Elevated PSA - What does it mean and next steps

Chill

Je Suis BARF
Staff member
This is a complete and total overshare for me. But I'm hoping that it will spark a conversation about prostate cancer and all of the unknowns that come along with it. Also, it is self serving because I have to get out of my head.

Firstly, if you are a 50 year old male and have not had it yet, get the PSA test done. It is a blood test, that's it. From there they can get a good idea if there is activity in the prostate (no, not that kind). Early detection is a good thing. Waiting until there are symptoms is not. Not talking about it is worse.

Back story it that I am a 51 year old male and this is the year of blood tests and benchmarks. I have family history of diabetes and high cholesterol, so those are the tests I keep an eye on. What I was not prepared for was the PSA test (prostate-specific antigen) coming back "elevated".

The PSA test has a "normal" range of 0-4, anything above that is considered "elevated". An elevated PSA can be caused by other things like inflammation elsewhere in the body. So as a double check, they run another test to see how much of the antigen is attached to proteins. If the antigen is attached to proteins, there is potentially cancer in the prostate. My tests came back at 5.4 and 5.9. Off the the Urologist.

After a conversation about peeing and hard-ons, there was a lot of "nothing to be too concerned about" and "you are on the younger side to be in the office". The Dr was re-assuring me that this is all early stage stuff. Then there was the manual check. And an immediate "small node" comment and a "let's get you scheduled for an MRI".

From here, in order to determine what is going on and to what extent, they can either do a biopsy or an MRI. The biopsy is the gold standard (12 core samples) but can be overkill in the early stages. The MRI is less invasive but can still identify lesions or anomalies (bumps) that would indicate cancer or not.

And that is where I am. Could be something, could be nothing. The MRI has not been scheduled yet but hoping to have it in the next couple of weeks.

I'm hoping that others will chime in with their experience and knowledge.
 

rodr

Well-known member
You are smart to be paying attention to it. It's a very common disease and early detection is key.

I just had an exam and PSA level was 3.1, so all good so far.
 

R3DS!X

Whatever that means
Don't freak out about it.
The doctor will probably order a follow up test. another psa and psaf maybe.
 

Entoptic

Red Power!
Yea don’t freak out. Pop has been down this road a few times. Each time is more of a scare than anything but good on you for going through with this.
 

Abacinator

Unholy Blasphemies
My boss went in for a routine probing and had elevated PSA levels. Turned out to be the big C. They caught it early. He had his prostate removed and eventually got a clean bill of health.
 

Akira-R

Well-known member
My doctor told me he recommends against testing. My dad had it, and i'm 41 so i asked him about the test. Supposedly you test at 40 if you have an immediate family member who had it.

He basically gave me a printout/site that showed the risks can be more harmful than helpful. A high PSA doesn't mean you have it. But it will probably cause you to move to the next step, which is biopsy. Infections can happen from the biopsy just from the location they have to probe with a needle.

Then you have to decide whether or not the cancer is growing/spreading or just inactive.

I tossed the printout, and i'm having trouble looking for the sheet that had all the numbers/percentages.

But here are a few:
https://www.cdc.gov/cancer/prostate/basic_info/benefits-harms.htm
https://www.cancer.gov/types/prostate/hp/prostate-screening-pdq
https://www.uspreventiveservicestas...ationStatementFinal/prostate-cancer-screening

I have Kaiser for full disclosure.
 

rodr

Well-known member
So 2-3% of American men die from prostate cancer, yet screening and treatment are not worth the risk? That's a pretty sorry testimonial for the state of modern medicine.
 

Archimedes

Fire Watcher
As others have said, don't freak out at this point. It could be nothing, or it could be something easily treatable.

Twice in my life I freaked out after reading MRIs (one of my brain, one of my back), only to have doctors, weeks later, explain to me why my life was not over. I'm learning not to overreact...
 

bikewanker

Well-known member
No personal prostate knowledge only close by. I went with MRI and a second opinion. Suppose I was fortunate that it was obvious something had to be done.
Good on you for getting it out of your head and on here.
Your in my thoughts Christian. We expect updates.
 

kuksul08

Suh Dude
I did some reading on it and a single PSA test is not reliable. You need to have them annually (or more) and monitor trends, kinda like an oil analysis. I have a feeling most doctors given your age would say come back next year and we will monitor it.

Biopsy is sometimes advised against because it's invasive and if you do have a problem it can exacerbate it or cause spreading. A non-invasive method is probably preferred.

If it is cancer, early detection means 100% 5-year survival rate and something like 99% 10-year and 98% 15-year. Pretty much curable if found in the early stages, and those few % end up dying of something else usually heart related. At age 51 that would be considered super early stages so you're on the right track by going to the doc and not ignoring it. That said it's an extremely well-known thing and slow progressing so I wouldn't lose sleep over it.

Source: webMD, public research papers, etc.
 

bikeama

Super Moderator
Staff member
You are smart to be paying attention to it. It's a very common disease and early detection is key.

I just had an exam and PSA level was 3.1, so all good so far.

THIS ^^^^^



My doctor told me he recommends against testing. My dad had it, and i'm 41 so i asked him about the test. Supposedly you test at 40 if you have an immediate family member who had it.

He basically gave me a printout/site that showed the risks can be more harmful than helpful. A high PSA doesn't mean you have it. But it will probably cause you to move to the next step, which is biopsy. Infections can happen from the biopsy just from the location they have to probe with a needle.

Then you have to decide whether or not the cancer is growing/spreading or just inactive.

I tossed the printout, and i'm having trouble looking for the sheet that had all the numbers/percentages.

But here are a few:
https://www.cdc.gov/cancer/prostate/basic_info/benefits-harms.htm
https://www.cancer.gov/types/prostate/hp/prostate-screening-pdq
https://www.uspreventiveservicestas...ationStatementFinal/prostate-cancer-screening

I have Kaiser for full disclosure.

NOT THIS ^^^^^


What is it about Kaiser? A good friend was told poop smear OK does not need a colonoscopy. Until poop smear was not OK. 12" of colon removed.


I have had PSA tests from 40 because of family history. Colonoscopy from 40 because of family history. I was not a perfect asshole after more than polyps removed I was on a 3-year check for many years. Get yourself checked.
 

Snaggy

Well-known member
So 2-3% of American men die from prostate cancer, yet screening and treatment are not worth the risk? That's a pretty sorry testimonial for the state of modern medicine.

Over a million men worldwide have been enrolled in studies to determine the value of early detection and treatment of prostate cancer. It's still hotly debated by cancer experts. It seems to have little impact on death from prostate cancer. Considering that treatment will likely cause impotence and incontinence, as well as the less likely but real risks of bleeding, blood clots, infection, death etc, maybe aggressive treatment isn't for everyone. Plus, most prostate cancers are slow growing and can usually be held at bay for years.

The current recommendations are for your primary doctor to first bring it up between the age of 40-50 depending on risk factors, and explain to you why screening has down sides as well as upsides. At this point everybody wants prostate screening of course. When a cancer is found early, everyone feels that another life has been saved. Nobody stops to think that a man was deprived of sexuality and bladder control, often to no benefit. Most 50 year old men don't even see a primary doctor.

But it's not a conspiracy, or a death panel thing, a lot of altruistic, dedicated, brilliant minds are working as hard as they can on it, and giving the best advice as they see it. There's a severe shortage of urologists looming too.

But if you want screening, go ask for it. I get screened.
 

Chill

Je Suis BARF
Staff member
Medical advise on BARF. LOL. Right?? Just like relationship advice :rofl

I appreciate all of the feedback! It is really helping me calm the fuck down. And this is all good info, even the opinions, because, you know, everyone has got one of those too.
 

two wheel tramp

exploring!
I'd say go for the least invasive tests possible, get checked often and have them do the biopsy if things are not staying steady.

Also: wangdinger.

In all seriousness my mom's sweetie was stricken with prostate cancer last year. The disease can get bent. :x I'll be saying heathen prayers for you.
 

Akira-R

Well-known member
THIS ^^^^^





NOT THIS ^^^^^


What is it about Kaiser? A good friend was told poop smear OK does not need a colonoscopy. Until poop smear was not OK. 12" of colon removed.


I have had PSA tests from 40 because of family history. Colonoscopy from 40 because of family history. I was not a perfect asshole after more than polyps removed I was on a 3-year check for many years. Get yourself checked.

I'm just sharing the conversation I had with my doctor on this exact subject just a few weeks ago. I went in asking for the test, and was presented information about the tests and procedures. At 41 years old, it is still not recommended until 50. My father had went through treatment for prostate cancer just a year ago. That was the reason I went in. I still have the option to get screened, but i'll wait til i'm closer to 50.

Everyone should have the conversation with their doctors/specialists and decide on their own plan that makes sense for them.
 

mlm

Contrarian
Ain’t getting old fun!

I’ve gone through a few off test results over the years, and so far so good. My fav was the dermatologist commenting “that doesn’t look good...we should do a biopsy”. A week later it was nothing, but a fun wait.

Your doing the right thing getting checked out and this is unlikely to be your last imperfect result. Good luck and remember it’s probably nothing :thumbup
 

Melissa

Peace,Love and Harmony
Dear Chill,
My heart and thoughts are with you at this time. Hoping you and your prostate are happy and healthy.
Love,
Melissa
 
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