How high can PSA go and not be PC?

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Jerry L.
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Date Joined Feb 2010
Total Posts : 2367
   Posted 11/16/2010 9:33 PM (GMT -6)   
I have a friend who has a PSA of 18 up from 12 in 6 months or so. He's gotten a biopsy before that showed nothing. I don't know when that was performed, but am going to find out. I believe he's had bladder cancer that he has dealt with. I'm probably going to stress the importance of the importance of another biopsy. But, how high can a person's PSA go and not be PC?

Thanks
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Robotic Surgery
Jan. 2010 T3b, Gleason 9
Feb. 2010 Adjuvant Radiation

PSA History:
-----------------
Nov. 2009 4.30
Feb. 2010 <.05
May 2010 <.05
Aug. 2010 <.05
Nov. 2010 <.05

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2603
   Posted 11/16/2010 9:53 PM (GMT -6)   
Jerry,
 
I'm certainly not an expert, but traditionally anything over 4 is a pretty good indicator of PC.  I think John T had multiple  biopsies before they found PC.  Probably he needs to get a color doppler, which is how John's was found I believe.
 
Goodlife

gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 340
   Posted 11/16/2010 9:59 PM (GMT -6)   
my brother in Germany had 12 psa and did not have cancer. nono

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2284
   Posted 11/16/2010 10:21 PM (GMT -6)   
There are indeed rare cases where men have double digit PSA numbers and cancer can not be found..There is a genetic urine test that CAN tell if it's cancer, but the companies licensed to provide the test are dragging their feet bringing the test to market..

The Color Doppler Ultrasound in the hands of an expert can be helpful and as a last resort, a saturation biopsy, done in the hospital under general anesthesia is almost certain to find any cancer..

Many of us here have had multiple biopsies before the cancer was found..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

Terry Herbert
Regular Member


Date Joined Sep 2010
Total Posts : 92
   Posted 11/16/2010 11:01 PM (GMT -6)   
I read a report of a man here in Australia who had a PSA of over 300 ng/ml. No PCa was found and after treatment for a bladder infection, it was said that his PSA returned to "normal"

about 35% of men with a PSA over 4.00 ng/ml will be found to have PCa. The majority will not. There are no studies that I know off that demonstrate the range of what might be termed 'normal' levels of PSA.

You might find it useful to read a piece I wrote to help newbies to understand the basics of PSA testing. It is on my site at www.yana.org.PSA101.htm
Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 227
   Posted 11/17/2010 2:31 AM (GMT -6)   
.... and then there are the many here, who have had repeated TRUS Bx's and return a negative, whilst the PSA rises, and finally a Positive, suggesting ( one presumes ) that the original TRUS-Bx's 'missed' the real problem.
I think that I have also read of the cancer site being at the front of the prostate and hence avoided detection.

I understand that a PSA reading is a reading of the "state of distress" of prostate cells, and so anything that presents an irritant, to the prostate, could cause a PSA rise.

Terry -- Can't find that PSA101 url ? Are you sure about that syntax? Looks most dubious !
.
.
Nov 2009 = First-PSA 5.3 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-'10 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May-'10 = RRP-Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED -85%, Cont -5%
+17W First 'DRY' day. ED -90%

Terry Herbert
Regular Member


Date Joined Sep 2010
Total Posts : 92
   Posted 11/17/2010 4:31 AM (GMT -6)   
http://www.yananow.net/PSA101.htm

Sorry
Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey

jayny
New Member


Date Joined Oct 2012
Total Posts : 2
   Posted 11/1/2012 2:19 PM (GMT -6)   
My psa is 10 and have had 2 biopsy's and no cancer

Just had green light surgery for blocked urinary tract and in 2 weeks it is going well still some pain and bleeding

Jwald18671

littlenm
Regular Member


Date Joined Nov 2012
Total Posts : 320
   Posted 11/4/2012 5:02 PM (GMT -6)   
My husband had just had 3 PSA tests done all 2 weeks apart. 25, 27 and 29 respectively. Pelvic CT scan clear and waiting for the biopsy results. Does PSA at this level mean it has spread?

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 2367
   Posted 11/4/2012 6:16 PM (GMT -6)   
Littlenm,
 
Welcome to Healing Well.  You've found a great place for information and all things related to the prostate. 
 
Just because the PSA is abnormally high, it does not mean that it has spread outside the prostate.  In fact, with just that little information, we don't know if there is cancer or not.
 
Take one step at a time.  The PSA is not a perfect test, but it is the best that's out there.  It could be due to prostatitis or other things, but what you need is more information.  And, that is why he is getting a biopsy.
 
Just to give us more info... What were his PSAs in year's past?  Has he had a digital rectal exam (DRE) and what was the result of that?  How old is?
 
