Should I be concerned about my little brother

Is a PSA that is constantly between 5.4 and 6.3 a concern even if it is not rising.

Hi Moz,
If he didn't have a brother with PCa then I wouldn't have some concern. There are stories of elevated PSA out that I know of at least one. And the one I know does not ever test positive for PCa. That stated, he should remain diligent on his tests. I would think that even if it does not rise after some period, another biopsy would be logical. But I'm guessing. Your positive biopsy should be enough to keep him acutely aware.

Tony

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Age 45 (44 when Dx)

chaso36 speaks almost exactly for my statistics. Mine stayed between 3.8 and 4.2 for probably 10 years, before jumping to 7.6 in 4 months. With now a history of prostate cancer in the family (you), it is even more likely that he is susceptile to it. My doc said if mine were biopsied 2 years ago, most likely it would have come back negative. I would recommend your brother get to a regular Urologist, if he hasn't and get some good numbers from a credible lab to check...With your cancer the odds have greathly increased his susceptability to it, along with anyone else in the family.

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James C. 

My sister-in-law's father (not sure exactly what that is to me)  had two negative biopsies after following up on a high PSA.  The third biopsy showed PCa.  A good friend's dad had a similar situation back in May and said take the prostate out and when they did, they found PCa as well.  I'm not trying to scare you, but my dad's idiot PCP sat on his 5-6 PSA for TWO YEARS before sending him to the urologist AND....you can see from my father's stats below what the outcome has been.  Better safe then sorry if you ask me!  You are a good brother...stay on him!  Hopefully, it's nothing, but the worst thing you can do is nothing.  Best wishes! 

My brother-in-law's PSA has been slowly rising over the past 5 years and he has had three biopsies during that time with negative results.  They have him on an every six months PSA check.  It has not gone up every test as sometimes it would fall back a few tenths of a point and then rise higher the next time.  It is now at about 6.5.  I have talked with urologists that have patients that have PSA's between 10 and 20 for several years and have had as many as five biopsies with all being negative.  As long as your brother is in te hands of a good urologist then he is probably okay. 

Tamu

Dear Mozart,

I am not posting much these days, and others have given you a lot of valuable advice here - just an opinion from me too and who knows really? The stringent medical follow-up regularly seems to be the main thing on your side here with regards to your brother.

All I can really say is that my husband with a PSA of 3.5 (at 48 years at the time), DID have prostate cancer (multi-focal but confined to 2 specific areas close together), however the (12 core) biopsy picked up only 1 x 5% positive in 1 core and all others negative. As you know, biopsies can miss small cancers. We have exactly the same dilemma here with my 54 year old brother-in-law who had a PSA in January 07 of 4.0, refused follow-up or repeat anything, and is only NOW getting his PSA re-checked (so he tells his mother - my mother-in-law). Even now, I am not so sure he is following this up at all, and this is extremely worrying. He still has not seen a specialist, despite all efforts of the rest of the family. So maybe the thing is to check out your brother's doctor and make sure he is experienced (an expert) in the area - if so, this may not be a concern if he is being monitored carefully, but to me this PSA reading seems high in light of his age. My understanding is that a PSA for a man of 49 should be less than 2.5 but of the higher readings not all are cancers (my husband was told his odds were 50/50 of having cancer pre-biopsy).

I reckon the good news with your bro is that he is having regular testing, therefore he is being monitored, and Tamu's words are wise on that point.

If you check out his doctor (privately - reputation etc) maybe a second opinion on his PSA's and tests so far would be helpful to suggest to him? I think with this disease, and knowing his family risk now, that you will probably always worry about him, but keeping him to his tests and appointments so that if there is a problem it can be addressed early, is all you can really do. And that seems what you are right into here with your questions.

Hope you do not mind me chipping in here - I am ultra sensitive to high PSA's in younger men - it makes my heart pound with anxiety... Good luck to you, and also in watching over your little brother. cheers, Lana

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Creed_three

Mozart:

Family history is one of the "red flags" you should be aware of when checking for Pca - you are twice as likely to get Pca if your father had it  and 3 times as likely if it's a brother.  With your brother's PSA jumping around, is he aware of the things you should abstain from for 72 hr before PSA (heavy exercising or activity, bike riding, sex, digital exam).  Also, a "free" PSA might show if there should be a concern.

Dutch