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I Am 50 Years Old. I Was Referred To A
Question: I am 50 years old. I was referred to a Urologist in 2014 and have had annual PSA and DRE. PSA was 0.6 each year from 2014 through 2018, and normal DRE. Started Proscar for BPH in Nov. 2018. In November, 2019, PSA of 0.7 after being on Proscar for one year. I would have expected PSA to decline or stay the same (have read that PSA levels drop on average 50% on Proscar). Urologist wanted to retest in 6 months. He did say, "I'm not worried about it" but wanted to see more data. DRE was normal.
Since then I have had PSA checked several times. History is:
--Baseline 2014-2018--0.6
--2018 Started Proscar
--November 2019 (after one year on Proscar)--0.7
--December 2019--0.4
--January 2020--0.5
--February 2020--0.4
--June 12 2020--0.9
--June 24 2020--0.4
--June 26 2020--0.7
--July 9 2020--2.0
--July 16 2020--1.0
I have consulted 2 urologists--one doesn't seem concerned at all about PSA numbers and said fluctuations could be due to some post void residual that I have, and that I should just get PSA tested annually. Other urologist is "not really" concerned and suggest retest in 6 months. Neither recommended a biopsy or other testing and DRE continues to be normal.
I read somewhere that PSA on Proscar should be stable and stay low, and that any increase could be a sign of a problem. My PSA seems to randomly increase and decrease in short intervals of time--particularly in the last one month in which it has ranged from 0.4 to 2.0. Should I be worried about the fluctuations in PSA?
Since then I have had PSA checked several times. History is:
--Baseline 2014-2018--0.6
--2018 Started Proscar
--November 2019 (after one year on Proscar)--0.7
--December 2019--0.4
--January 2020--0.5
--February 2020--0.4
--June 12 2020--0.9
--June 24 2020--0.4
--June 26 2020--0.7
--July 9 2020--2.0
--July 16 2020--1.0
I have consulted 2 urologists--one doesn't seem concerned at all about PSA numbers and said fluctuations could be due to some post void residual that I have, and that I should just get PSA tested annually. Other urologist is "not really" concerned and suggest retest in 6 months. Neither recommended a biopsy or other testing and DRE continues to be normal.
I read somewhere that PSA on Proscar should be stable and stay low, and that any increase could be a sign of a problem. My PSA seems to randomly increase and decrease in short intervals of time--particularly in the last one month in which it has ranged from 0.4 to 2.0. Should I be worried about the fluctuations in PSA?
Brief Answer:
No need to be worried. Continue every 6 months monitoring of PSA
Detailed Answer:
Good day and thank you for being with healthcare magic!
Like with your previous urologist I agree with them anf i'm not really worried with the small fluctuations that you are seeing. i will be worried if there is an increasing trend in your serum psa and i'm sure you read about doubling time where in the psa increases or doubles itself in a span of few months.
We are being cautious with unnecessary biopsies because biopsies have complications also which may be severe in some cases. I believe you don't need a biopsy and just continue with your psa monitoring every six months and psa can be elevated with lower urinary tract symptoms and difficulty in voiding.
No need to be worried. Continue every 6 months monitoring of PSA
Detailed Answer:
Good day and thank you for being with healthcare magic!
Like with your previous urologist I agree with them anf i'm not really worried with the small fluctuations that you are seeing. i will be worried if there is an increasing trend in your serum psa and i'm sure you read about doubling time where in the psa increases or doubles itself in a span of few months.
We are being cautious with unnecessary biopsies because biopsies have complications also which may be severe in some cases. I believe you don't need a biopsy and just continue with your psa monitoring every six months and psa can be elevated with lower urinary tract symptoms and difficulty in voiding.
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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