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Prostate Cancer Network
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Newbie. Increasing psa. What to do next?

I am 63 yo. My psa has been rising as follows. 6.4 May16. 6.9 Nov16. 8.1 Aug17. 9.1 Jan18. My Urologist has been wanting to do biopsies since mid 16. After I did some research I paid for a multi parametric Mri scan in April 17. The results were as follows. Prostate volume 93cc (large). Psa density 0.07. Prostate intact. No significant abnormal diffusion restriction or signal intensity in peripheral or central zones of prostate. Seminal vesicles normal. No pelvic lymphadenopathy. Conclusion. PIRADs 2 ie presence of clinically significant prostatic malignancy is less likely.

Even after the mri results, my urologist still wants to do biopsies. Could there be some other reason for my increase in psa rather than PCa? I am thinking of paying for another mri soon to see if there are any changes. Surely the scan would pick up any abnormalities? Would appreciate any help as I'm not sure if I'm doing the right thing.

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There are many things that contribute to an occasional higher PSA, but over time these external events cause the PSA to pop back. ONLY a real biopsy with tissue samples can identify cancer. Im 76, had a rising PSA at age 73, PSA was 6 then 7 then 8, etc. Overall health was excellent, normal prostate, sonogram was normal. When it hit 9, I had a biopsy. 7 of 12 cores had cancer, Gleason 7. Last year, I had brachy and external radiation. In August, no cancer. Want to no more, just ask.

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Get the biopsies.

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Please get the biopsy. Trust me, it is better to get a biopsy and find out that you are fine than not and end up with advanced cancer. You really want to catch Cancer as soon as is possible.

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MRI guided biopsy. Only way to know if the cancer is slow or aggressive is to sample.

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Appreciate your reply. The MRI scan showed nothing untoward in my prostate. That was a year ago and I'm thinking of paying for another. If there is any sign of cancerous cells then of course I will get an MRI guided biopsy. I don't see the need for biopsies at the moment as there is nothing to 'aim at' so to speak. There is currently a move in NHS England to have MRI scans prior to biopsies to prevent men having unnecessary biopsies.

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I'd still do the biopsy. Other than a little pain, it really is the best way to see what's going on inside. MRI's can't find small cancer cells.

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Get the biopsy sooner rather than later and get a new urologist. The longer you wait the worse it’s going to get. Sorry about not sugar coating the news but for your sake get it done.

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Listen to your newfound network friends. Get a biopsy!

My PSA was lower than your, but had the same slow rise pattern. My first biopsy found 7% cancer in one of twelve cores. I asked for an MRI-guided biopsy, and my Urologist found a good place for it, but the timing was wrong as I go to Florida for winter and that Urologist said I'd have to fly back for a follow-up and that it could wait until June. Then, while pursuing some life insurance, the underwriter insisted on a biopsy. It found cancer in 4 cores, with 3 in close juxtaposition. I then scheduled an MRI-guided biopsy plus robotic surgery. The MRI provided clear evidence of where the cancer was, and indicated that it was contained in the capsule. Then during the surgery, they found that there had, in fact, been a small break out that the surgeon felt he had taken care of.

Since the surgery, my two PSA have been below 1/10th of a %, with another in process as it is time to re-visit the surgeon for another review. I had significant incontinence, but by doing the Kegel exercises daily, I'm now doing very well and only seem to have serious leakage when lifting heavy things (I'm ok with dropping that activit!), and some golf rounds (not ready to stop that one!). Hopefully, when I see the surgeon again in a couple of weeks, I'll be able to stop taking one pill a day that supposedly is helping my sphincter to tighten and thus reduce the leakage.

I wonder what might have happened if I'd waited a few more months before doing another biopsy, but at least I do not have regrets over a more severe situation. Even in one's 70s, I think we all still feel invincible as we did when in our teens. It's ok to feel that way, but it is also good to do prudent things, such as a biopsy. And again, listen to those on this network. They helped me, and they will help you.

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Welcome to the group. To answer your question, yes there are a lot of others things besides cancer that can raise your PSA. My brother’s PSA was about 17. He had a biopsy which showed it was non-cancerous. However, every six months (now recently extended to yearly) he goes in for another biopsy. On the other hand, my PSA was just 4.7 when they found out that I had Stage 4A Cancer.

The key to the above story is to get a biopsy. It is not that painful. In fact it feels like someone is snapping a rubber band down there. If for no other reason than for your own sake of mind, please get tested. Really it is not that bad.

I have a liking to 1954 as that was the year my wife was born. You are now part of our family. Hopefully you get the biopsy and everything is clear. Even then you should say a part of this group because people like us we have to stick together.

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