Prostate Cancer Survivors






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PSA going up & down

Just wondered about anyone else’s experience... PSA was “normal” (as they say) for years. I had a colonoscopy and my next PSA, 1 month later, jumped 2 points (6). Since then (5 years), every 6 months it seems to go up and down. Last one went to 9.9 (from 6.9 but the one previous to that was 7.5) so now my primary physician is referring me to a urologist. A couple of questions.

We know sex, bike riding, etc can cause PSA to increase prior to the blood test but has anyone had something (similar to a colonoscopy) start a PSA up/down cycle? Also, what would anyone suggest for next steps to initially avoid a biopsy - 4K blood test, MRI, etc?

63 years old, good health (slight HBP - low dose medication), lots of exercise, not overweight, no cancer history in family, all “functions” work fine, no dribbling, no getting up at night, nothing else abnormal about health. PSA “Free” chart - 17% for age and straight PSA.

Thoughts from this forum?


Re: PSA going up & down

The history you provide appears to be rare if not unique, perhaps, explaining why no one on this site has commented thus far.
A biopsy may give you some of the information you need to make a good decision for yourself.
Best wishes Don O.

Re: PSA going up & down

Thanks for the reply. My GP has suggested a 4K, MRI or enzyme test prior to an actual biopsy due to the uniqueness of my situation so will probably initially go that route. Any comments from the forum as to experiences with any of those 3 diagnostic tools? Thx

Re: PSA going up & down

My PSA did similar. 2-3 for years. Then 6. A week later 10. Get the MRI if you Pi-rads score is low they may not do a biopsy. Even if they do a biopsy they'll know where to put the needles.

Re: PSA going up & down

Following a PSA reading of 5.8 and a range of of inconclusive tests, including a MRI, I had a transperineal biopsy in 2013. My urology consultant thought that I would end up having a biopsy at some stage and it might be as well to have one sooner rather than later. Quite glad really as the biopsy found extensive cancer which was treated by surgery, radiotherapy and hormone therapy in the following 3 years. Some unavoidable side effects but generally I consider myself fortunate and continue to enjoy life. These decisions are always difficult. Best of luck with yours.

Re: PSA going up & down

Just to conclude this post (as it applies to me anyway), I found a very caring, prostate cancer surviving, minimally invasive treatment thinking doctor. He suggested a 3T MRI w/wo contrast prior to a biopsy. Being a long distance away (to avoid 2 trips), the MRI scheduled one afternoon, biopsy the next morning. The morning after the MRI, we met with the Urologist and he told us the radiologist and himself could find absolutely no signs of cancer lesions. What he did find was a prostate 6x larger than normal! With no symptoms, no cancer history in family, etc we skipped the biopsy and he indicated that he would not be concerned (absent any future symptoms) until a PSA much higher. So, please find a doctor who wants the real story before performing any type of biopsy.