Dramatic increase in PSA reading

I am 61 years old.  I am 5'11 1/4" and weigh 220 pounds. My father died of prostate cancer at age 71.  I take ZOKOR once daily and Acyclovir twice daily.  My cholesterol is 171 mg/dl and HDL is 35 mg/dl.  Cholesterol Ratio is 4.8%. Triglycerides are 256.

I have annual physicals, but recently took another physical for an insurance policy.  My PSA reading went from 2.8 to 6.2 in the five month interval between physicals.  My last three PSA readings are listed below:

Nov. 16, 2002:  PSA (Abbott)    2.7 ng/ml
Oct. 23, 2003:  PSA             2.8 ng/ml
Mar. 18, 2004:  PSA             6.2 ng/ml
(Mar. 18, 2004) Free PSA        20%

Is such an increase in PSA readings (2.8 to 6.2)in 5 months likely or possible?  Are false PSA readings common?  Should I be alarmed?  What action/treatment should I take?

Thank you.

[Kevin Pho, MD]

The major causes of an elevated serum PSA include:
* Benign prostatic hyperplasia (BPH)
* Prostate cancer
* Prostatic inflammation
* Perineal trauma

Certainly, any rise in PSA readings is of concern and warrants further evaluation.  A lower free PSA percentage is associated with an increased risk of aggressive cancer.  

As to "false PSA", it may be due to other causes that can raise the PSA.  A simple digital rectal exam can elevate the PSA.

I would consider a urology referral for further evaluation and to consider a prostate biopsy.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.