Low Psa. Is this unusual?

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Diagnosed two years ago after physical exam by my GP after I experiences poor urine flow and incomplete bladder emptying. PSA was normal 1.4 so came as a bit of a shock, I thought I had an enlarged prostate.

Biopsy recorded prostate cancer Gleason 6. After MRI scan I was sent for trans perineal biopsy under general anaesthetic (template)

cancer upgraded to Gleason 3+4.

i am currently on active surveillance PSA every 6 months, MRI yearly.

My PSA has risen slowly over the two years and is now 2.7. I have a MRI in a few months.

compared to others in this forum I consider myself lucky the cancer was identified early.

As my PSA is not a good identifier of the cancer, being so low for my age at 75. Are yearly MRI scans frequent enough to check on progress of the cancer or am I  overthinking things?

  • Hi Minnow and welcome 

    I was on AS for 4 years and had a yearly MRI which was fine.

    Yours is a bit unusual because the PSA is near normal.

    Some aggressive cancers have a low PSA although with a Gleeson of  3 + 4 it could hardly be called aggressive.

    However it could be worth pushing for a MRI a bit earlier than 1 year just to be on the safe side.

    Perhaps explain that you're concerned about low PSA and aggressive cancer although I must say again that at present nothing shows that.

    Best wishes 

    Steve 

  • Hi Minnow and welcome to our club, even if you didn't want to be here.

    I was diagnosed with a PSA of 4.7 and a Gleason score of 3+4=7 in 2020. 18 months of AS and my PSA had risen to 14 and Gleason score 4+5=9, so like Grundo says a low PSA can be quite normal but pushing for a MRI might be a good idea, even if just for a bit of reassurance.

    You can read my journey by clicking on the picture of my cat.

    Good luck on your journey and please keep us posted on how you get on.

    Best wishes 

    Peter 

  • Thanks Steve for your story and perspective. Having been on AS for 4 years with annual MRI scans is good news to me and somewhat puts my mind at rest.

  • Thanks Peter for your reply. Sorry to hear for your upgraded Gleason score. My main worry is catching any metastasis early. I think another conversation is needed although I have raised my concerns with my nominated cancer nurse.

  • Hello  

    A warm welcome to the club.

    From personal experience when they upgrade your Gleason Score - you know something's going on (I went from a 7 to a 9!!).

    I have raised my concerns with my nominated cancer nurse.

    I think you are quite correct and I would be looking for their opinion.

    Please keep us posted as to the outcome.

    Best wishes - Brian.

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  • Hi Peter. I’m so sorry to read about your situation. Approx 5/6 years ago (I was aged about 51/52) I took a PSI test which came back at 3.2 after Bill Turnbull, the newsreader, urged men to take a test as his had been diagnosed too late. My PSI is now 5.4 over 2 tests over the last year. So it was suggested I take an MRI which my consultant said he feels there’s a 60% likelihood that I have some cancer although he said he felt it was localised just in my prostate and no evidence on the MRI that it had spread. So I have a Biopsy booked for 11th June and quite honestly I’m terrified of the outcome. I don’t want to die (obviously) but I also don’t want to lose my prostate. For me, it’s a terrifying time. I’ve been tearful and anxious. Probably my worst experience in life so far

  • Good Morning  

    A warm welcome to the online Community - we are a cracking bunch even though I say it myself,

    The worry once your PSA starts to rise is fully understandable - and a PSA of 5.4 is quite low. The biopsy itself is the one pat of the prostate journey most men fear but it's not too bad and at least once it's over - you will have some answers.

    Surgery to remove your prostate is one route - Hormone Therapy/Radiotherapy is another treatment - both are normally with "the intention to cure".

    For me, it’s a terrifying time. I’ve been tearful and anxious. Probably my worst experience in life so far

    I can understand your anxiety - please give our support line a call on 0808 808 00 00 (8am to 8pm 7 days a week) the wonderful folk there will be happy to give you some extra support.

    If you have a "Maggie's" near you - this is a cancer support charity where you can just drop in for a chat and some support - call in and see them - here's the link to their home page to find your local branch - www.maggies.org/.../

    If I can do anything for you please let me know - we are as a Community all here for you.

    Best wishes - Brian.

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    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

    Strength, Courage, Faith, Hope, Defiance, VICTORY.

    I am a Macmillan volunteer.

  • Thank you Brian. I’m terrified. I’m not handling this very well at all but thank you so much for your kind reply and support

  • I’ve read your story my friend and what a story. You’re an inspiration. I have my biopsy on 11th June. I’m terrified. But feel better with all the very kind responses I’ve received and stories I’ve read. I’m 57. I don’t want my prostate removed. I will take any other treatment offered bar that

  • Hi  , how did the biopsy go yesterday? Best wishes, David