PSA Confusion

June 7, 2006 8:03 PM

I need resources to help me negotiate/make sense of the minefield of my "prostate specific antigen" (PSA) score/level.

When I started having an annual PSA test 4 years ago, my physician warned me about the ambiguity of the results. After three years of normal results, now at the age of 50+ I find my score has gone up by 2 and 1/2 points in the last year, but still within the normal range. The digital exam was slightly enlarged but smooth.

My doctor gave me a number of options including do nothing, take a "free PSA" test, be referred to a urologist, etc, and told me to call him next week with my answer.

In trying to find up to date information on the web, I find contradictory, out of date, and confusing information, everywhere, including the fact that the physician developer of the test no longer thinks it is an accurate diagnostic tool. I also found that John Kerry had a score lower than mine and had a biopsy and eventual prostatectomy.

Does anyone know where I can find accurate and current information about PSA levels?

posted by Xurando to health & fitness (5 comments total)

NCI's PSA about PSA

More in depth reading can be found at the NLM.
posted by Mr. Gunn at 8:47 PM on June 7, 2006

I would make use of PubMed, where you can search nearly all of the biomedical/biological periodical literature. If you don't have much background in biology or medicine, it might be daunting, but it's a good place to find out what all the latest ideas are.
posted by shoos at 2:39 AM on June 8, 2006

here
posted by shoos at 2:41 AM on June 8, 2006

You leave out two important pieces of information:

1) Do you have difficulty peeing? Dribbling? Low force of stream? Frequent UTIs?

2) What is your threshold for undergoing invasive procedures that may turn out to be negative?

These are going to be the two questions that determine what eventually happens. You can answer them here, but the Internet is of course not where you should receive medical advice.

Just to muddy the waters further, it's worth knowing that most men with prostate cancer die with prostate cancer but not of prostate cancer.
posted by ikkyu2 at 11:49 AM on June 8, 2006

When I was your age I had an eleveated PSA over a period of several years. I was referred to a urologist and eventually had a biopsy which was negative. Over next two years PSA still elevated and so had second biopsy which was positive and decided to have prostate surgery. I'd suggest you consult with a urologist instead of your PCP re such an important decision. My PSA scores then were in the single digits, don't remember exactly what they were.

It may be the case that most old men die with prostrate cancer, but if prostate cancer spreads at a younger age one will not get to be an old man.

I followed the controversy then and now and do not regret having surgery, since I'm alive and the problem is gone. Good luck.
posted by madstop1 at 4:45 PM on June 8, 2006