Flunctuating PSA

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New Member

Date Joined Apr 2009
Total Posts : 5
   Posted 5/9/2009 2:33 AM (GMT -6)   
Has anyone out there had such a fluctuating psa?
Husbands psa history.
05-5.9   AGE 52
Doc says because 1st & last are the same, there`s nothing going on, so come back in a year.
We had our own psa & free psa done a week after the last one came back, 5.7 free psa 21.
Can`t see much on internet about the free psa. Do you guys think hubby`s is fine?
Next thing we could have a PCA3 test, its expensive, do you think we should put it behind us, and wait for next years PSA. 

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 5/9/2009 10:19 AM (GMT -6)   
If it were my husband, I would recommend a second opinion and get a biopsy done. I would also reference the current PSA guidelines and ask your husband's doctor why it is ok that your husband's PSA is above the "normal" range. My father's FP did the same thing and waited two years watching my father's PSA while it hovered around 5.5-6 and finally my family intervened and had my father see a specialist, who confirmed that he had cancer and it ended up spreading. I feel confident that if we had caught it sooner, that it would have been curable and my father would not have had to go through radiation and HT like he is going through now. I hope your case is different and hopefully your husband's biopsy comes back negative, but I wouldn't wait to rule it out. I don't mean to scare you, but your situation reminds me of my father's and I am furious with my father's FP. Best of luck and keep us posted.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 5/9/2009 4:08 PM (GMT -6)   

Hi Tizzal,

I am new here too, and probably not the best person in the world to give advice, but my psa went 3.7-3.8-3.4-4.0, I had no symptoms really, just a bit of a dribble after urination from time to time.  Has he had a DRE done yet ?.  Knowing what I know now,and if I where in your position, I would be definately having a biopsy.  Biopsy's are not that bad, and to my knowledge about the only way of really finding out whats going on.  Good Luck, and stay positive..................cheers Nothard

Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
Gleason 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason 4+3=7
Stage T2c
Three small foci total volume 10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week (unbelievable)
ED- taking Meds/ No result yet
PSA 28/1/09 0.03
PSA 24/2/09 0.03
"Everyday in Everyway I get better"

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 5/9/2009 4:19 PM (GMT -6)   
I have a friend that has PSA fluctuating between 4 and 6 has had two biopsies in the past three years and both came back negative. I cannot say do not worry, however it is highly possible that this is a norm for your husband. never hurts to get a second opinion just for peace of mind. Keep us posted as to how things go.

peace and love
My PSA at diagnosis was 16.3
age 47 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
Testosterone keeps rising, the current number is 156, up from 57 in May
T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

Elite Member

Date Joined Oct 2008
Total Posts : 25382
   Posted 5/9/2009 5:44 PM (GMT -6)   
I agree with Doting Daughter's advice here. I think she stated it well.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 6 month on 5/9

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2460
   Posted 5/9/2009 5:49 PM (GMT -6)   
The norm for free PSA is 25% or higher. My PSA never reached 4 and yet I had cancer. I suggest that you gey a second opinion and may be have a 20 core biopsy.
Age: 67
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09
Surgeon: Dr. Randy Fagin, Austin TX.
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Bilateral 10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
seminal vesicles clean
Lymph nodes: not dissected
1st PSA test 4/7/09 result <0.1

Regular Member

Date Joined May 2009
Total Posts : 54
   Posted 5/9/2009 6:33 PM (GMT -6)   
Actually the "norm" for fPSA is not 25%. Rather, the 25% cutoff point you often read about is a level at which you have about a 90% chance of not having prostate cancer.
However that is not the norm. In fact in some studies, the median value for a men who did NOT have prostate cancer was only 18% while the median for those with prostate cancer was 8.8%.

Various studies use cutoff values anywhere from 14% to 27% depending on how much margin for safety they want to include under the value.
In this case Tizzal's husband value of 21% should NOT give her reason to think it means he has prostate cancer.
I would have more concern about the higher PSA values than the fPSA of 21%.


New Member

Date Joined Apr 2009
Total Posts : 5
   Posted 5/9/2009 7:04 PM (GMT -6)   

Thanks for all your advice,

In answer to Nothards question, hubby had a positive DRE back in 05 before the negative biopsy.

Would BPH cause the PSA to rise to those levels and then drop back down again?

Doc says he needs to see 3 consecutive rises to warrant another biopsy.

Think we will go for a PCA3 test. Though I`m not sure if that will confirm anything either.

Will keep you all informed.



Forum Moderator

Date Joined Sep 2008
Total Posts : 4240
   Posted 5/9/2009 7:40 PM (GMT -6)   

Dear Tizzal:

Here is a link that may help you with the free PSA analysis:


And, as you will note, you may get some solace from the statement in this link "...most men with prostate cancer have a free PSA of less than 15%".

And here is a fairly complete, but somewhat complex, discussion of the PCA3 test:


However, I would personally be somewhat suspicious of a doc that says "nothing is going on" with a man in his early 50's with obviously elevated PSA.  Has he ruled out BPH?  In any case, since you obviously have doubts about your physician's advice, I would suggest you find the best urologist you can and go to him/her for another opinion.  Just waiting another year does not make sense to me...


Age 62
Gleason 4 +3 = 7
PSA 4.2
2 of 16 cores cancerous
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 5/1/09.

Regular Member

Date Joined Apr 2009
Total Posts : 133
   Posted 5/10/2009 7:40 PM (GMT -6)   

Hello T,

After I was told that my PSA was 5.3, I researched and found several references to fPSA and had both done before I committed to a biopsy. The fPSA was 22% and i thought for sure that i was not going to mbe in this club. The doc said, well, statistically speaking, you have ~80 chance of no PCa and then said "what about the other 20%?" The gold standard at that point is a biopsy. Sure enough, I was in the 20%.


Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....

Regular Member

Date Joined Jan 2009
Total Posts : 48
   Posted 5/10/2009 9:28 PM (GMT -6)   
My stats are somewhat similar, except my 1st biopsy showed one sample being "atypical." My latest PSA was 5.2 with 21% free. I just saw my URO on Thursday and he recommended another biopsy just to be on the safe side. I'm scheduled for the 21st.

Another factor to consider is the size of the prostate. Your hubby's doc should know that from the first biopsy. I've read that a rule of thumb is that if your PSA is around 10% the weight of the prostate it might be considered normal.

2004: 2.0
2006: 4.0 (40% Free)
2007: 3.1
2008: 5.03
2009: 5.20 (21% Free)

Biopsy (age 58)
August 2008: 1 core of 12 was "atypical" Prostate weight 46 grams
May 2009: ??

Family history: Father and Grandfather both had PCa

New Member

Date Joined Apr 2009
Total Posts : 5
   Posted 5/11/2009 5:40 AM (GMT -6)   

All your replies make for very interesting thought!

TeddyG & Gmike having very similiar stats.

Maybe we are just to early for anything positive to show up, seem to be in no-mans land!

Booked a PCA3 test, so will keep you posted.

Many Thanks



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