My Psa Increased From 1.09 To 2.01 In 10 Months

Posted on Wed, 24 Jun 2020

Question: My psa increased from 1.09 to 2.01 in 10 months after being in the low 1’s for years. Had sex 60 hours prior to test but no other possible reason noted. Had a negative 30 core biopsy(targeted/blanket) after mri of Pirads 4 10 months ago. Last Dre was prior to biopsy and was negative. I’m concerned about velocity of increase as I’ve read .4 increase should prompt consideration for biopsy. Should I have a Dre and would it be better done by a urologist or would my pcp for 40 years be equally adept @ Dre? Probability of cancer/clinically significant pc would be appreciated.
Thanks! XXXXXXX

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

Brief Answer:
No need to go for biopsy immediately,

Detailed Answer:
hello
Thanks for query .

Based on the facts that you have posted you have been thoroughly investigated and screened for Cancer of Prostate .

Considering the negative MRI guided prostate biopsy report barely 10 months old slight rising PSA does not demand for repeat biopsy .

The rise of 1 ng in PSA can be due to enlarged prostate with infection of the prostate which is very common at this age .

Take antibiotics like Bactrim D.S along with Nitrofurantoin twice daily for two weeks and repeat PSA .Please note that it is a matter of concern if PSA shows rising trend done every two weeks for two consecutive months and not otherwise .

You can get DRE done by your experienced primary care physician to look for any palpable hard nodule on the posterior surface of Prostate .

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

.

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

Follow up: Dr. Dr. P. T. Patil (23 minutes later)

If my psa rises after 2 weeks for 2 months, would that indicate a more aggressive cancer and would I have likely caught it early? Mri, phi or any other test helpful?
Thanks very much! XXXXXXX

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

Brief Answer:
PSA is just a guideline for further investigations

Detailed Answer:
Hello
Thanks for follow up .

PSA does not help to determine the grade or severity of cancer of prostate.It is a tool to decide modality of investigations like biopsy or MRI to decide the line of treatment It is the grade of the cancer that is confirmed on biopsy findings ,MRI findings like spread of the disease beyond prostate that is the deciding factor in management of cancer of prostate .

Thanks and Regards.
Dr Patil.

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