So my PSA has skyrocketed

[Simon1972]

This has me worried, and I'm not sure what options I can reasonably take. My PSA has been increasing, no sex before testing, no bike riding just a pure increase.

July 2014. 1.44
August 2015 1.79
Dec 16. 2.63
Range 0.25- 2.2

Been on trt since December 2014



Now, the CA19-9 came back at 4 for a range of <39

For those that are unaware this is what the CA19-9 test is for....

The CA 19-9 is a simple blood test that measures the level of antigens (substances that cause the immune system to make a specific immune response) in the blood serum of a person with pancreatic cancer. CA 19-9 antigens are the substances released by pancreatic tumor cells.


So pancreatic cancer is definitely out....

I was going in for my appointment in two days, looks like I should ask for an ultrasound maybe on the prostate,?? Rather avoid a biopsy if I can unless its needed. I have health insurance so all is covered... Just wanted guidance , as we tend to not think straight when things affect ourselves directly

Thanks guys.

[hammerheart]

My PSA spiked to 7.5 last February, that made me freak out but both DRE and ultrasound were unremarkable. It returned to normal in a month. I wish I hadn't even tested it for.

Baseline PSA was actually higher before TRT (1.5 vs 0.5).

Your elevation is minimal and nothing I'd be concerned about, I see abs no reason for biopsy, just a regular check with the uro plus an ultrasound will do.

BTW 2.62 sounds normal for a 40 yo.

Is your estro well in check? What about DHT?

[Simon1972]

Thanks compare, I'm 45 years old, oestradiol came in at less than 44.

[Mr.BB]

Yes, ultrasound. Everybody should do an abdominal ultrasound (prostate included) every 5 years after 35 anyways.

Did you notice any increase in the number of times you go to pee?

Probably time to start finasteride to control BPH.

[Simon1972]

Yes, ultrasound. Everybody should do an abdominal ultrasound (prostate included) every 5 years after 35 anyways.

Did you notice any increase in the number of times you go to pee?

Probably time to start finasteride to control BPH.

I have noticed a slower stream, that's a sign right there.

I was planning to ask for antibiotics course in the first instance, followed by an ultrasound 3 weeks later to gauge the antibiotics effectiveness. Thats to rule out prostatitis, of course with follow up PSA test.

If that fails finasteride is the next option.

Hopefully that's a good health plan, anything else you can think of?

Really don't want to get off the trt if I can help it.

[Mr.BB]

Dont worry about getting off TRT, ultimately its your decision not the doctor. Dont know your dosages, might be better to use 100-125mg PW, but this should also be controlled by e2 and dht values.

Antibiotics if you dont have symptoms of prostatitis might be a bit over the line. Or you have been putting it in some dirty places? (joke hehehehe)

Be ready for the finger heheheh, quite standard procedure for ultrasound with prostate size evaluation. Most likely you will have slight BPH and uro will put you on finasteride. Sooner or later we all have to go that route.

[Simon1972]

I'm on 150mg a week, e is controlled , dht wasn't tested, I will ask for this in future tests.

I'd rather hoped it was just prostatitis, so hoping I've got just that...we will see,

Thanks for the speedy replies guys, most appreciated. I think I've got a plan now to follow.

[bullshark99]

I went thru almost identical scenario over the past few months. I'm 48, 5 yrs of TRT. My PSA jumped to 3. Stay the hell away of the biopsy, ultrasound, insist on it.
More than likely you have nothing to worry about, 2.7 isn't that high anyway. If you get it done again also get the Free % PSA as well, just another marker.

[kelkel]

Look into a 3T MRI if possible. Non-invasive.