PSA came back a little high. Now what?

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Defy Medical TRT clinic doctor
I didn't have sex/orgasm in the 48 hours prior to the test. Am I going to need to quit TRT? Lower my dose?

Thats only a discussion for you and your Dr what are we really supposed to tell except, take it up with your Dr...you know it's high, very high infact, so what's left to say?
 
You're not making sense with your line of questioning. TRT doesn't cause a PSA to go above range unless you were at the edge to begin with. They typically only reduce testosterone if you indeed have cancer.

Vince wants to know the history of the psa because it gives some insight. If you've gone from 1.1 to 2.2 to 3.5 and now 4.4 in 2 years that's a bad sign. If you are always 1.2 this could very easily be lab error or a prostate infection they can easily treat.

Thank you...spot on.
 

Nashtide

Member
Thank you...spot on.
I apologize. My PSA has always been low. Less than one. Now it's 4.4 with no symptoms. DRE was normal. I suppose I mistakenly thought TRT was related to PSA otherwise why do we test for it? Wouldn't I have symptoms if I had an infection? I already have an appointment with a urologist. Just seeking group wisdom.
 

CoastWatcher

Moderator
I apologize. My PSA has always been low. Less than one. Now it's 4.4 with no symptoms. DRE was normal. I suppose I mistakenly thought TRT was related to PSA otherwise why do we test for it? Wouldn't I have symptoms if I had an infection? I already have an appointment with a urologist. Just seeking group wisdom.
A prostate infection/prostatitis presents with symptoms...except when it doesn't. Not trying to be snide, but I've had bouts with strong discomfort, and most recently dealt with a rising PSA that was symptom-free. I went from .72 to 1.79 in three months. The rate of rise suggested prostatitis and antibiotics succeeded in reducing the PSA value to .83. So, this is a pressing issue, but no reason to panic.
 

Nashtide

Member
As said you may not have symptoms. Why we test PSA is actually a good question. There's always a slight rise initially, and I guess doctors just want to keep an eye on it. My Dr. actually didn't test PSA for me for a couple of years. I asked why, and he just said there's no need for someone under 40. Now that my father has prostate cancer we test.

Try not to freak out about it. That number is not some gold standard. It's a loose indicator. Could be anything at this point.
Thanks. Not freaking out at all. I'll re-test in a month. I suppose I urinate frequently, I assumed that was all the water I drink. It also seems to be taking longer to finish peeing. But no pain or discomfort and certainly neither of the mentioned symptoms are profound.
 

lexer

New Member
Nashtide
how old are you? TRT dosage?
the frequent urination amd taking longer to finish urinating is indicative of an enlarged prostate, not a big deal.
the jump in psa is rather large, could be an infection. See what the urologist says.
 

Nashtide

Member
Nashtide
how old are you? TRT dosage?
the frequent urination amd taking longer to finish urinating is indicative of an enlarged prostate, not a big deal.
the jump in psa is rather large, could be an infection. See what the urologist says.
I'm 56. The dre was normal so I don't think it's bph. Could be an infection. I have an appointment with the urologist in a few weeks. I take 50mg T cyp twice weekly.
 

OMI100

Member
How old are you? Older you are the better chance of a higher PSA.
Prostate infection will shoot your PSA up.
Rate of rise is another indicator.
Get a 4K blood test.
If your DR starts singing BIOPSY get a 3T-MP-MRI FIRST.
Go to https://www.inspire.com/groups/ and join this group: https://www.inspire.com/groups/us-too-prostate-cancer/ .
Read and learn.
Read about 4K blood test.
Read about 3T-MP-MRI and who is best at doing and reading the test
Read about the different BIOPYs.
Read about rising PSA levels.
Arm yourself with all the knowledge you can.
If your DR then wants to do a BIOPSY you can make a decision based on knowledge and understanding of the procedures.
Understand the different types of BIOPSYs and the difference between real time where you are in the tube and the DR uses the real time MRI image and picks correct locations for the needle or he uses of the MRI image as an overlay in another procedure that is not real time MRI to do the same sort of thing.
Order your own PSA test from Discountedlabs (if your state allows you to order your one blood labs) and tract it yourself.
Read some of my own post on my situation with a stubborn prostate infection.
After all of above and you do end up with PCa understand the treatment options.
Some cancer is so slow in growth that depending on your age you may die from old age first so why treat it.
LASTLY DONT FREAK OUT....
BTW research PCa and testosterone. It seems that the first thing out of a lot a DRs mouth is you need to STOP TRT.
Get a copy of Mogentalers book "Testosterone for life" and read the section on PCa and TRT.
Get a copy of Lee Myer's book "Natural VS testosterone Therapy" and the section on PCa and TRT.
Get a copy of Shippen's book "Testosterone Syndrome" and read the sections on PCa. An old book, but you can find copies on used book retailers on Amazon.
May be others and if other folks know of additional good books that cover PCa and TRT please post.
 
