High PSA despite procedure

Diseases & Conditions Prostate Cancer
1
about 1 1/2 years ago , I had the Green Light procedure where the prostate is vaporized , making it smaller. Mine was huge . The doctor said the removed about 40% of the prostate . It went well, and I was able to pee again . I had many exams , two biopsies , and no cancer found . I was told the high PSA might be due to the enlarged prostate . Despite the procedure , the number is still high , about 14 now . My doctor , who is going to retire at the end of the month , does not seem concerned. I think he just wants to push his patients off to another doctor and does not want to be bothered . If it is not cancer , what else is causing the high numbers ? I am not eating spicy foods , riding a bike , and not a lot of sex before the last blood test. Should I be worried ? Is there anything I can do to lower the PSA numbers ? Thank you !
2
Hopefully you are seeing a urologist about these continuing issues. There are drugs that can lower PSA but do not change the cancer situation, just lower the value as a byproduct of the drug.

I think it may be worthwhile to ask your urologist about a PSMA Pet scan which has the ability to highlight where prostate cancer or the source of the PSA might be. Biopsies can miss small lesions so not finding cancer is good but not definitive. You might just be the odd duck with a high PSA issue but it is hard to sleep well not knowing what is causing it.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
3
Thanks Mumbo . I had an ultra sound a few days ago . I get the results next week . The waiting is the hardest part .
4
Avodart reduces non-cancerous PSA. So, by gageing the depth of PSA decline a very coarse estimate of PCa probability can be assessed. It has a very long half life, leading to the need of one year or longer for atteining a quasi-steady state. The accepted rule of thumb is that in PCa cases it halves the PSA count. The real value of it is that it removes the variability of the benign PSA, thus exposing any steady increase, a definitive indication of PCa.
5
Thanks , Justfor . I see the urologist on Tuesday . I will ask if Avodart will work for me .
6
Jack, PSA is really not the issue. The issue is what is causing it. Taking a medication that suppresses PSA, if there is cancer present, can give a false sense of security.

Remember, PSA is not a symptom of anything. It is an indicator that 'something' is happening, and the goal must be to figure out what it is.
Age at Diagnosis: 56
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA Non-Detect since April, 2015
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024
7
Isn’t this what biopsies and scans are for?
8
Those last two posts are especially on point. You do need to follow up, and the fact that your current urologist is going to retire is actually a step forward. Hope you can find a good replacement. Your chances of finding one at an academic medical center are pretty good.

Post Edited (Sr Sailor) : 5/12/2026 2:13:15 PM (GMT-4)

9
I was prescribed an antibiotic and am scheduled for another blood test mid June . Then I have an MRI a week later . Hopefully , the antibiotic will lower the numbers . But , because my urologist is leaving , I need to get a new one . Hopefully , he can just review the notes from the doctor I use now and I won't have to go through all the exams again . Thanks for all you help and advice .
10
Get with your URO office NOW and start getting copies of your records. Odds are they'll offer them anyway...but I would call.
11
Depending on where you live and the quality of medical care available, your records are usually easily available to other providers after you sign a records release form. However, it is good idea to have copies of all the major stuff like scans, biopsies, pathology, blood tests, etc in your possession for reference. In recent years, information sharing has become a lot easier.

Now, if your doctor is part of a small practice in a rural area, you may have to actually pick up paper records and get them to the new doctor. I have not had to do anything remotely similar in years and even many dentists have gone to electronic records and digital x-rays now. Just ask your provider how you get your records.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
12

Hope you have been faring well this summer.

Have you gotten lined up with a new urologist?

Keep us updated & hope you are doing your best ~

CYCLONE ~ # Iowa State University