Can PSA be 40 with repeated negative biopsies?

[lancastrian]

7 years ago at at age 69 I had a PSA of 4.5. Over this time after 4 negative TRUSs  (36 needles) my PSA rose progresively to 35. On DRE I have a nodule at the usual position for cancer.  My prostate is large but causes little trouble in micturation. During this time I have fathered 3 children. Sex is frequent and enjoyable.
After the last TRUS I had a big bleed rectally. Can all these needles have missed a cancer? Should I have more TRUSs.


This discussion is related to PSA Blood Test.

[starstein]

My father's psa went from 11 to 33 within 6 months.  He has had biopsies done, all negative.  We are so very worried, but trying to stay positive and prayerful.  Do any docs know the chances of this type of rapid increase in psa and cancer?  He is getting more tests run next week.  Are there specific questions or test types we should require?  Thank you.

[lancastrian]

Thank you!

Lancastrian.

[HeinrikMD]

Hi,

Yes the PSA may be elevated and yet there is no detectable cancer. Bear in mind that it is prostate specific not prostate cancer specific. If the prostate is large, then the PSA would be elevated. PSA cannot stand alone to predict cancer being present or not.

There are cases of patients with prostatitis (an infection) which may have PSA values in the 60s level (there is even a report of a man with a level of 103 ng/mL without cancer).

There is some work on variations of PSA, which would involve rate of doubling or speed of the PSA rising. For your case however, these may not be applicable as your levels are already high. There are some tests that are in the works which may be better suited for your case.

Til then, it may be more rational perhaps to look at your symptoms as part of the decision to do anything invasive again.

Stay positive.