[QUOTE=Bryan73;4241184]I have a PSA of 4.4. 3 cure options locally. Surgery, external radiation or radiation implants. The da Vinci Surgery is available in Houston. I'm 73 years old and never had health problems. What is survival time if no treatment. If Medicare covers it is the Da Vinci surgery better than laproscopic? The idea of having to wear Depends does not appeal to me at all.[/QUOTE]
Welcome to this discussion forum. Hopefully your visit will be short…that is, hopefully, you won’t really need this site. Most of the guys here have, or have had, prostate cancer (PC). [I]So far, based on what you've written, you don’t have PC[/I]. You simply have a PSA of 4.4...maybe there is more than what you have written, but I would be only guessing...
Having an elevated PSA score does [U]not[/U] mean that you have PC. In fact, in a published study of men who had a PSA level between 4.1 and 9.9 ng/mL and who underwent a prostate biopsy, 65-75% were found not to have PC. There are several possible (probable) non-cancerous reasons for an elevated PSA, including BPH and prostatitis (infection). In fact, even riding a bike or sexual activity in the day or two before a PSA test will result in a temporarily high PSA test result.
Actually, there is some consensus that at age 73, your current PSA of 4.4 ng/mL is [I]not even considered out of the normal range[/I]. It is well documented that the PSA increases naturally with age, and so some medical organizations have recommended that doctors use an “age-adjusted” scale of PSA. The American Urological Association (AUA) published (online, free) a 2009 update to their document “[B]Prostate Specific Antigen Best Practice Statement[/B]” with these values of “normal” age ranges for PSA based on ethnic background.
..40-49........0-2.0 ng/mL.........0-2.0 ng/mL...........0-2.5 ng/mL
..50-59........0-3.0 ng/mL.........0-4.0 ng/mL...........0-3.5 ng/mL
..60-69........0-4.0 ng/mL.........0-4.5 ng/mL...........0-4.5 ng/mL
..70-79........0-5.0 ng/mL.........0-5.5 ng/mL...........0-6.5 ng/mL
At age 73 with 4.4 ng/mL, it really doesn’t matter what your ethnic background is, you are not above the age-adjusted normal range.
So, the only way that one knows that they do have prostate cancer is if a prostate biopsy is performed, and a pathologist confirms the presence of PC cells. Even then, there is a very wide range of possible outcomes. The pathologist would give a “score” (called a “Gleason score”) to the cancerous cells which is a preliminary indication of aggressiveness. It would be fairly uncommon for someone with such a low PSA score to have an aggressive PC. Secondly, the pathologist would count the occurrence of samples with cancer versus those with no cancer. Again, it would be fairly uncommon for someone with a low PSA to have very many cancerous samples. Someone in their 70’s with low PSA, low Gleason score, and low number of cancerous samples would likely be best suited to NOT do pursue any of the aggressive treatments. Instead, they would probably do best to make some tweaks to their diet and lifestyle to help put the odds in their favor of slowing further growth of the PC, and then do their best to get on with life and forget about PC. PC is typically a slow growing cancer, and it would be highly unlikely to ever bother them in any way.
Bryan, I hope this info helps you understand the PSA and PC picture a little better. Please do come back and post more questions if appropriate.