Big Spike in PSA

[Checkmate123]

I was diagnosed with a non-aggressive prostate cancer in 2018. I have a Gleason score of 6 and T1 tumor. It was recommended by my doctors to practice under active surveillance. Last week, I had a PSA test and I received the news that my PSA has jumped two points within 5 months since my last test. Is this usual for this type of cancer to jump within a short period of time?

[doc1947g]

Hello, I am 73 y.o. and was diagnosed early March 2020 with Gleason (4+3) Grade 3, Unfavorable Intermediate Risk.

But we do not know all your story: Age, Number of positive cores out of total cores, Health status, country.

What was your PSA pre-biopsies and what it is now.

[Checkmate123 in reply to doc1947g]

Am 62 years old, my Gleason score is (3+3=6 ) grade T1 ( a non-distinct tumor), my MRI was clear, cancer cells found in 30% of core biopsies. With the exception that I have hypothyroidism, I am good health. My last PSA pre-biopsy in 2018 was 6.20

[doc1947g in reply to Checkmate123]

What is your PSA now and the ones before with the months between.

[Tall_Allen]

Yes, it is very common. That's why PSA changes are not used by major programs to determine if it's time to end AS. Analyzing the results of the major programs, it was found that PSA changes did not predict grade progression.

The reason that PSA is non-determinative is that there are so many possible sources of benign PSA bounces - prostatitis, BPH, retention, sex, bicycling.

It may be time, however, for a new mpMRI. I think PHI (prostate health index) is a better test for tracking than just PSA. It is less prone to such bounces.

[Checkmate123 in reply to Tall_Allen]

Thank for your feedback. I have a feeling several of the possible causations you've listed may have attributed to the sharp increase. I have made an appointment with my oncologist via his office portal. Getting a quick response from my doctor has been difficult during COVID which is why I'm feeling anxious about this. Thanks, again!

[thierry in reply to Checkmate123]

Hi , Trust me , you Don't have to worry at all , as far as you are carefully followed , as it seems to be the case . so no worries , and good understanding of the matter . Regards

[Hidden in reply to Checkmate123]

You have an oncologist already? I'm a little surprised at that since you mentioned active surveillance.

[aceace12]

having an orgasm the night before my PSA check made mine go up .... try to remember what you was doing 2-4 days prior to test

[Checkmate123 in reply to aceace12]

This is good information to know. Thanks!

[Mufj]

PSA is notorious for making big jumps. PSA increases due to cancer are usually small but steady so you look for a series of steady increases. Large sudden jumps are usually due to some sort of inflamation or irritation to prostate(TA mentioned examples) you will often see big drops

I am on AS and my PSA jumped from 3.2 to 4.3 in about 3 mo. Subsequent biopsy(previously scheduled) showed inflamation in 3 cores no change in cancerh

So that was cause of jump. Next psa 3mo later was down to 3.7

So youre inrease by itself is not a concern regarding cancer but may mask underlying increases TA idea of PHI sounds good. Will talk to my docs about it

[Checkmate123]

Thank you so much. I appreciate the sharing of your experience with me. I feel so relieved.