7 months ago I got a Transrectal Color Dopplar from the renowned Dr. Bahn, and he said he found a lesion in the left side of my prostate that is most likely prostatatis since my PSA was low at 1.0 and free PSA was 46%, and believed it was not cancerous and told me to get a PSA test every 6 months. The reason why I went to get this test was because on DRE my urologist felt my left prostate was "harder" than my right side although there were no nodules.
Since then, my PSA rose from 1.0 to 1.4 in 7 months, but free PSA ratio is the same at 46%. Is this a cause for alarm?
I know a rising PSA level is not a good thing, especially in such a short time frame (and I have no infection), but the free PSA ratio remains high at 46%.
I am not exactly sure what to make of this data, I am waiting another 4 weeks to get another PSA test since I want to eliminate the possibility this is just a random spike.
But the lesion that showed up on the Color Dopplar does worry me as well as the fact my urologist said the left prostate felt "harder" than the right one. It is just a weird situation with conflicting data that confuses me, so I'd really appreciate it if some of you could shed light on what to make out of all this.
At the age of 32, it is highly unlikely that you would have PC. Not impossible, of course, but not very likely.
As for free PSA, the doctors get suspicious when it goes below 10%. Generally, anything above 25% is considered excellent, so you are just fine there. Also keep in mind that fPSA is not a diagnosis one way or the other, but is usually just another clue that can sometimes be useful.
Other things can cause a slight rise in PSA, including infection even if you don't think you had one at that particular time.
Before your next PSA test, do not have any sex, do not perform any vigorous exercise, do not ride a bike or have any DRE performed in the 72 hours before the blood draw. Anything that stresses the prostate can put a temporary spike into the PSA reading.
Best of luck to you!
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Firm erections now briefly happening in early mornings, 2 years post-op