSA 6.15

7 Nov 17: PSA 5.9

Biopsy scheduled for 17 Nov 17

Thanks to all of you for such an informative website.

[Dr_WHO]

PSA is a helpful test, but it is not without it’s issues. Many men here were diagnosed with advanced cancer but have low PSA. Mine was 4.7 when they found I had Stage 4D1. On the other hand my brother had a PSA in the 20’s, but it was the result of Prostatitis, which as you indicated is a condition where the prostate becomes inflamed due to an infection or another cause. The fact that yours is jumping around like it is may be the result of an infection that is not yet under control.

What were the results of your digital exam? That would be helpful. In any case because your PSA levels really demand a biopsy. My brother had one which they used to rule out cancer. Let’s hope that you have similar results!

Walt (a chemist not a MD)

[bigtrev46 in reply to Dr_WHO]

Walt, Thanks for your reply.

My DRE was done by the Uro and said everything felt normal. Assuming that's a good thing!?

[Dr_WHO in reply to bigtrev46]

That is a very, very good thing!

[bigtrev46 in reply to Dr_WHO]

Thanks yet again,

As you know, the waiting and uncertainty is pretty tough.

Like told, my Uro was hoping for a steeper decline, but at the same time he didn't seem to be too alarmed yet. Maybe that's their training, just shrug and make a recommendation for biopsy.

[Hidden in reply to Dr_WHO]

Yes, my PSA was a low 2.7 when I was diagnosed gleason 8. The DRE is what got me referred to a urologist. I've heard that PSA can jump around a bit, even being related to whether one had sex the day before the lab work.

[Roger2Dodger]

I agree with Dr WHO regarding the PSA testing. My only advice or comment is get a biopsy. That is the only way to determine if cancer is present. Then all the speculation will be gone, and informative decisions can be made on your next course of action.

G'Luck

[bigtrev46 in reply to Roger2Dodger]

I agree and will be getting my biopsy done on Friday, 17 Nov. Will be good to get rid of the speculation.

I understand there are people diagnosed with both very high and very low PSA numbers. Just thought it odd that mine climbed rapidly for 6 months then started a slow decline after starting antibiotics. Also understand PSA jumping around a bit. I did my testing at the same lab so that would get rid of that variable, and didn't do anything for a few days prior.

Just wondering if anyone else has had an experience similar. Thanks again for the replies.

[bigtrev46]

I got my biopsy today so now the next wait begins. Sucks.

[bigtrev46]

Update:

I just received my biopsy results back from the Uro. Negative for PC! Will do my follow-up in 6mo and see where PSA/fPSA stands.

Thank you all for your responses and hope you have a great Thanksgiving!