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New Member

Date Joined Oct 2009
Total Posts : 3
   Posted 10/16/2009 11:03 AM (GMT -6)   
  Hi  I am a 60 year old white male.  Two years ago, my PSA test was 4.8.  I had a biopsy and I was told I did not have cancer.  I had a PSA test this month and now it's a 5.8, two years later.
I don't know if I should go in and have another biopsy or do nothing and not worry about it.  I read so many conflicting stuff about the PSA test.

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 10/16/2009 11:16 AM (GMT -6)   
Boy, that is a tough call. Did your uro say anything about an enlarged prostate -- that could account for the PSA as could an infection or s*xual activity shortly before the test. Did your doctor have an opinion?

If it were me, I would seriously consider another biopsy -- perhaps color doppler guided if that is available to you.

Do you have a record of prior PSA tests? The rate of change, such as doubling time, can be meaningful. You will probably get other feedback here, don't believe us, but if it seems like there are lots of possible issues that your doctor did not raise, then perhaps a second opinion is in order.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 10/16/2009 11:24 AM (GMT -6)   
Hi Jimster...yeah like geezer said it is a tough call. I know the standard is .75 rise in 12 months, but there are certain types of prostate cancer that don't give off much PSA and even the location may be difficult to find on biopsies. What did your uro suggest? At your age, I don't recommend just pushing this off without getting to the bottom. It could be just BHP or enlarged prostate, but you need to know for sure. Definitely don't sweep this under the rug.

BTW welcome to our corner of the world. Glad you found us.
You are beating back cancer, so hold your head up with dignity
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 10/16/2009 11:30 AM (GMT -6)   
Hello Jim,

Welcome to HW. If it were me, with what you wrote, I would want to have another biopsy (I know they are not fun), its going to be the only way to know if you are still safe from PC at this point. The first one you had could have simply missed it. It took 3 biopsies with me over 18 months to hit pay dirt.

I hope you don't have PC, this is one club that you dont' want to be a member of.

Please keep us posted.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Veteran Member

Date Joined Sep 2008
Total Posts : 744
   Posted 10/16/2009 11:43 AM (GMT -6)   
I would also add to get a fPSA test and perhaps a PCA3 test. This will help in determining the odds if cancer is present.

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 10/16/2009 12:12 PM (GMT -6)   
I have a 73 year old friend who's PCA crept up to 12 or so over several years. He had a few biopsy's over the years...Then he got a biiger jump to about 20 and the biopsy confirmed he had PC.

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 10/16/2009 1:27 PM (GMT -6)   
If your doc is not concerned, change the doc. PSA this high without a reason is a problem.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug

New Member

Date Joined Oct 2009
Total Posts : 3
   Posted 10/16/2009 1:32 PM (GMT -6)   
Thanks for all of your comments. I recall that my PSA reults over prior years was between 3 and 4 until two years ago and had the biopsy. I have an appointment with my regular physician and will discuss it with him, but I am thinking that I might want to wait until the next test and see what happens. I guess my saying that is really me not wanting to deal with it and hoping it's ok.
No, I didn't have any type of sexual activity before the last PSA, as I knew that could affect the results.
Thanks again for all of your comments.

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 10/16/2009 2:16 PM (GMT -6)   
You need to re-biopsy and ask if there is a more detailed biopsy available through your urologist. If not you might look into a saturation biopsy to test more areas of the prostate...

Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My Journal is at
My InfoLink page is at Tony's Prostate Cancer InfoLink Page


Regular Member

Date Joined Jan 2009
Total Posts : 36
   Posted 10/16/2009 2:31 PM (GMT -6)   
The biopsy is a way to detect cancer but it often doesn't detect it. As several have said here, it sometimes takes multiple biopsies over years before the biopsy finds cancer. I had very high PSA over the last 10 - 11 years and had several biopsies that did not detect the cancer (although the cancer was probably present).

Age now 70, 69 at Dx December 22, 2008
PSA 1998 5.2, 2000 2.5, 2003 5.4, 2004 7.4, 2005 15.9, 2006 20.5, 2007 31.5, 2008 34 and 32.9
Biopsy 1998-no cancer, 2003 - no cancer, 2006 - 12 samples, no cancer but PIN, Dec. 2008 - 12 samples, 2 positive with Gleason 4+3 = 7 on each. PIN on 3 others.
Di Vinci surgery on 2/10/2009, Austin TX
Pathology post surgery T3a, Gleason (4+3)7 with tertiary pattern 5.
NX,MX,R1, margin involvement 1-2 mm
Catheter removed on February 23.
First PSA, followup on April 6, 2009 with 0.01 (lowest they can measure)
April 20, 2009 - no more pads
Second PSA, August 10, 2009 0.01
Now on 6 month PSA cycle

New Member

Date Joined Oct 2009
Total Posts : 3
   Posted 10/16/2009 6:20 PM (GMT -6)   
I would like to also discuss something involving sex and the PSA score.
Although I didn't have an orgasm 36 hours before my test, I usually do ********* once or twice a day.  Is it possible that is the reason for my high PSA and why my biopsy was o.k.?
I was reading a report from BBC news and it suggests that men who ********* frequently has a lesseer chance of getting PC.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 10/16/2009 6:38 PM (GMT -6)   
Most literature on the subject says ANY sexual activity approximately 36 to 48 hours or less from psa testing can cause a rise in levels. This includes intercourse, prostate massage and musterbation. Also, prostate infection (prostatis) can elevate it. In my case mine raised from around 4.0 to 7.6 at which time I was referred to a Urologist who first ran me thru a course of Cipro antibiotics for a month, then a month for it to clear my system, then a retest, which came back 6.7, at which time I got a biopsy.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN

Old Sailor
Regular Member

Date Joined Aug 2009
Total Posts : 209
   Posted 10/16/2009 7:57 PM (GMT -6)   
The Old Sailor strongly recommends a saturation biopsy (usually about 25-30 specimens).  Very easy because you get general anesthesia, much easier than an in office biopsy under local anesthesia.  I had 4.5 in 9/08 followed by a 10 core biopsy, all negative  Then in July 09, 5.6 followed by saturation biopsy which found 5 of 28 Pca, 2 were gleason 8! Research shows (my surgeon pioneered the saturation biopsy) that nearly 45% of men with rising psa and previous negative biopsies are found to have cancer on saturation biopsy because the saturation biopsy goes through the perineum vice rectum which gives the urologist a template on the prostate and gives him the exact location of the cancer if present.  I had RRP on 13 Aug.  Doing fine now but never knew I would have cancer if relied on regular biopsies. 

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 10/16/2009 10:10 PM (GMT -6)   
I have a friend that has an elevated PSA of 6.5 and he had a saturation biopsy last year and came back negative. This year he had a PSA of 7.5 and was scheduled for another biopsy and still no cancer. The uro said that some men just have elevated PSA. I think my friend did right in having another biopsy and I would encourage you to do the same if nothing else it will be peace of mind. I would bet you do not have cancer but us folks here at HW would like to know for sure. We care and we hope you do not become one of our members due to having cancer.

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
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

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

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