Last edited:

Nashtide

Member
How old are you? Older you are the better chance of a higher PSA.
Prostate infection will shoot your PSA up.
Rate of rise is another indicator.
Get a 4K blood test.
If your DR starts singing BIOPSY get a 3T-MP-MRI FIRST.
Go to https://www.inspire.com/groups/ and join this group: https://www.inspire.com/groups/us-too-prostate-cancer/ .
Read and learn.
Read about 4K blood test.
Read about 3T-MP-MRI and who is best at doing and reading the test
Read about the different BIOPYs.
Read about rising PSA levels.
Arm yourself with all the knowledge you can.
If your DR then wants to do a BIOPSY you can make a decision based on knowledge and understanding of the procedures.
Understand the different types of BIOPSYs and the difference between real time where you are in the tube and the DR uses the real time MRI image and picks correct locations for the needle or he uses of the MRI image as an overlay in another procedure that is not real time MRI to do the same sort of thing.
Order your own PSA test from Discountedlabs (if your state allows you to order your one blood labs) and tract it yourself.
Read some of my own post on my situation with a stubborn prostate infection.
After all of above and you do end up with PCa understand the treatment options.
Some cancer is so slow in growth that depending on your age you may die from old age first so why treat it.
LASTLY DONT FREAK OUT....
BTW research PCa and testosterone. It seems that the first thing out of a lot a DRs mouth is you need to STOP TRT.
Get a copy of Mogentalers book "Testosterone for life" and read the section on PCa and TRT.
Get a copy of Lee Myer's book "Natural VS testosterone Therapy" and the section on PCa and TRT.
Get a copy of Shippen's book "Testosterone Syndrome" and read the sections on PCa. An old book, but you can find copies on used book retailers on Amazon.
May be others and if other folks know of additional good books that cover PCa and TRT please post.
Thanks. I am not freaking out. I will see the urologist in a few weeks and go from there. I'm nowhere close to having a biopsy. At the very least I'd want to re test PSA and have the MRI. I'm 56 and this is the first PSA above 1.
 

OMI100

Member
Thanks. I am not freaking out. I will see the urologist in a few weeks and go from there. I'm nowhere close to having a biopsy. At the very least I'd want to re test PSA and have the MRI. I'm 56 and this is the first PSA above 1.
Got it, but I would still do some research on the front end so when I did see the URO I would have a better understanding of what he was recommending / talking about. That's just me:)
 

lexer

New Member
U need to have the urologist do a DRE and he will determine if its bph. Unless its very large, most regular docs are terrible at diagnosing bph.. they can spot suspicious prostates ( cancer),,
 

Pauly_P

Member
Orrin, great info. I've read Shippens book, maybe on your recommendation, and now reading "You can Beat Prostrate Cancer", by Marckini. I'll read Morgentalers book next.

I was never offered the 4k blood test, and only offered the 3T MRI after 2 previous negative biopsy's. However my first one was 8 years ago now, don't think they had those then. Unfortunately if you look hard enough for prostrate cancer in one with elevated PSA you will probably find it unless the cause is BPH or an infection.

You can have BPH without having a huge prostrate. I have a fairly normal size prostrate, and DRE is fine, as in negative. The great thing about the 3T MRI is that is gives you some peace of mind as they scan your entire pelvic floor and pretty much rule out anything else going on. The bladder also get's scaned. Funny they also picked up on a hamstring injury I've been fighting for a bit.
 

Nashtide

Member
U need to have the urologist do a DRE and he will determine if its bph. Unless its very large, most regular docs are terrible at diagnosing bph.. they can spot suspicious prostates ( cancer),,
My doc is a pretty humble guy. He knows what he doesn't know. That's why I'm off to the urologist.
 

Pauly_P

Member
Orrin, great info. I've read Shippens book, maybe on your recommendation, and now reading "You can Beat Prostrate Cancer", by Marckini. I'll read Morgentalers book next.

You had a 3T-MP-MRI?

Here is where I had it, the top of the MRI printout just says 3T. http://www.usmdimagingcenter.com/imaging/services

Then I had the Fusion biopsy a week later. They did not offer me the MRI biopsy, where they do the biopsy in the tube. They overlay the MRI image with the live ultrasound image. I did all this in January of this year. I have a history of my PSA bouncing around, started 8 years ago, went up to high 8's, and settled back into the 3's until my last physical in September where it was 4.1. I had 1 core at 10% out of 17. On active surveillance now I guess. I'm trying to educate myself to see what my options are. Also seeing what my options are of staying on TRT, I've been told go get off, by my uro. I'm reducing my dose each and every week. Feel free to ask any other questions.
 

OMI100

Member
Here is where I had it, the top of the MRI printout just says 3T. http://www.usmdimagingcenter.com/imaging/services

Then I had the Fusion biopsy a week later. They did not offer me the MRI biopsy, where they do the biopsy in the tube. They overlay the MRI image with the live ultrasound image. I did all this in January of this year. I have a history of my PSA bouncing around, started 8 years ago, went up to high 8's, and settled back into the 3's until my last physical in September where it was 4.1. I had 1 core at 10% out of 17. On active surveillance now I guess. I'm trying to educate myself to see what my options are. Also seeing what my options are of staying on TRT, I've been told go get off, by my uro. I'm reducing my dose each and every week. Feel free to ask any other questions.
So the MRI did find an area of concern.
Get Morgentalers book. He does a good job of debunking the whole TEST is gas fuel for PCa. He clearly explains how one study taken out of context and misrepresented has turned into medical dogma for decades
Also Lee Myer's book has a good section to read starting on page 341 that you need to read!!!!!
Inspire has a LOT of info from guys that have been down this road.
I seem to remember reading that one could get the cores evaluated for the type of PCa and how aggressive it is.
You can also read stories of guys that get chemically castrated and have NO T in their system Not good!!!
 
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