Jerry L.

littlenm
Regular Member


Date Joined Nov 2012
Total Posts : 320
   Posted 11/4/2012 9:14 PM (GMT -6)   
No other previous PSAs. 67 years old. Evidence of cancer on DRE. No infection. Biiopsy results tomorrow, I am just so on edge. Also, we are at the Mayo in Scottsdale. I hope they are good

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 2367
   Posted 11/4/2012 9:57 PM (GMT -6)   
littlenm,
 
Hang in there.  There are lots of options.  Try to remain calm...I know, it's easier said then done.  I'm going to post a new post out there to Welcome you to the forum.  More people will probably read that thread and will able to answer your question about Mayo...
 
Jerry
 
 
 

littlenm
Regular Member


Date Joined Nov 2012
Total Posts : 320
   Posted 11/4/2012 10:18 PM (GMT -6)   
Thanks Jerry by the way. I was kind of rushing for my last entry because myhusband was entering the room.

sachsmart
New Member


Date Joined Mar 2014
Total Posts : 1
   Posted 3/11/2014 2:55 PM (GMT -6)   
Hi
I just joined the forum and have already found a tonne of useful information. Here is my (or my fathers) situation:
 
My Father is 71yrs, generally very healthy and leads an active life. Last friday he suddenly had trouble urinating at night and complained about pain. He went to his general doctor who thought it was a UT infection and gave him antibiotics, he also refered him to a specialist.
 
The urologist/nephrologist did various tests including a DRE (from what he described, I was not with him) and sent him for blood and urine analysis. He also sent him for a scanning.
 
All blood work was normal for kidney function etc. The scanning indicated an enlarged prostate (54gms) but the PSA test came out with a reading of 37.1. We are all very worried about this.
 
The doctor will conduct a biopsy on thursday. The only abnormal thing my father had was a pain when he streached his leg on the OUTSIDE of his thigh/lower hip. Nowhere near the prostate. This has been there only when he squats and only for the last 2 months.
 
What do you guys think the odds are of this being 1) PCa 2) If PCa having spread without showing any urinary symptoms 3) Likelyness of an infection, DRE or BPA (which he seems to have) driving the PCA this high?
 
He has never before had a prostate exam or had a PCA to my knowledge.
 
Thanks for your help.
 
Worried sick sad confused

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 1917
   Posted 3/11/2014 3:52 PM (GMT -6)   
Prostatitis and acute urinary retention can send PSA soaring. In fact, quick jumps like that are often symptomatic of those. Maybe a round of antibiotics will bring his PSA back down. He can also have a PCA3 test - he can ask the urologist if he can also check the urine catch for pathogens.

- Allen

johncaelen
Regular Member


Date Joined Jan 2013
Total Posts : 89
   Posted 3/16/2014 5:38 PM (GMT -6)   
It took 8 biopsies before my pc was found, I read if would take 1000 cores to.cover the entire prostate. Only thing I could recommend would be a saturated biopsy but don't stop trying as my biopsies were uncomfortable but they saved my life. Best of luck to you!
PSA 2.3 2007/ 3.2 2009/ 10.14 2013
7-biospy's including 1-saturated biopsy no cancer found but a-typical cells have been found
53-years old
UPDATE psa 10.14 cancer found-t1 gleason6 1positive core out of 16 54yrs old, UPDATE Robotic Prostatectomy (Dr Han, John Hopkins)
1-6-2014 Confined to prostate neg. margin, neg. lymph, gleason 3+3

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3220
   Posted 3/16/2014 6:35 PM (GMT -6)   
When my PSA was 17.8 people told me "Don't panic. It can get that high from prostatitis."

Wrong....
Age: 61, Mar 38 yrs, 56 dx, PSA: 4/09 17.8, 6/09 23.2
Biopsy: 6/09 Pos 7/12, 20-70%, G 4+3, Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: G 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE pres., PNI exten., Sem Ves, Vas def clear, Lymph 0/13
Incont.: AdV Sling 1/11
ED: Quadmix
PSA: 10/09 .04, 7/10 <0.01, 7/11 <0.01, 1/12 <0.02, 9/12 <0.02, 4/13 <0.02, 3/14 <0.02!

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 2367
   Posted 3/16/2014 7:14 PM (GMT -6)   
john...

8 biopsies? Oh my gosh... if it was 12 at a clip, that's 96 times...and I thought I couldn't handle the 12 I got...

Worried guy---I hear you...
11/09 Dx at Age 44 ----------- 4.03
12/09 DaVinci Surgery,t3b,g9 <.05
2/10 Adj. Radiation ----------- <.05
3/11 PSA Rise/Scans/Spot ---- .09
on Pelvic Bone
4/11 HT/XGEVA/Spot Radiation -- .06

2012 -- <.015 (ADT3 until October)
2013 -- <.015 (off HT entire year)
3/2014 -- <.015


Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 192
   Posted 3/16/2014 7:34 PM (GMT -6)   
I had 20 biopsies which were negative. When my PSA reached 6.0 the Uro did a 28 core saturation biopsy of which 5 were PCA (2 gleason 8, 2 seven and 1 six.) RRP pathology was Gleason 4+5. The Old Sailor

lapilot
Regular Member


Date Joined Nov 2012
Total Posts : 280
   Posted 3/17/2014 12:33 PM (GMT -6)   
Two fairly common causes for elevated PSA are Benign prostatic hyperplasia (the larger the prostate the more PSA it can produce) and prostate and urinary infections. Both can be easily detected.
Age 60, Parametric MRI 8/18/13 negative findings
biopsy 9/5/13, PSA 6.2, 13 core of which 6 are postive
left laterial base 10% G6(3+3)
left laterial apex 10% G6(3+3)
right base 15% G7(3+4)
right laterial base 15% G6(3+3)
right laterial mid 60% G6(3+3)
right lateral apex 20% G6(3+3)
Robot Surgery scheduled 11/11/13
Post surgery path T2c N0

Inchoation
Regular Member


Date Joined Jan 2014
Total Posts : 335
   Posted 3/17/2014 5:18 PM (GMT -6)   
I'm not so sure prostate infections can be so easily detected. I took 52 days worth of antibiotics over a 4 month period for what was thought to be prostatitis. The uro told me I very well could've had chronic prostatitis along with PCa as the reason my PSA was double digits. He told me sometime you never know what role an infection is playing in your PSA number.

After three "failed" PSA's the lowest being 9+...52 days of antibiotics...and a 3rd PSA test level of 12.4 I could no longer fool myself that I was just fine. Had biopsy which revealed PCa...3 cores one at 60% G7 and concerns of spread.

As everyone here knows...there are a million stories and things can go a million different ways.
45 at dx
PSA's: 11.7, 9.8 and 12.4
Biopsy Dx 7/29/13 Two cores 3+4 and one 3+3 no PNI
RALP da Vinci w/Nerve Sparing 8/29/13 Mayo Clinic Rochester MN
Pathology: single tumor .2x.1.x.1cm PT2n0mx downgraded to Gleason 6
Follow up PSA 12/06/13 0.06
Incontinence: No longer.
ED: Wife says I'm "85%" :) NO MEDS

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3220
   Posted 3/17/2014 6:50 PM (GMT -6)   
They say the "free PSA " % can indicate PCa - or not. The lower it is, the more likely you have PCa. BUT in my case, the lab could not run the test since my PSA was above 15ng/ml - above their testing limit. Lucky me...

See if you can have a free PSA % done before your PSA goes above 10.
Here is a chart to help you with the results. You can find a better one with a quick search.
-----------------------------------
Probability of finding prostate cancer based on % free PSA in men with a total PSA between 4 ng/ml and 10 ng/ml
% free PSA ..... Probability of prostate cancer
0%–10% ........ 56%
10%–15% ...... 28%
15%–20% ...... 20%
20%–25% ...... 16%
Greater than 25%..... 8%
SOURCE: Journal of the American Medical Association, May 20, 1998.
Age: 61, Mar 38 yrs, 56 dx, PSA: 4/09 17.8, 6/09 23.2
Biopsy: 6/09 Pos 7/12, 20-70%, G 4+3, Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: G 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE pres., PNI exten., Sem Ves, Vas def clear, Lymph 0/13
Incont.: AdV Sling 1/11
ED: Quadmix
PSA: 10/09 .04, 7/10 <0.01, 7/11 <0.01, 1/12 <0.02, 9/12 <0.02, 4/13 <0.02, 3/14 <0.02!

Post Edited (Worried Guy) : 3/19/2014 6:49:41 AM (GMT-6)


PSA3DOT7
Regular Member


Date Joined Dec 2013
Total Posts : 188
   Posted 3/19/2014 7:24 AM (GMT -6)   
Its all probabilities nowadays.

So if you have a PSA of 3.7 (< 4.0) you probably have PCa but ...

Having a PSA reading above a limit AFTER intervention may NOT be good either ...
DX 2013 Age 58
Gleason 9 (5+4) 1/16 +cores
no Mets, lymph node , seminal vesicles clear
PSA < 0.01 (11/2013, 01/2014, 02/2014)
pre-Op PSA 3.7 (08/2013), 2.4(03/2012), 1.9 (12/2010), 1.6 (12/2009) -- 0.8 (03/2004)
RRP Oct2013, Nerve sparing one side
ED - PDE5i 60% erections 2/week
Continent - Feb 2014
HRT Testogel 50mg/5mg day
T2 Db on Insulin
Hypertension
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