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Cancer: Prostate Message Board

Cancer: Prostate Board Index

Re: Rapid PSA rise
Dec 30, 2011
[COLOR="DarkGreen"]Hi Bill, and and here's my welcome to the Board! :)

Here are some additional thoughts about the sharp increase in PSA from 5.9 to 9.5 in about 37 days, based on your initial post:[/COLOR]

[QUOTE=noizewave;4897912]My PSA was 4.3 a year ago. One month ago it was tested and it had risen to 5.9. I saw a urologist and he gave me an antibiotice for 30 days to treat possible infection. A week after finishing that I was tested again. Now it is 9.5! Has anyone else had this happen and what was result? Thank you,


[COLOR="darkgreen"]Infection is the most likely cause of such an increase. Did you have any symptoms of infection, or did the doctor find any signs? Your doctor was responding to the initial rise from 4.3 to 5.9 in a year, but he had no way of knowing if that rise was gradual, or if it started just a short time ago. It's quite possible the PSA test was done shortly after an infection had developed which was boosting PSA, and that infection may have expanded in the next five weeks, causing the sharp increase. Typically, such sharp increases are not due to prostate cancer, though occasionally they can be.

You might think that the antibiotic should have knocked out any infection, but that is far from the case. It is standard for doctors to try an antibiotic, or several, to see if they can get lucky and cure an infection; sometimes they also do cultures to try to pin down the specific cause. Often, even when an infection is the problem and the doctor is good, he cannot nail it down. Sometimes the antibiotic will be right for the bacterium, but the bacterium will be resistant so there will be no effect.

The pattern of change in PSA scores is a key clue in determining what is going on, and the rapid increase in your score is actually going to help you here: you can do more PSA tests shortly and get key evidence. Here's how it works. Infections tend to wax and wane, and PSA scores vary as they do, going up and down. On the other hand, active prostate cancer results in a doubling of PSA [I]that is produced by the cancer cells[/I] when they divide, as 10,000 cancer cells become 20,000, then 20,000 split into 40,000, followed by 40,000 into 80,000, and so on, each split taking the same time. Therefore, if the cells take a month to mature to the splitting point, PSA from the cancer will double in a month, etc.

If cancer is the primary cause of the jump, then you would expect another jump in a short time; roughly, since you say an increase of a bit over 50% in five weeks, you would expect more than 50% in another five weeks, and prorated increases each week. If you get a PSA a week after your last test, you would expect a one fifth increase (one week versus five weeks) increase or about 20%, which would be about 9.5 X 120% = about 11.4, and so on for two weeks, or three weeks, etc. You can get more precise with this, including use of formulas that are readily available, but you probably see what I'm driving at.

If infection is the cause, on the other hand (much more likely), then the PSA might increase much more sharply yet, or it could stabilize, or it could actually drop, or it might increase but not sharply, even mimicking the pattern of cancer. Odds are that infection would not do the latter, and odds are strong that it would not do it over a series of tests. It is not rare for infections to drive PSA up to 50 and do it quickly at times; one doctor told us survivors of a case where a patients PSA rose to 200 before the infection was finally cured, whereupon his PSA returned to normal!

Of course, some of the PSA is still going to be produced by uninfected normal cells, and some may be simply due to more healthy cells as a result of benign growth (BPH, there are some formulas to relate prostate size to healthy cell PSA). It is possible to have PSA with components from initial healthy prostate cells, from benign growth healthy cells, from infected cells, and from prostate cancer. However, the sharp change that you are seeing is likely due to infection, with cancer next most likely (in my layman's view), but with the other causes also possible but a lot less likely. Sex is unlikely to explain much of the increase you had, but it could account for a bit. Lab error could account for a whole lot but is unlikely. (That said, it happened to me, resulting in a reading of around 20 instead of around the true value of about 8.)

The other causes Baptista mentioned are also possible of course, and there are additional odd causes. One expert in prostate cancer related the case of an avid competitive cyclist whose PSA hit 1,000. When he suspended his cycling, which, done a certain way, can amount to a prostate massage, his PSA returned to normal!

Here's hoping you do not obtain formal credentials to join our club of survivors!

Take care,

Jim :wave:[/COLOR]

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