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Elevated PSA levels
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Anon_930 posted:
My husband, age 59, just had his annual check-up. He has had some symptoms of enlarged prostate, but for the past three years his psa levels were around .56 or so. This year, however they are at 5.2...a dramatic increase. The doctor couldn't detect any abnormalities during a digital exam, but notes that he isn't a urologist and doesn't have the experience they would have.

He gave my husband several suggestions, namely a referral to a urologist or wait 3 months and test over to see if it is still elevated. Our doctor did mention cancer (yikes!), and if it is cancer at this point we wouldn't know if it was slow growing or aggressive. His concern was if the test was accurate that the jump was so dramatic. My husband opted for the retest in 3 months and our doctor said he thought that was an acceptable choice, but we could change our mind at any time after we talked it over and did our own research.

My question...is that a good choice do you feel? It is difficult for me because he doesn't really want to talk about it much and definitely won't let me share anything I read about it with him...prefers to do his own research, and doesn't want me to talk to others about it. He did tell me a few people he was okay with me talking to, but as his wife, I'm concerned/worried. I know it is his body and I respect that, but we have been married for 34 years and it affects me, too.

If you have any insight or encouragement for me, I would love to hear your thoughts. I am really trying to respect him and his privacy. I would want the same from him. Thanks!
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billh99 responded:
There are many things that cause an increase in PSA that are not related to having cancer.

They include an inflammation of the prostrate and physical activity.

That include, but not limited, to things like having sex or bike riding.

If the digital exam was done before drawing blood for the PSA test that can cause a rise.

It is common to do a retest on PSA after a single elevated reading.

If inflammation of the prostate is suspected then he should be treated with an antibiotic and some period of time for that to work.

Otherwise a retest can be done in a week or two.
 
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An_250419 responded:
I understand where you are coming from - I was in your spot 14 months ago. Husband 70 yo, PSA slowly rising to 5.1. Bone scan & CT scan negative. Told we had time to research, read, and decide. 1/12 - Biopsy done & found 4 of 12 cores affected - Gleason 4 3. Told by 3 drs. he was a good candidate for any of of the 3 options - surgery, seeds, or radiation. Talked to several friends that went thru the different options. He wanted least invasive route - chose radiation. RO suggested 4 wks RT followed by seeds (because of Gleason score). This was completed in April, 2012. A friend that went thru this said "hormone therapy was the worst". So - we opted out of that! Now, 10 months later, after PSA of 3.7, 4.3, 5.2 - we find out PCa has spread to bones and my world has been blown apart. My hearfelt opinion is the "side effects" of surgery is nothing compared to this!! Get 2nd and even 3rd opinions & don't put it off! Thanks for listening.
 
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jameshodge responded:
I think that waiting is quite acceptable. The PSA can be a fickle test at times and waiting would help find out if something is wrong. It does affect you but you can help by reasearching Super Beta Prostate testimonials . It might be a good supplement to start with for the 3 months and see if it helps. It's natural and so side-effects are not an issue but ask your doctor first.
 
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Basir U Tareen, MD responded:
In the absence of any symptoms suggesting prostatitis, infection or other benign cause for PSA elevation that is a dramatic rise. I would re-check it now. Why wait 3 months? If there is evidence of any infection or symptoms of prostatitis I would treat with antibiotics and re-check within 3-4 weeks.

At the very least you should see a urologist to consider doing a biopsy if the PSA really is 5.

Unfortunately primary care doctors have been discouraged from PSA testing by the US Preventative Task Force that believes we over-treat prostate cancer. While this is true in many cases I believe that you should always acquire the information and if a patient has cancer that is the time to have an educated discussion about treatment options (which include active surveillance)

Bottom line: I would re-check the PSA now and if still elevated see a urologist about doing a biopsy. If there is an aggressive cancer you would rather know about it now rather than 3 months from now or a year from now.

best of luck,
Dr Tareen
 
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djtimewilltell replied to Basir U Tareen, MD's response:
Thank you, everyone for your insight and suggestions. I would be more comfortable if my husband would get his levels rechecked sooner than later and if the levels are still elevated make an appointment with a urologist. I am going to try to talk him in to doing that...if nothing else, than for my peace of mind. I agree with Dr. Tareen; if it is aggressive cancer, I'd rather spend the extra two months treating it before it gets more invasive. If it's nothing, I'd rather know that sooner than later, too. This is hard!
 
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jameshodge responded:
I don't know about PSA levels but if your husband does have issues with his prostate then always go for natural remedies before trying anything a bit more extensive. Super Beta Prostate is a natural nutritional supplement. It contains all the nutrients and vitamins required to promote a healthy prostate and has no side effects. It's a great natural remedy for prostate problems. My husband saw this advertisement http://www.youtube.com/watch?v=tu24Vh1uXv4 and decided to give it a shot after consulting his doctor. He's been taking it for the last 9 months and has been happier than ever.


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