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Urology (Expert Forum)
Extremely PSA and extremely high free PSA
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.
Extremely PSA and extremely high free PSA
by SmithJackson, Dec 13, 2004 12:00AM
My PSA went from 4.5 to 13 in the past 18 months. When it was 4.5, I had a biopsy done that was negative. So my doctor ordered another one as well as an bone and CT scan. He also took more blood to check my free PSA. My bone scan and CT scan were both negative. He took 6 biopsies which were all negative. But the blood taken at the time of the biopsy showed my PSA now went up to 36 (in a period of one month) and the free PSA was 49% (up from 16% 18 months ago). He says perhaps we need to do more biopsies of more the transition zone rather than the peripheral zone or perhaps there is prostatis. How is it possible to have such a large jump in one month in PSA? Also, how is it possible to have such a large absolute number PSA and such a large percentage of free PSA? I am totally confused and any help would be greatly appreciated. Thanks.
Doctor's Answer
by Kevin Pho, MD, Dec 14, 2004 12:00AM
, Dec 14, 2004 12:00AM
An increased free PSA is correlated with an increasing chance of prostate cancer. I agree that more biopsies are needed to rule out this diagnosis. And yes, prostatitis can raise the PSA as well.
Other non-cancer causes that can raise the PSA would be any type of prostate procedure (i.e. a biopsy or a digital rectal exam). However, in these cases, the PSA will normally decrease after a few weeks.
If the tests remain non-revealing, you may want to consider imaging the prostate - either with a transrectal ultrasound, or with an MRI.
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.
Medical Weblog:
kevinmd_b
Other non-cancer causes that can raise the PSA would be any type of prostate procedure (i.e. a biopsy or a digital rectal exam). However, in these cases, the PSA will normally decrease after a few weeks.
If the tests remain non-revealing, you may want to consider imaging the prostate - either with a transrectal ultrasound, or with an MRI.
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.
Medical Weblog:
kevinmd_b
Member Comments
by SmithJackson, Dec 22, 2004 12:00AM
To: Prostate Cancer
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