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Brian,
I think you misunderstood what the Mayo doctor said. He probably was talking about a PSA of greater than 1.0 means you still have prostate cancer if you have had your prostate out. A PSA above 20 has a very high probability for cancer but even then it is not certain. A PSA of 3.18 just means that there is something causing a higher than average PSA reading. Any type of prostate inflamation, infection or irritation will give a 3.18 reading and that is why the doctors want a recheck to see if there is an upward PSA trend. With a negative DRE and a low PSA reading he is far more likley to die from lightning that PC in the next few years.
The important point is that the doctors will be monitoring the situation and on alert for PC. How you end up dying from PC is by not seeing a doctor until you've got a very advanced case or having a doctor that didn't consider PC until it is too late.
Sorry to read of your concern (which is quite understandable) about your son's elevated PSA.
Although there has been a deal of discussion about PSA there are still many misunderstandings. The two main items that everyone should know and keep in mind (and some doctors are not fully aware of these basics) are:
1. PSA is NOT prostate cancer specific. The PSA level measured may indicated that there is cancer in the prostate, it may indicated that there is some other infection of the gland or the baldder or it may be unexplained. You may find it helpful to read PSA 101
2. There is no definition of what a 'normal' level of PSA is. The standard 'trip-wire' at which most doctors will refer to a urologist and which will usually land up with a biopsy is 4.0 ng/ml. But about 65% of men with that level of PSA will NOT be diagnosed with prostate cancer and about 25% of men with a level of PSA lower than 4.0 ng/ml WOULD BE diagnosed with prostate cancer if they were biopsied.
I have seen a report of a man with a PSA of over 300 ng/ml who was diagnosed with a bladder infection and who was treated with antibiotics resulting in a lowerig of his PSA back to less than 4.00 ng/ml.
It is a good idea to eep an eye on your son's PSA levels, but at the same time it would be wise to th0roughly investigate the possibiity of infections or disease in the prostate gland and bladder.
Sorry to hear about your son's psa going up. I know how concerning that can be. My husband and I just went through a simular experience.
His psa was going up and then down, with the first one at 3.9 and then going down to 2.3.
The first urologist he saw wanted to do a biopsy right away. But after doing alot of research on psa, biopsy and other options, we elected to see a different urologist for a second opinion. Glad we did.
He explained how psa levels can be different in all men and that no two men will have the same levels, normal or not. And that alot of things can cause an elevated psa besides pc.
One test he did for my husband was a PCA3 urine test. It came back negative for cancer, so a biopsy was not needed after all.
Their website is pca3.org
It has alot of information on the test, which labs here in the country interpret the test and which doctors (which our doc was) are trained in the specimen collection. We live in Colorado so we found several doctors here. And to our surprise, our insurance covered the test(Aetna).
Another sometimes helpful test is the free psa test along with the total psa. But in our case it was the pca3 test that put all our fears to rest.
teri,
The PCA3 test is a bit better than the PSA test but it can't come back negative for cancer. One may get a low number back and it means your probability will be low that you have prostate cancer but PC is still a possibility. Nothing is certain with PC diagnosis, treatment and outcome yet.
