Question :- at what PSA level should your doctor refer you to a specialist

Hi DS and welcome 

Probably the most important thing is what the MRI said assuming u have had one.

Potentially that can tell u more than a biopsy although u  need the biopsy for a Gleeson score

You say stage 4 but I don't think this staging is TNM although u should have a TNM score from the MRI scan.

Do u have a Gleeson score?

Regards 

Steve 

This is a page from Prostate Cancer UK which MIGHT help:

https://prostatecanceruk.org/for-health-professionals/guidelines/navigating-nice-ng12-and-pcrmp-guidelines-on-psa-testing/#:~:text=The%20guidelines%20recommend%20different%20PSA%20thresholds%20that%20should,threshold%20of%203.0ng/ml%20for%20all%20men%20over%2050.

It refers to 2 different sets of guidelines. It is meant for use by professionals, which excludes me, so I don't dare comment further.

The introductory paragraph does, however, point out that other symptoms have an effect. If you decide to follow these links through, take care to ensure that you understand them.

I know exactly how much of a shock the diagnosis can be, having gone through this myself in the last six months. Some refer to this as "the best club no one wants to be in". Although I don't like having PC I am very glad I found this group.

There are many people on this group with a wide variety of experience. In the main they are optimistic, well-informed and cheerful, considering.

You might want to fill in your profile with as much as possible about your diagnosis. That helps people give you better advice and help.

Go back to your main page, look to the green banner and the small armchair at the top right. Touch the small armchair, select "Profile" and start typing. You might find it helpful.

Keep smiling.

Hi DivonneS If it’s taken 7 years to reach PSA of 16, I think you have plenty of time to have the full diagnostic pathway without fear of it getting out of control.  What was the PSA over the last year?  This will give an indication of doubling time.  AW

Hi Grundo & thx for responding.

After my PSA reached 16 I did have a MRI which showed 2 small white spots on my prostrate. Based on this I had a biopsy.

The result showed a Gleeson score of 4+4 on one sample out of 14. The Urologist said even though only one it is still rated as stage 4.

Hope this clarifies.

TC S

Hi & thx for your help.

Over last 12 months it moved from 14 to 16.

TC S

Yes that does help, so doesn't look too bad still potentially curable.

Hopefully the other scans don't show anything.

If literally small white spots then should be fine after surgery or radiotherapy 

Best wishes 

Steve 

Hello DivonneS . Hello and welcome.

There is no exact answer to this but as a general rule men under 60 with a PSA above 2.5 and men over 60 with a PSA above 4.0 should be investigated further and offered a scan or a biopsy. This threshold can vary from different governments eg. I think NICE is slightly higher but it gives you an idea of what numbers you are looking at. If negative then a repeat about a year later can be carried out as confirmation that nothing is going on. It then depends on the rate of the PSA increase along with the size of the increase but one article suggests it should be less than 0.7 per year. Other factors which might come in to play are the level of free PSA - if below 1 then it is a warning sign, if you have a history of prostate problems, how large is the prostate (larger prostates tend to produce more PSA). 

I can understand your shock at suddenly being diagnosed with stage 4 prostate cancer when you have been monitoring the PSA regularly. Once you have all the results back it would be helpful if you updated your profile so that more individual advice can be offered. In the meantime I have attached information on how prostate cancer is staged.

https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/what-do-my-test-results-mean

Unfortunately you are at the difficult waiting time for test, diagnosis and then treatment.

Please come back with any questions.

Thankyou very much for your responses & all the others.

I have just realised joining this group was an excellent idea!!  Onwards & upwards!!!!

Hi DevonneS.

Welcome to our prostate family yes we are all a great bunch.

This was also one of my better ideas as it is very confusing and scary upon diagnosis.

But please please come back to me if there's anything that I can help/support you with as I am just over 12mnts into my PC journey.

Prostate Worrier.

Thx & I wish you all the best on your journey. Its certainly a bit scary!!!

TC