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Is PSA level of 4.7 a cause for concern?

DOCTOR OF THE MONTH - Feb 2018
Feb 2018
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General Surgeon
Practicing since : 1984
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I am a 58 year old male in good health . recent blood test shows a 4.7 psa . about 6 years ago I came back with 3.8 psa - went to urologist - DRE negative, mildly enlarged prostate - subsequent blood tests showed lower psa . most recently 2.45 in OCT 2015 nothing in 2016 - so I know 4.7 is elevated - but I have had some history of slightly elevated ( 3.8) - I am making appointment with urologist - but trying to get additional advice on this . I know psa testing and its validity is an on going battle . I imagine the topic of a biopsies will come up since this reading is over 4- my concern is not the biopsy itself but the side effects and even the general concept of disrupting the prostate gland with needles and what that means .

what do you think
Thu, 19 Apr 2018 in Urinary and Bladder Problems
 
 
Answered by Dr. T Chandrakant 27 minutes later
Brief Answer:
Not many side effects or not much disruption of prostate.

Detailed Answer:
Hi.
Thanks for your query, albeit very specific.
Noted the history and understood the concerns.
PSA of 4.7 is just elevated above the normal range and should not be taken very seriously unless proved otherwise as there are other factors that too increase PSA like infection, congestion and so on.
Your concern is about the side effects of biopsy and the general concept of disrupting the prostate gland with needles.
Practically speaking not many side effects are known to occur after needle biopsy of prostate and the result is either to confirm or to RULE-OUT cancer that is the most important concern.
DRE has an important role to play and should/will be done.
Non-invasive procedures like Ultrasonography of prostate and genitourinary tract either per-abdomen or per-rectal gives good opinion; MRI of prostate gives the better resolution. You can discuss these points also with your Urologist. Of course your Urologist will follow the protocol in such a case.
Do not worry about needle biopsy as it does not disrupt prostate and is more accurate and is done only if indicated by other investigations as mentioned/discussed above.
I hope this answers your query; please feel free to ask for further relevant queries if you feel that there is a gap of communication.
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