Prostate Cancer Expert Forum
Too young for prostate cancer
About This Forum:

This forum is for questions about: Advanced or Metastatic Prostate Cancer, Biopsy, Bone Scan, Blood in Urine or Semen, Benign Prostatic Hyperplasia (BPH), CT Scan, Cystoscopy, Erectile Dysfunction, Hormone Therapy, Incontinence, Pain (abdomen, low back or hip), PSA Test, Prostatitis , Radiation Therapy, Rectal Exam, Recurrent Cancer, Risk Factors, Screening, Staging (Tumor size; Metastasis), Surgery, Transrectal Ultrasound, Urinary Difficulty or Burning, Urinary Urgency (Leaking), Watchful Waiting.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Too young for prostate cancer

Hi,

I am a 36 year old male. I am currently based abroad. I had some pain urinating this past summer after I spent many days sitting on a stool at the office and was seen by a urologist at an American certified hospital. After some urine tests, UTI was ruled out. Since I am a black male and since my father was diagnosed with prostate cancer last year at 65, the doctor asked me to take a PSA test as well as a free PSA test on Aug 30 (PSA 8.880 ng/ml and free PSA 1.37 ng/ml). He also put me on antibiotics and anti-inflammatories. The urination issue was resolved thereafter and there was nothing odd detected during the the DRE. Follow up tests (free psa and psa) were taken on Oct. 25. (PSA 7.460ng/mL and FPSA of .55 ng/mL). The doctor asked me to get back on antibiotics and asked that I be tested again in November but was too busy to follow through with recommendations. He's not sure if I have prostate cancer or prostatitis.

Interestingly, when I was 24 and 30, I had visited doctors regarding pain around my left testicle. During the first visit at 24, the dr. had a scan done on the testicle and it was fine. On the second visit at 30, the urologist thought it was the vericose seal and put me on anti inflammatories. Apparently, the spinning classes were responsible for the pain. Issue was resolved after taking the meds.

Now, any advice on how to proceed? I will take the test again but I feel like I will be asked to take it again and again and again....
Related Discussions
242579_tn?1252114771
Thank you for your question. PSA is a protein created by the cells of the prostate gland. The prostate is made up of small glands and ducts that secrete PSA and it is usually washed out of the body via urine. As the prostate changes through BPH, prostatitis, cancer, the glandular architecture changes and the more PSA is secreted into the blood stream; making PSA a useful test in examining prostate disease.

Depending on who you ask, a PSA level above 2 - 4 ng/mL is a call for biopsy. Often times BPH, prostatitis, and prostate cancer are not mutually exclusive events. It sounds like you had a bout with prostatitis. Unfortunately, short-course antibiotics often times does not treat the condition fully and it can turn into a chronic condition.

Other confounding factors related to a PSA rise include 1) ejaculation prior to testing 2) DRE prior to testing 3) lab variation (although two consecutive tests have been elevated this is less likely to be the case).

Given your PSA levels, family history of PCa, and African American race, a biopsy may be in order to rule out prostate cancer.

Thank you for your question and good luck.

Sincerely,

Ashutosh (Ash) K. Tewari, MD
www.cornellroboticprostate.org

This forum is for information only. The contents, such as graphics, images, text, quoted information and all other materials ("Content") are provided for reference only, do not claim to be complete or exhaustive or to be applicable to any particular individual's medical condition
. Users should always consult with a qualified and licensed physician
or other medical care provider. Users are warned to follow the advice of their physicians without delay regardless of anything read in this forum. The Weill Cornell Prostate Cancer Institute assumes no duty to correct or update the Content nor to resolve or clarify any inconsistent information which may be a part of the Content. Reliance on any Content is solely at the User's risk. This forum may contain health or medically related materials considered sexually explicit. Users are warned that if they may be offended by such Content, an alternate source of information should be found. Publication of information or reference in forum to specific sources such as specific products, procedures, physicians, treatments, or diagnoses are for information only and are not endorsements of the Weill Cornell Prostate Cancer Institute.
3 Comments
Blank
Avatar_m_tn
Thanks for your recommendation.

What I don't seem to understand is the relationship between PSA and Free PSA. In most of these forums, the FPSA is presented as a percentage but the data I received is as mentioned above. I heard that the lower the FPSA and the higher the PSA, the higher the likelihood of prostate cancer. is that true? Also, based on what you see from my PSA and FPSA results, should I worry? The doctors were not clear with me regarding these results and I want to get an additional opinion.
Blank
242579_tn?1252114771
Serum PSA is also known as tPSA or Total PSA. Most simply this is made up of fPSA (free PSA) and cPSA (complexed). Complexed means attached to proteins.

Published literature suggests that prostate cancer is more likely to be present if the ratio of fPSA to tPSA is less than 15%; therefore, low free PSA values are more likely to be associated with prostate cancer than high free PSA values.

These compared measurements of free PSA and complexed PSA improve the ability to tell whether a rising PSA is from cancer or benign prostatic disease (e.g. BPH).
Blank
Continue discussion Blank
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank