My Borther's rise in PSA

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Hello,

Thought I would ask here first about this.  My brother had to have some routine blood tests and asked me if it was worth asking them to do PSA again even though he had had one about 6 months prior - he will be 71 in July.  I told him by all means add the test in while they do all the other blood tests.  He has now had the results and his PSA has gone from around 1.9 six months ago to 4.  Before the test I told him no sexual activity and no heavy exercise for 48 hours - he was always OK on the heavy exercise LOL!  I told him 4 is not bad and if it stayed at 4 for his age it was probably OK but his GP is concerned about the rise in 6 months.  BTW he lives in South Africa so things work slightly differently there and he has been having PSA and DE annually since he was around 40 as his works medical insurance dictated this.  In fact it was because of him that I started to get checked, as until he mentioned getting the tests and exams I hadn't even heard of them at all.  He has now been referred to a urologist I have told him that a doubling in around 6 months may not be anything to worry about and it is good that his GP is referring him.  I think here they would have, in the first instance sent him for another PSA test.  I kept telling him that they are doing good things and if anything sinister is to be found they are going to find it early.  However, I could hear the worry in his voice so just wanted to check what I have told him with  all of you first.

I am unsure of things as this isn't the way it went with me as my PSA rose slowly over 3 to 4 years - so slowly in fact that no one was over concerned and maybe I should have been sent for a biopsy a year earlier.  Anyway, nothing we can do about that.  Just worrying that I give him the right information and support.  It is very unsettling and upsetting when you hear the worry in a loved one's voice.  Already going through similar with my sister as my brother-in-law was diagnosed with aggressive gullet cancer just after I finished my treatment 2 years ago.  At the mo he is doing fairly well had a massive operation and then 14 weeks of chemo nearly two years on now and he is not so bad and has a consultation on Friday - am hoping against hope that they have miraculously cured him though at the beginning we were told that was very unlikely and that he should just go home and live the rest of his life as fully as he could manage and no treatment suggested - however they then decided they would treat and they really threw everything at him and he has gone through some bad times with all the chemo. 

On a brighter note(?) It has just stopped snowing here in Sunny Wales.  Such a difference after the lovely hot sunny weather all last week - up until two days ago.  We have planted out roses and put a new garden bench together that we had had in the garage in bits over the winter as didn't think it worth putting it out in the bad weather over winter!  LOL  So it must be our fault that we have this weather.

All the best to all of you.

Des

  • 'Good morning Des

    I would say that it is something to be concerned about.

    Before my diagnosis in 2013 I had always monitored my psa (after reading loads of  articles on psa) and it was always about 2 ish. Then suddenly in Sept '12 it went to over 4,  The rest is history as they say  and obviously  for your brother it may now hover around 4  and not be a problem but definitely worth monitoring.

    All the best

    Steve

  • Yes they are monitoring as I said he gets a PSA test every year anyway and I presume now after being referred to a urologist he may get one more often or may even be sent for a biopsy now.  It was a long time ago that my PSA was 2 but thankfully now it is a lot less let's hope it never gets back to that number!

    All the best Steve and thanks for your reply.

    Des

  • Hi Grundo,

    Thanks for your reply.  Had a look at your profile and wonder how you are doing now?  As it is a year since you updated your PSA on there at .93  Has it stayed down there?  Hope so.

    All the best

    Des

  • FormerMember
    FormerMember in reply to freefaller

    Freefaller,

    Just had a look around and for a man in his 70s PSA can be up to 7.  But, in a large sample who had PSA up to 7 they found 38% had prostate cancer. 

    I've always said that the PSA test by itself is so limited as to be almost useless but can be used as a pointer to further investigation.  I agree with your brother's doctor that the increase warrants further tests.  Perhaps active surveillance with 3 monthly tests to watch the PSA level.  If the next one goes to say 6, then obvious cause for concern.

    My brother has PCa too (PSA 10 Gleason 9 T2 N0 M0) so I understand where you are coming  from.  He can't have an op (heart attack) so on bicalutamide for life after radiotherapy.   

    All the best

  • Hi Des

    Latest psa .74, still going down and the c. Centre seem happy with that, so hope it keeps on in that way.

    I think that it doesn't matter if it doesn't go lower as the nadir (low point) may have been reached,  so long as it doesn't start climbing again , fingers crossed.

    Steve

  • Yes I did explain to him that it had to be monitored now and that his GP was doing the correct thing by referring him on though the PSA was still low a rise like this should be investigated and watched.  Also told him that PSA alone is not an indicator of cancer just a warning to look further for reasons for rise - whether cancer or other prostate conditions.  Probably made a mistake in telling him that a low PSA did not necessarily mean no or low grade cancer - could have kicked myself after I said this.  Still better to know the parameters you are working in.

    Thanks for your reply.

    Take care,

    Des

  • Good that it is still going down.  Hope it stays there.

    Des