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Urology (Expert Forum)
Elevated PSA, low Free PSA, High-grade PIN
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Elevated PSA, low Free PSA, High-grade PIN
by dbk1946, Jun 14, 2006 12:00AM
I am 59 years old. I had my first PSA test last August and it was elevated (5.5). Two months later, my PSA was 6.6 and six weeks later, it was 7.7. Negative DRE. Blood in semen. Because of the velocity of the change, I guess, my urologist did a TRUS with biopsy (10 cores) in January of this year. The result showed high-grade PIN. My urologist scheduled a repeat biopsy in June. The path report on that biopsy didn't mention PIN and simply stated "No tumor seen." My urologist wants to simply follow my case with periodic PSA tests. My question to you is, PIN doesn't simply go away and with the velocity of change in my PSA, coupled with the low free PSA and the PIN, I have little faith in the last path report. Should I get a second opinion and/or second path and what do you think is causing my abnormal results? Thanks for your time.
Doctor's Answer
by Kevin Pho, MD, Jun 15, 2006 12:00AM
, Jun 15, 2006 12:00AM
High-grade PIN is associated with prostate cancer. The approach to this scenario is unclear at this time. Repeating the biopsy again is recommended, since the biopsy can miss potential cancer cells.
If the third biopsy continues to be negative, periodic PSA tests should be followed closely. If the PSA continues to increase, further biopsies may be needed.
Obtaining another urological opinion can be done. These options can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_
If the third biopsy continues to be negative, periodic PSA tests should be followed closely. If the PSA continues to increase, further biopsies may be needed.
Obtaining another urological opinion can be done. These options can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_
