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PSA rise 1.8 to 19.1 in 6 months

54 yr old male. For the past 5 yrs, including six months ago, my PSA was level with readings around 1.8/1.9. Urologist was not concerned because they have been stable, but he checks me every 6 months. Last week, I got a result of 19.1. So, I went from 1.8 to 19.1 in six months. They repeated the test on the same sample the next day and got the same result. Drew a new sample the next day and same result. He has always said that I have a slightly enlarged prostate, but to me that would in no way account for this level and rapid rise. I do not have any noticeable signs of an infection/inflammation.

Obviously, this scares me to death. I have always heard prostate cancer is slow growing most of the time, so the 10X increase in just six months all the sudden has me convinced this is a aggressive cancer that has already progressed. Urologist has ordered an mri then plans to do a biopsy.

    1. Get the biopsy done and go on step at a time. Hoping for the best.

      1. Agree one step at a time. And YES Prostate Cancer is slow growing so you have time to make decisions.
        Here is what I learned on my journey with prostate cancer. A PSA level is not an indication of Prostate Cancer (Pca). The test simply measures the amount of PSA in ones blood stream. A large prostate naturally produces more PSA than a smaller one.

        A rapid increase in PSA can suggest the presence of cancer that may be contained or not. The MRI will give the urologist and you an "indication" if any spread has occurred beyond the gland. The biopsy provides 12 or more samples for a pathologist to examine, after which a Gleason or aggressiveness score will be assigned.

        If your gut feeling is leaning in the direction of treatment ... now is a good time to give some thought to your comfort level with potential treatment options. Your urologist will make suggestions based on findings.

        Today I would ask about how the biopsy will be done and also about Proton treatment. One biopsy method is performed through the rectal wall. The other is done through the patch of skin located between the rectum and scrotum. Not all urologists are doing the latter ... never hurts to ask. Both are being used today. The latter does not require the use of antibiotics as it does not penetrate the rectal wall .

        While the words you have prostate cancer are scary it is also good to remember that today PCa is considered a treatable disease. Wishing you the best - please keep us up to speed on your journey ... Dennis(ProstateCancer.net TEAM)

    2. Hi . I want to start with a question. Considering your PSA was consistently in the normal range (under 4.0) was there a reason your doctor was checking you every six months? Something like a family history or previously having a genetic test? I ask because if there was a particular reason the doctor was concerned, the next question would be whether there was a reason to be concerned about having a more severe/faster growing case? While your PSA increased rapidly or, to use the more technical term, had a high velocity, this does not necessarily mean a more severe case or that the cancer would have escaped the prostate. As others have said, it is important to make a plan and move from there. Nothing is certain until you have a biopsy. Please feel free to keep us posted on how you are doing and ask questions. There are plenty of men here who have been where you are. Best, Richard (ProstateCancer.net Team)

      1. Hi. I have been asked about the 6 mo visits a few times. When I started PSA testing 4 years ago (I am 54 now) I had a reading from one lab of 2.2. So I went to a urologist and he started testing me every 6 months. Since then the readings have ranged as low as 1.5 and high as 1.9, mostly 1.8. He was never too concerned because he said he had a baseline and he would watch it. At one point he gave me the option of coming in once per year and I said I would stick with every six months. He gave no indication he was concerned. No family history except father with an enlarged prostate at 60 and grandfather with late in life (80s) prostate cancer that was not his cause of death. No other testing or risk factor mentioned. My question, is this kind of sudden significant spike (1.8 to 19.1 in 6 mos) normally due to inflammation (asymptotic in my case) or normally due to cancer.

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