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PSAV 88%. Large prostate of 68 cc. Does this indicate cancer?

Jul 2016
User rating for this question
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Answered by

Practicing since : 1971
Answered : 5079 Questions
I have spoken to Dr XXXXXXX and I could never rate him because your system failed to register the rating. I need some precisions from him, see questions below:

1. My biggest concern is my PSAV, 88% increase in less than one year 5.22 in October 2012, 9.79 in August 2013. Could that be due to anything other than cancer, my understanding is that my large prostate of 68 cc would on its own generate a PSA of 4.8, so 5.22 was almost normal. Does this mean I now have cancer and does it mean it has just started.

2. I have read that a PSA jump in less than one year of more than 2ng doesn't just indicate cancer but an aggressive cancer, XXXXXXX Score equal or higher than 7, is that right. Prostatitis has been ruled out by a normal urine test and two PSA tests were carried out on 20/6/2013 and 6/8/2013 which confirmed results 9.9 and 9.79.

3. Is the lack of progression of my PSA between the above two recent dates encouraging, does it suggest the PCa may not be that aggressive?

4. What comments do you have on my Free to Normal PSA ratio of 16% (better than 10% but not as good as 25%!)?

5. What do you think of my PSAD of 14.4?

6. Bone pains and metastasis: I have had an ankle pain for 5 years (which was investigated in late 2008 and nothing was found). It is still present but only at night. Am I right in thinking this cannot be related to my PCa?
I have recently experienced a pain in the lower part of my left femur which happens during the day intermittently, should I worry about that? I do NOT have any pelvic or hip pains at all! Is that encouraging?

7. Does my PSA of 9.79 suggest that my PCa is not advanced or metastatic? Some have suggested that a metastatic PCa would produce PSA readings in excess of 150.

I am planning to have my first biopsy (at least 12 core) around August 18th/19th but I would like to know what to expect?
Posted Thu, 29 Aug 2013 in Men's Health
Answered by Dr. P. T. Patil 6 hours later
Brief Answer:
PSA rise indicate probable cancer, Biopsy advised.

Detailed Answer:
Thanks for fresh query.I will try to address your queries point to point.

1) Your PSA which has raised from 504 to 9.9 in a year is suggestive of cancer of prostate. Here is no other pathology where PSA gets raised.PSA estimation is a primary tool to detect cancer of the prostate followed world wide.A PSA of 9.9 colud be due to enlarged prostate also.Cancer can be diagnosed and confirmed only on Biopsy.

2) Gleson's scoring can not be decided on PSA values .It is graded on histopathological findings.of the prostate Biopsy.

3)Aggressiveness of the cancer is decided on Biopsy findings and nor fully on PSA values.

4)Ratio of Free PSA to total PSA is important and very valuable to confirm cancer prostate when values odf PSA are in a range of 5t0 10ng.

5)PSA of 14,4 needs to be confirmed by Biopsy only.

6)Your ankle joint pain is not due to metastasis of cancer prostate.

7) PSA 0f 9.9 does not suggest advanced cancer.
Thanks and regards.

Above answer was peer-reviewed by
Follow-up: PSAV 88%. Large prostate of 68 cc. Does this indicate cancer? 18 minutes later
Many thanks for your helpful, detailed answers, it appears that you do NOT yet rule out the possibility of a benign biopsy, you just think it is unlikely.

I will try and close the discussion and review your response but the system wasn't working last time!

Answered by Dr. P. T. Patil 8 minutes later
Brief Answer:
Please read out final answer as detailed below

Detailed Answer:
Your serum PSA being below 10ng, there are chances of it being due to Benign enlargement of Prostate. However it has to be confirmed only by prostate biopsy .

Thanks and Regards,
Above answer was peer-reviewed by
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