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Posted By HFHS M.D.-KR on July 30, 1998 at 17:27:42:

In Reply to: PSA posted by hjm on July 21, 1998 at 12:56:48:

I am 56. I have had an enlarged prostate for about 10 years.  I am currently taking 8 mg cardura.  Overthe years my PSA level was between 2-2.9.  Last September it was 2.9. On my annual vist to my urologist 2 weeks later, he took a PSA and a free PSA test with rtesults of PSA 9 and Free PSA 15.  I had a biopsy.  Itwas negative.  on successive three month visits the PSA level was 6.4 and 6, with free PSA of 15.  I was always suspicious of the quick rise, and about a week after the last test, had another ne done at a different lab.  I just got a report of PSA of 8 with free PSA of 21.  The doctor is talking of another biopsy.  I am, of corse panicked.  I have been experiencing very requent urination over the last 6 months, significantly more than usual.  I had a cystoscope and the results were negative.  Where am I going with all this?  Much appreciate a sense of direction for a lost traveler.n
Dear HJM,
PSA (Prostate Specific Antigen) is an important tool used by urologists to detect prostate cancer. A PSA level of greater than 4.0ng/ml is associated with prostate cancer. Recently research efforts have been directed at assessing the rate of rise in PSA over time as well evaluation of free PSA. It is currently felt that a rise in PSA of greater than 0.75ng/dl in one year or a rise of greater than 20 % over 2 years is suspicious for cancer. There are several factors that can falsely elevate the PSA including  urinary tract infections, foley catheterizations, recent prostate biopsy ( less than 6 weeks ago) and a severely enlarged prostate. Prostate biopsy is performed when the PSA is greater than 4.0 ng/dl to evaluate for prostate cancer.
In your case  the rapid rise in your PSA was appropriately evaluated with a biopsy. In the absence of infection or  the other causes of falsely elevated PSA  previously mentioned, a repeat biopsy is wise . You are young and apparently otherwise healthy. Early detection of a cancer would result in a very high chance of cure. A repeat biopsy is warranted in your case.Some men undergo three or more biopsies before the cancer is detected. It is worth the effort because the cure rate is quite high when detected early in the course of the disease.
Benign prostatic hypertrophy (BPH) and prostate cancer can coexist. The symptoms of frequent urination and urgent urination are common.While the prostate cancer issue is being evaluated , it would be prudent to discuss with your doctor the various treatment options for enlarged prostate (BPH).
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you  may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
*keyword: PSA
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