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PSA Readings
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PSA Readings

  I am a 59 year old in good health. About 2 years ago my PSA level went ,in a year, from below 4 to 7.6. I went to a Urologist who did a Ultrasound and biopsy. Path results negative, report said atrophy and mild prostatitis. Next 6 month check PSA continued to rise above 11. Another biopsy with same results on pathology.  Next checkup at 6 months PSA up to 12.5. Third biopsy; same results. Last check in June PSA went down to 7.9 and free PSA went from 9 to 13%. Can anyone suggest a theory  to explain what might be going on?  The only drug I take during this period is Tegretol for Trigeminal Neuralgia. More recently also started taking Lipitor. Would appreciate any thoughts on my fluctuating PSA level. Mnay thanks.
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Dear Allan,
It seems like you have been well exposed to the elevated PSA and negative pathology on ultrasound guided prostate biopsy arena/dilemma.  The reason I say dilemma is because as urologists there is no clear cut answer as to how many ultrasound guided biopsies need to be done for progressively elevating PSA before we decide enough is enough and to call it quits.  One can conceivably perform a biopsy every 6 months (for a long time) and still not obtain any evidence for cancer.  In fact, the yield of a positive biopsy for prostate cancer is less and less as each subsequent biopsy is performed .  On one hand, one is happy not to obtain cancer, but on the other hand the question of the elevated PSA pops back up and at one point one needs to either repeat a biopsy, or ignore the elevated PSA.  As you can probably tell, it can be frustrating not only for the patient, but also for the physician who feels responsible to the patient.
It
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