PSA keeps rising

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Hi,

I’ve posted here before. I have a strong family history of prostate cancer at a young age (40s and 50s). My PSA has been measured from the age of 40 (I’m now 50).

2011 - 2018: 0.5 to 0.7

2018: 0.6 to 1.8

2019: 2.0

2020: 2.0

2021: October 1.8, December 4.0, February 4.9, March 5.9

I have a normal prostate (30 cc) no BPH and no UTI.

I’ve also had a PET CT due to back pain and weight loss (I’ve had bladder cancer) with FDG uptake at a spot in my spine.

I am living in Norway and have been told to give it another few months to repeat the PSA test and that the area on PET couldn’t be prostate cancer with only 5.9 PSA. This is the third time I’ve been told to wait so I paid for a private online appointment with a urologist in London. He didn’t agree about the PET, thought my rapid rise in PSA combined with family history was a concern and has told me I should have a quality mpMRI as well as a PSMA PET scan.

My Norwegian doctor will never agree to this so I’m going to self pay and come home to the UK. My question is if anyone knows where I can get this done and how much it will all cost?

Also, is it true that with a PSA of 5.9 there is no chance of spread. I’d feel very reassured if that is the case.

Many thanks for your help!

Alex

Grundo over 3 years ago

Hi Alex

From what I have learnt over the years PSa of 6 would indicate that it hasn't spread.

However there are a few very rare aggressive PCs that produce very little PSa although u would have to be very unlikely to be in that category.

U don't say when the last scan was but if within the last year and it indicated a contained smallish tumour then looks like you're ok.

I don't know the price of private scans but possibly just another MRI done by NHS would suffice

Steve

AlexMP over 3 years ago in reply to Grundo

Hi Steve,

AlexMP over 3 years ago in reply to Grundo

Hi Steve,

Thanks for your reply and sorry for multiple replies from me. Every time I pressed return, it sent you a reply!

I had an MRI over a year ago. This is what it said about the size and location of the lesion: “In a dorsal location on the right of the base in the peripheral zone there is a tumor typical lesion. It measures 1.1 x 0.5 x 0.7 cm. PIRADS 4. The borderline with the capsule is difficult to assess due to motion artefact. No certain conclusions can be drawn with regard to any invasion of the seminal vesicles.”

They only took 3 targeted biopsies which were negative - atrophy and inflammation.

The London urologist said a new MRI was necessary as I’ve had a steep increase in PSA since then.

Cheers

Alex

Grundo over 3 years ago in reply to AlexMP

Hi Alex

So yes, time for another MRI, and yes I believe mp MRI more detailed.

Your PSa is still low so hopefully the MRI will show tumour still similar but important to see if it's near the capsule edge.

Sounds like u may be nearing time for treatment.

Steve

AlexMP over 3 years ago in reply to Grundo

Hi Steve,

Thanks a lot. Much appreciated. I’ll go ahead with the MRI at least. I’m hoping still that it will exclude prostate cancer as I had an operation to remove a bladder tumour yesterday and may be facing bladder removal. There is an option to do the op and leave the prostate in place, which would best maintain sex life and continence. Hence my eagerness to find out about the prostate. Life doesn’t give us easy choices!

Thanks again

Alex

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