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Cancer: Prostate Message Board


Cancer: Prostate Board Index


I am a white 55 year old male. I visited an urologist last week because my primary care physician was concerned about the changes in my PSA levels. There have been no changes in urinary habits.
8/4/2004 1.6 (52 yrs)
1/17/2006 3.5 (53 yrs)
8/15/2006 2.3 (54 yrs)
4/6/2007 3.6 (54 yrs)
All DRMs have been normal with no lumps, nodules, etc. The Urologist mention that the prostate was small.

I mentioned to the Urologist that I had sex the morning of the 4/6/2007 PSA test and could this had raised the PSA? He said having sex could raise or lower the PSA levels. (I also am 90% sure that I had sex on the day or within 2 days of the 1/17 test since I had been cleared by my cardiologist for sex on 1/15/07. I had a heart attack a few weeks earlier and needed to make up for lost time.)

He wants me to come back in October for another PSA test and then we’ll discuss the results and make a plan.

Is it unusual for the PSA numbers to go up and down like this? The urologist thought it was a good sign that they came down after the initial 3.5 reading.

Is it normal to wait this long for another PSA test? Why not do a biopsy ?

When he first told me, I thought it sounded like a good plan. However, over the weekend, I began to have my doubts, probably most likely due to the nerves kicking in. I keep telling my self that odds are still in my favor that it is not PC, but even if it is PC, it looks like it is in an early stage and should be cureable. Most of the time it works but there are times… I have bought the Walsh book and have ordered the Strum book.
Hi, my PSA's are lower than yours and I got 1 biopsy core tested positive for cancer. I am currently doing the watchful waiting thing and on 3 month PSA tests. What the Doc is looking for is consecutive increases in the PSA levels. The Yo-Yo readings like you and I are having is fairly normal. (mine have been .8, 1.3, .6. I am still pretty confused but its slowly getting clearer.
The catch for you is a Biopsy is a hit and miss thing. They are placing 12+ little core sampling needles into your prostate and it is very easy to miss a small cancer cell. This test is not too much fun either.
The other thing that I have found is that a Gleason score of 6 is pretty much the lowest detectable cancer. Some labs may come back with a 5, but most labs would rate the same sample @ a 6.
If you have the biopsy, Your next PSA test will most likely be a bit elevated due to the stress caused by the Biopsy (up to 2 months or so).
In our age group a PSA of 3.5 was the magic number for concern, many Doc's are now lowering this number to 2.5. But there are many things that can effect a PSA score other than Cancer.
Hope this helps: Bob

[QUOTE=Pilgrim55;3153472]I am a white 55 year old male. I visited an urologist last week because my primary care physician was concerned about the changes in my PSA levels. There have been no changes in urinary habits.
8/4/2004 1.6 (52 yrs)
1/17/2006 3.5 (53 yrs)
8/15/2006 2.3 (54 yrs)
4/6/2007 3.6 (54 yrs)
All DRMs have been normal with no lumps, nodules, etc. The Urologist mention that the prostate was small.

I mentioned to the Urologist that I had sex the morning of the 4/6/2007 PSA test and could this had raised the PSA? He said having sex could raise or lower the PSA levels. (I also am 90% sure that I had sex on the day or within 2 days of the 1/17 test since I had been cleared by my cardiologist for sex on 1/15/07. I had a heart attack a few weeks earlier and needed to make up for lost time.)

He wants me to come back in October for another PSA test and then we’ll discuss the results and make a plan.

Is it unusual for the PSA numbers to go up and down like this? The urologist thought it was a good sign that they came down after the initial 3.5 reading.

Is it normal to wait this long for another PSA test? Why not do a biopsy ?

When he first told me, I thought it sounded like a good plan. However, over the weekend, I began to have my doubts, probably most likely due to the nerves kicking in. I keep telling my self that odds are still in my favor that it is not PC, but even if it is PC, it looks like it is in an early stage and should be cureable. Most of the time it works but there are times… I have bought the Walsh book and have ordered the Strum book.[/QUOTE]
All,

I would like to thank everyone for their responses. It's nice to know that there is a palce I can get some good info and support!

I decided to get a PSA test this Thursday at work for $25. (Am abstaining from sex for this one!!) Apparently my insurance won't cover another test until October. No matter what the results, I'll see the urologist in October and get his opinion.

In the last day or so, I have been able to get some more info about sexual relations and how it can change a guy's PSA level.

1) In Walsh's Surviving Prostate Cancer book, 2nd Ed, he says on page 146 that "Sexual activity can elevate PSA as well:PSA levels can increase as much as 41 percent in less than an hour after ejaculation." Unfortunately, there is no reference. They mention that DREs can raise PSA. They do mention 2 studies that rule out bike riding as a cause of artificially elevated PSAs. No references on the bike studies or the DRE.

2) There was study was in Urology. 1997 Aug;50(2):239-43, that "When normal biologic variation was accounted for, 40% of men, at 24 hours after ejaculation, had total PSA levels above the baseline level. Similarly, 24 hours after ejaculation, the percent free PSA remained above baseline level in 10% and below baseline level in 35% of the men. " (Everybody had PSA below 4 at the start of the test.

The abstract is here
[url]http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=***5295&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus[/url]


3) This is a note about one patient., Hell J Nucl Med. 2007 May-Aug;10(2):119. A 52 year old man had a PSA of 1.2. His PSA was 6 and 7 on 2 separate occasions after having sex within 24 hours.

Here's the link

[url]http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17684590&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus[/url]



So it looks like some males can have elevated PSAs from sex.





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