Signifficant PSA LEVELS

[apttony]

I'm an 81 year old man who has had an enlarged prostate for several months. PSA tests levels 9.1 and 8.1 (several months apart).

My Father died of prostate cancer, which had spread to other parts of his body. Follwing a Digital Anal test, my prostate was reported as "smoothly enlarged and sulcus palpable".

I am currently being treated with Tamsulosin MR 400mcg capsules.

I have a brother who was diagnosed 10 years ago with similar, and recieved chemo and hormone treatment, and now in remission.

I have a second brother who also diagnosed via biopsies with two if 15 samples taken been positive.

At what point or level of PSA would further testing be justfied?

All comments would be welcome.

Thank you.

Tony

[Justfor_]

ASAP would be an euphemism. You are late already.

[Derf4223]

You are as good a candidate as I have ever heard of for getting a biopsy etc. Do you have a urologist? Your PSA numbers are not good and rising. But a high PSA only tells a competent urologist to do a biopsy, the results of which will be definitive. Good luck

[Tall_Allen]

Can you get a Prostate Health Index (PHI) blood test? It can help discriminate between BPH and PCa. If not, an mpMRI might be able to find any suspicious areas.

[HealthRiver]

From cancer.org: "Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3. Most men without prostate cancer have PSA levels under 4 ng/mL of blood."

There do seem to be other factors, such as the PSA relative to prostate size.

But, especially given your family history, you may want to get an MRI now. An mRI before a biopsy, which can then be used to help target a biopsy as needed.

My PSA at age 60 was in the 4 to 5 range on a couple tests, which to me sounded in keeping with my prostate size. The free PSA, though, was very low, which the urologist flagged (my primary care doctor was nonplussed but referred me anyway). After preliminary hemming and hawing on my part, I did get an MRI and they did discover a lesion. That MRI led them to do a biopsy, and that led to the treatment I've now completed.

An MRI seems the standard first step.

[tsim]

Has it jumped to that level somewhat recently since being at a stable lower lever?

[apttony in reply to tsim]

Unfortunately I don't know. I have been fighting PMR for the last 6 years, now down to low steroid level. This time last year i developed 24/7 diahrea. Brought under control in April and thought to be Diverticular after bowel scan. Then the prostate problem became obvious, prompting the need for a PSA test at 9.1

It all could well have been hidden. I have an appointment with GP next Friday, with thfe intention of pursuing further investigations. MRI scan / biopsy

[apttony]

Thank you all for your helpful replies. Much appreciated.

Now waiting for sensible discussion with GP on Friday.

Regards to all.

[tsim]

I hope it's nothing serious and good luck with your other inflammation issues