Small Hard Spot in 1995..Now PSA on the rise

Johnny · New User Joined: 29 Dec 2006 Posts: 3

About 12 years ago my Dr. told me that I had a small hard spot on my prostate. He said not to be alarmed but just be aware that it is there. In May of 2005 I had a PSA and it was .65. Yesterday I had another test and it was .70. I did not go through my Dr. for the last test. I just went to a clinic and had blood work done. I will be 55 this coming Feb. I know that the value of the PSA test results can be hard to address. Should I be concerned and get an app. with my Dr.? I was thinking about re testing in about 6 months and see if it is continuing to rise. I don't have a history of the cancer in my family. However, my father who is 80 has an enlarged prostate and my grandfather on my mothers side had to have his worked on to be able to pee when he was 70. He never was told he had the cancer but died at 74 of natural causes. I don't remember the test results from years before, but they were close to zero until 2005 and now seem to be on the rise. Is it normal when you get my age for the numbers to start creeping up? I know 3 men whom I work with. Their PSA was at 3 and after the biopsy they had them removed. Two are doing fine but the one who is 60 is starting his second round of treatment because his PSA keeps going up. It has been about 5 years since he had it removed.

johnw100 · Posted: Fri Dec 29, 2006 3:43 pm Post subject: PSA

There is no such thing as a "normal" PSA.
Various things can affect it, most common being size of the prostate.
The prostate naturally produces PSA, and the larger the gland the more PSA is porduced. As we age, the gland often becomes larger, producing more PSA.

For a PSA reading to be meaningful, it needs to be related to the prostate size, or "PSA density" calculated by dividing the PSA reading by size of the prostate.

The point you mendioned about velosity is cause for concern when there's a quick rise, for example more than .75 rise in a year or if it doubles in a short timeframe. Bear in mind that these tests can bounce around a bit, so several are needed to confirm a trend, rather than one isolated unusual result.

If one becomes concerned about changes in that categroy, advice could be sought about having a "free PSA" test, which indicates the probability of PC, and a DRE done.

Regular DRE is advisable in any event, especially given your profile. It should be done by an experienced doctor as it's subjective. What might feel like a harmless lump to one doctor could feel like something more suspicious to another more experienced person.

John

brainman

Johnny, I do not know if your insurance will pay, but it sound like you should have a new prostate check and PSA check every year with your doctor. If you do not have confidence in your doctor, find another one. But I would talk about this “change” with a doctor. Good luck.
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