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Is There Anything Else That Could Elevate PSA So Rapidly Except Highly Progressive Cancer?

Posted on Fri, 21 Jun 2024

Question: Hi there

I am in panic. I think I have advanced prostate cancer. I am 54 years old, male. I had quite bad bladder infection 6 weeks ago. 2 types of antibiotics, the second helped (cipro), as the bacteria was Pseudomonas. Since then I still have some 5% of my symptoms, namely more frequent urination. The flow of urine is good and I don't have any more burning when urinating.

But I have tested my PSA after 18 months. It was 0.66 18 months ago and 10 days ago it was 1.34. From what I read this is alarming velocity. I tested today again, because 10 days ago my uricult was still positive, but now it is all clear. Today I had 1.37. That is 0.03 increase in only 10 days. So at this rate I will have over 2.5 normal in 6 months and I will be dead in 1 year.

I have urology appointment in 4 days by my anxiety is so high right now I am looking how to live after prostate removal :-(

I applied for stomach ultrasound. My last test was also 18 months ago, prostate was all ok, 18 mm3.

Is there anything else that could elevate PSA so rapidly except highly progressive cancer?

Answered by Dr. Dr. P. T. Patil (22 hours later)

Brief Answer:
Relax, You do not have Cancer of Prostate at all

Detailed Answer:
Hello
Thanks for your query.

Based on the facts that you have posted,I can assure you that you do not have Cancer of Prostate at all . P.S.A level of below 4 is absolutely within normal range.Variation off P S A level by few counts is normal and is due to U T I that you have .

Cancer of Prostate is suspected when two P S A levels carried out at one month interval are above 4 ng .

Do not worried at all

Thanks and Regatds
Dr Patil

Above answer was peer-reviewed by : Dr. Saisudha Kotla

Follow up: Dr. Dr. P. T. Patil (11 hours later)

Thank you, but I am not sure you understand where my worry is. Ok, PSA has gone "up" from 1.33 (when I still had UTI) to 1.36 (when I was all clear) in 10 days, but my main concern is the doubling of my PSA in 17 months:

December 2011: 0.46
December 2021: 0.66
May 2023: 1.33 (and 10 days later 1.36).

I got rid of UTI end of April.

Can such PSA velocity in 17 months mean anything other than cancer? If PSA goes up this way I will have 5 next year and in 2 years I am dead of cancer.

Thank you in advance for your answer.

Answered by Dr. Dr. P. T. Patil (59 minutes later)

Brief Answer:
We’d not worry as long as PSA is below 4 ng

Detailed Answer:
Hellos
Thanks for follow up .

PSA varies even on day to basis and when one gets UTI or when there is change in sexual activities of an individual .

It is of no significance as long as it is not raised above 4ng.It is your anxiety that is bothering you.

Thanks and Regards
Dr.Patil

Above answer was peer-reviewed by : Dr. LAKSHMI

Follow up: Dr. Dr. P. T. Patil (4 hours later)

So you try to tell me 100% increase in PSA-velocity in 17 months is no concern? I know about daily fluctuations, but 100% in less than year and half? It seems it won't go down to 0.66 any more...

What can cause such increase? I didn't have any sport, bicycle or sexual activity before taking this last test where PSA is highest.
XXXXXXX

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
What you consider increase in PSA is not in real sense increase.

Detailed Answer:
Hello
Thanks for writing again
Raised PSA above 4 is considered as a increase in PSA .Any variation in PSA is not considered to be raised as long as it is below normal levels of 4 ng.
Thanks and Regards
Dr Patil

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. P. T. Patil (15 hours later)

My problem in understanding is that PSA increases over the years by some %. If it goes up like this I will soon hit 4.

I also read on many forums stories of prostate cancer patients, when they did write their PSA levels and it was a spike in one year from like1.7 to 3.4, it always turned out to be prostate cancer.

Question 1: Dr. XXXXXXX I looked at your references and you have been in Urology for a long time and seen many patients in all this years. Did you ever see patient with PSA spike so big in a year, to return to normal baseline that he had before or that the PSA didn't continue to increase further?

Question 2: My final question. I wanted to take % free PSA because it is more indicative of cancer if low, but the lady in the lab told me that at 1.35 I should't take it because the %fPSA could be wrong, because total PSA is not high enough. Is this true that %fPSA could show non-valid data in my case or should I do the test?

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
I do not give importance if PSA Is below 4.

Detailed Answer:
Hello Thanks for your follow up.
PSA does not raise or spike up unless one has cancer of Prostate .

I do not give importance as long as PSA IS below 4 . Slight increase is expected in UTI .Prostate infection or Enlarged Prostate

I am closing this discussion from my side.

Thanks
Dr Patil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (7 minutes later)

You said: "PSA does not raise or spike up unless one has cancer of Prostate . "

But it raised 100% in 17 months, so from your words I have cancer of prostate even if you don't give importance under 4.0. Because even under 4 it can rise fast.

Answered by Dr. Dr. P. T. Patil (32 minutes later)

Brief Answer:
PSA raised above 4 is considered to be suspicious of cancer

Detailed Answer:
Hello
You have mid interpreted my statement P SA raised or spiked above is suspected to be due to cancer of Prostate unless proved otherwise.
Rise within normal level of 4 has no significance

Thanks and Regards
Dr Patil

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar