I have BPH. In my 50’s my PSA went from 1 up to about 8 in just a couple years, then a reading of 12. My Urologist did a biopsy, then an MRI, then a prostate massage followed by urine and blood tests, then another biopsy. All negative. My prostate was 155 grams, which he said was the biggest in town. A couple years later he decided I should get an MRI guided biopsy, and he would take 30 cores this time. Still negative. He decided the high PSA must be due to a huge prostate, so he put me on Finasteride. My prostate shrank back to “large but within normal” size, and all symptoms subsided. Now my PSA ranges from 3.5 to 4.2 for the last 8-10 years and few issues. Bottom line, I wish I didn’t listen to the urologist so much. He was sure I must have cancer, but I obviously didn’t. There can be other reasons for the PSA to give a big number.
Thank you for your comment. You are absolutely right, the size of the prostate is important for PSA. But so is PSA dynamics. What we do in urology has slightly changed during the last years. Now there is a tendency to do multiparametric MRI first. Although the results are not 100% (but close) it helps to avoid unnecessary biopsies. However, every health care system is different. In my country, only private insurance will cover the costs of an MRI. So the statutory system only pays for biopsies. In the end, many variables have to be taken into account. I have one patient whom I observe without biopsies and his PSA is 12. Still I sleep well. Recently I sent another patient for biopsies with a suspicious MRI. His PSA is 2.4. With Finasteride you have to remember to double the PSA. So your “real” PSA is something around 8.
My father and my two youngest brothers had advanced prostate cancer and the prostate was removed in each case . My brothers were both in their early fifties and although the operation was a success and they both had few symptoms afterwards, the psychological issues were a big problem. My other brother and I are the eldest and have very low PSA, so it seems to be quite random. One important thing is that I have a regular checkup and always have, my youngest brothers never had a PSA test or examination and they regret it very much.
Excellent video. Had TURP surgery in late July, PSA was 14.5 pre-surgery (with Tamsulosin and Avodart) roughly 70 cc prostate gland; so really a PSA closer to 29 if you believe the need to double this reading when taking Avodart. 4 months post surgery it was measured at 18.6, this after 1/3 of my prostate had been removed. Surprised the PSA level was still this elevated, no evidence of prostatitis, and due for another biopsy in a few weeks. Also have low-grade cancer (3+3). Something I watch very closely given my father had prostate cancer.
I have BPH. My Prostate is 400% larger than normal but my PSA is 4.5. I have a Gleason Score of 3. My urologist has scheduled me for yet another biopsy and ultrasound. I am doing fine and the MRI shows no growth and very low numbers. Nevertheless, I am monitoring my prostate an a regular basis.
Hi I'm 65yrs young and for the last 14 months my psa level have been 12.4. My Urologist sent me for an MRI scan and the results came back as inflammation and enlarged prostrate. My Urologist said i have prostatitis, i suggested a biopsy but the Urologist was against me having a biopsy as their is nothing suspicious to target the biopsy needle. Im a little concerned as both my Dad and Grandad both passed away with prostrate cancer. I'm even contemplating to pay privately to have my prostrate removed as its giving me much anxiety. I took another psa blood test yesterday 2 months after my last blood test, im really hoping the levels have dropped🙏🙏
Thank you for your comment. It depends a bit on the circumstances, prostate size and PSA dynamics. A PSA above 10 is possible without having cancer. However, prostate MRI may miss clinically relevant cancers in a small percentage of cases. Under these special circumstances it could be an option to go for more advanced testing. Like the Select mdx test in order to get more reasons to perform or rule out a biopsy.
I'm 72 and underwent Brachytherapy for non-metastasized prostate cancer last November. My 6-month PSA was down to 0.23. I was told that not to be surprised if there was a "bounce" in PSA- happily there was not. Hoping it stays lowLike to add that there is no family history I had no symptoms, no enlarged prostate and did PSA and DREs yearly since I was 40. Elevated PSA +4 was detected in Sept 2021 and monitored until May of 2023 when biopsy revealed PCA
Excellent video! It is surprisingly difficult to get straight answers to these questions from my doctor, partly because appointments are so rushed there isn't time. 'McMedicine', I call it.
Is a digital rectal exam during a colonoscopy good enough? My family physician told me that since I was getting ready to have a colonoscopy, that the surgeon would do a DRE during my procedure. Nothing bad was found.
I have BPH. In my 50’s my PSA went from 1 up to about 8 in just a couple years, then a reading of 12. My Urologist did a biopsy, then an MRI, then a prostate massage followed by urine and blood tests, then another biopsy. All negative. My prostate was 155 grams, which he said was the biggest in town. A couple years later he decided I should get an MRI guided biopsy, and he would take 30 cores this time. Still negative. He decided the high PSA must be due to a huge prostate, so he put me on Finasteride. My prostate shrank back to “large but within normal” size, and all symptoms subsided. Now my PSA ranges from 3.5 to 4.2 for the last 8-10 years and few issues. Bottom line, I wish I didn’t listen to the urologist so much. He was sure I must have cancer, but I obviously didn’t. There can be other reasons for the PSA to give a big number.
Thank you for your comment. You are absolutely right, the size of the prostate is important for PSA. But so is PSA dynamics. What we do in urology has slightly changed during the last years. Now there is a tendency to do multiparametric MRI first. Although the results are not 100% (but close) it helps to avoid unnecessary biopsies. However, every health care system is different. In my country, only private insurance will cover the costs of an MRI. So the statutory system only pays for biopsies. In the end, many variables have to be taken into account. I have one patient whom I observe without biopsies and his PSA is 12. Still I sleep well. Recently I sent another patient for biopsies with a suspicious MRI. His PSA is 2.4. With Finasteride you have to remember to double the PSA. So your “real” PSA is something around 8.
I get check every year my dad had prostate cancer
My father and my two youngest brothers had advanced prostate cancer and the prostate was removed in each case . My brothers were both in their early fifties and although the operation was a success and they both had few symptoms afterwards, the psychological issues were a big problem. My other brother and I are the eldest and have very low PSA, so it seems to be quite random. One important thing is that I have a regular checkup and always have, my youngest brothers never had a PSA test or examination and they regret it very much.
Excellent video. Had TURP surgery in late July, PSA was 14.5 pre-surgery (with Tamsulosin and Avodart) roughly 70 cc prostate gland; so really a PSA closer to 29 if you believe the need to double this reading when taking Avodart. 4 months post surgery it was measured at 18.6, this after 1/3 of my prostate had been removed. Surprised the PSA level was still this elevated, no evidence of prostatitis, and due for another biopsy in a few weeks. Also have low-grade cancer (3+3). Something I watch very closely given my father had prostate cancer.
I have BPH. My Prostate is 400% larger than normal but my PSA is 4.5. I have a Gleason Score of 3. My urologist has scheduled me for yet another biopsy and ultrasound. I am doing fine and the MRI shows no growth and very low numbers. Nevertheless, I am monitoring my prostate an a regular basis.
Hi I'm 65yrs young and for the last 14 months my psa level have been 12.4. My Urologist sent me for an MRI scan and the results came back as inflammation and enlarged prostrate. My Urologist said i have prostatitis, i suggested a biopsy but the Urologist was against me having a biopsy as their is nothing suspicious to target the biopsy needle.
Im a little concerned as both my Dad and Grandad both passed away with prostrate cancer. I'm even contemplating to pay privately to have my prostrate removed as its giving me much anxiety.
I took another psa blood test yesterday 2 months after my last blood test, im really hoping the levels have dropped🙏🙏
Thank you for your comment. It depends a bit on the circumstances, prostate size and PSA dynamics. A PSA above 10 is possible without having cancer. However, prostate MRI may miss clinically relevant cancers in a small percentage of cases. Under these special circumstances it could be an option to go for more advanced testing. Like the Select mdx test in order to get more reasons to perform or rule out a biopsy.
Thank you
I'm 72 and underwent Brachytherapy for non-metastasized prostate cancer last November. My 6-month PSA was down to 0.23. I was told that not to be surprised if there was a "bounce" in PSA- happily there was not. Hoping it stays lowLike to add that there is no family history I had no symptoms, no enlarged prostate and did PSA and DREs yearly since I was 40. Elevated PSA +4 was detected in Sept 2021 and monitored until May of 2023 when biopsy revealed PCA
Its frightening
Excellent video! It is surprisingly difficult to get straight answers to these questions from my doctor, partly because appointments are so rushed there isn't time. 'McMedicine', I call it.
Thank you very much!
Great video my PSA has increased to 13 aged 59 2 lots of biopsy now on finasteride and reduced to 5.6
Great video. Elegant and to the point. Thank you.
Thank you, have a great weekend!
Is a digital rectal exam during a colonoscopy good enough? My family physician told me that since I was getting ready to have a colonoscopy, that the surgeon would do a DRE during my procedure. Nothing bad was found.
DRE is important but not enough. Not all tumours are in a location where they are palpable.
Thank you Doctor for posting this informative video.
Great video. Very easily explained
Thank you very much!
Great informations. Tnx very very much Doc stefan
Thank you, I am glad you still watch my videos!
Thank you
... excellent ... !!!
How often should I do a psa
I am going to talk about PSA in my next livestream on Friday.
I have 4.81 and nodule. What is my chance of having cancer. I am60 y old
You can calculate your risk here: www.prostatecancer-riskcalculator.com
My PSA is 2 I am 74 years old
With PSMA and MRI......this will be soon outdated.
Not during my career, that’s for sure.
My psa is .29, but my fpsa is.09....what am I supposed to think?
Free PSA is of no value in the very low range of total PSA.
👍🥂
Thank you! By the way, I found out that automatic notifications don’t work for short videos.