There is an age-related increase in the PSA, hence there is an expected rising pattern. Infections may also cause increases in PSA and there are some men which may have recurrent infections and cause fluctuations in the values. The actual thresholds of when to perform a biopsy would vary. One method is to consider the biopsy if the value hits 4, others would do is there is an accelerated rate of increase. Discuss this with your doctor.
The free PSA or any other PSA based derivative test doesn’t really effectively replace PSA as a screening method. PSA isn’t a good screening test in the first place. There is a continuum of risk, so that even those with a PSA less than 1 may harbor prostate cancer. If you use free PSA when the total PSA is less than 4, if you have cancer it can be found 90% of the time. If you don’t have cancer, you get biopsied for nothing 82% of the time. Discuss with your doctor about these risks, then come at an acceptable threshold for biopsy. Prostate cancer screening is not recommended, but it is offered to those men who are interested. Stay positive.
My 84 year old father had prostate cancer in 1992. He had surgery to remove the cancer, (prostectomy). Now, 17 years later, he is paralyzed from the waste down, and cannot control bladder and bowel functions. Possibly due to taking Lipitor. He was taken to see his urologist today, I was told the doctor was concerned that there had been a 30% increase having to do something with radicals. I'm assuming he was given a PSA test while there. I was told the doctor looked a little alarmed and has scheduled a bone scan. Do you know what this means? Does it mean that the cancer has returned and has spread to the bone?
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