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What Does My PSA Test Report Indicate?
Question: last week I had a PSA test run and it is 10.2 and the previous month I had a test and it was 9.2. In 2014 I had a test ran and it was 9.6. in 2011 I had 2 test run and they were 8.2 and 7.0 and I also had a biopsy which came out negative. In 2010 I had many tests ran and they varied from 9.3 to 6.1. I have had elevated prostate reading since 2006 and have 4 biospys and they have all come back negative. Is there any other way to check the prostate and what would you advise.
Brief Answer:
Please know your PSA velocity risk, free PSA level and do regular follow up
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. PSA is a marker for probability of prostate cancer when if shows a particular pattern of increase on consecutive blood tests. It should be remembered that PSA can also be raised in non cancerous situations like infection involving the prostate.
2. Discussing further on elevated PSA levels, 1 in 4 people with high PSA levels proceed to have a cancer. Your PSA velocity (rate of change in velocity) is required to be calculated through the years. This can be known by entering the PSA level and date of testing and then reviewing the results. The results indicates a probability by using mathematical calculations and formula.
3. The PSA circulates in the blood in two forms either free or bound to certain blood proteins. If you have a high PSA level but a low percentage of free PSA, then close follow up and ruling out cancer becomes important. This test is used for men with a PSA level in the borderline range between 4 and 10. Research shows that if more than a quarter (25%) of the total PSA is free, there is less chance of having prostate cancer. I recommend you also get a free PSA test done to know the risk of cancer if any.
4. However please continue to get PSA tested regularly and at least once a year and take treatment for any inflammation that you might be having. An ultrasound scan for prostate volume assessment is also required to know if an enlarged prostate is causing infections due to urinary symptoms. Alternatively a detailed evaluation of the prostate gland might also be required as recommended by your urologist as you have done earlier.
5. If you want to know the PSA velocity then please send me the dates and PSA value over the last few years. I will get back to you with the results.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please know your PSA velocity risk, free PSA level and do regular follow up
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. PSA is a marker for probability of prostate cancer when if shows a particular pattern of increase on consecutive blood tests. It should be remembered that PSA can also be raised in non cancerous situations like infection involving the prostate.
2. Discussing further on elevated PSA levels, 1 in 4 people with high PSA levels proceed to have a cancer. Your PSA velocity (rate of change in velocity) is required to be calculated through the years. This can be known by entering the PSA level and date of testing and then reviewing the results. The results indicates a probability by using mathematical calculations and formula.
3. The PSA circulates in the blood in two forms either free or bound to certain blood proteins. If you have a high PSA level but a low percentage of free PSA, then close follow up and ruling out cancer becomes important. This test is used for men with a PSA level in the borderline range between 4 and 10. Research shows that if more than a quarter (25%) of the total PSA is free, there is less chance of having prostate cancer. I recommend you also get a free PSA test done to know the risk of cancer if any.
4. However please continue to get PSA tested regularly and at least once a year and take treatment for any inflammation that you might be having. An ultrasound scan for prostate volume assessment is also required to know if an enlarged prostate is causing infections due to urinary symptoms. Alternatively a detailed evaluation of the prostate gland might also be required as recommended by your urologist as you have done earlier.
5. If you want to know the PSA velocity then please send me the dates and PSA value over the last few years. I will get back to you with the results.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Attached is my history of PSA tests to calculate the PSA velocities. I would appreciate a calculation to aid in my decisions.
PSA HISTORY FOR XXXXXXX XXXX. JR.
DATE PSA NUMBER
11/17/2003 2.6
6/28/2004 3.4
10/26/2004 3.2
11/15/2004 4.7
12/1/2004 Biopsy negative
6/10/2005 2.1
9/19/2005 2.10
1/4/2006 2.60
10/25/2006 4.19
12/21/2006 5.40
4/26/2007 5.14
11/13/2007 3.33
5/7/2008 4.60
11/6/2008 6.50
12/1/2008 4.60
1/14/2009 5.60
3/2/2009 7.00
5/6/2009 Biospy Negative
9/23/2009 4.90
3/24/2010 9.30
3/31/2010 6.10
4/16/2010 6.70
5/27/2010 6.80
6/29/2010 7.60
7/8/2010 Biopsy negative
8/3/2010 6.80
10/18/2010 8.70
11/15/2010 9.20
12/17/2010 7.60
2/14/2011 BIOPSY NEGATIVE
3/18/2011 8.20
9/29/2011 7.00
10/11/2013 8.60
2/2/15 9.3
3/4/15 10.2
PSA HISTORY FOR XXXXXXX XXXX. JR.
DATE PSA NUMBER
11/17/2003 2.6
6/28/2004 3.4
10/26/2004 3.2
11/15/2004 4.7
12/1/2004 Biopsy negative
6/10/2005 2.1
9/19/2005 2.10
1/4/2006 2.60
10/25/2006 4.19
12/21/2006 5.40
4/26/2007 5.14
11/13/2007 3.33
5/7/2008 4.60
11/6/2008 6.50
12/1/2008 4.60
1/14/2009 5.60
3/2/2009 7.00
5/6/2009 Biospy Negative
9/23/2009 4.90
3/24/2010 9.30
3/31/2010 6.10
4/16/2010 6.70
5/27/2010 6.80
6/29/2010 7.60
7/8/2010 Biopsy negative
8/3/2010 6.80
10/18/2010 8.70
11/15/2010 9.20
12/17/2010 7.60
2/14/2011 BIOPSY NEGATIVE
3/18/2011 8.20
9/29/2011 7.00
10/11/2013 8.60
2/2/15 9.3
3/4/15 10.2
Brief Answer:
Your PSA velocity is slightly less than high risk for cancer prostate
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The following values have been calculated from your data including PSA estimation on 31 occasions.
PSA DOUBLING TIME
Months
Doubling Time 62.8 months
Velocity 0.1 ng/mL/mo
Years
Doubling Time 5.2 years
Velocity 0.7 ng/mL/yr
2. The current medical literature states the following.
(i) The XXXXXXX Longitudinal Study of Aging (BLSA) found that men with a PSA rate of change (PSA velocity) greater than 0.75 ng/mL/year were at increased risk of being diagnosed with prostate cancer and that PSA velocity was more specific than a 4.0 ng/mL PSA cutoff.
(ii) Accurately measuring PSA velocity requires three serial readings, ideally with the same assay, obtained over at least a 12- to 24-month period.
3. In conclusion, your PSA velocity through the years is slightly less than the cut off for a high risk. In that case it will be better to follow up regularly and take informed decisions concerning tests and investigations in the years to come keeeping in mind serial PSA estimations and free PSA level.
4. I have answered your query to the best of my knowledge and with newer advances in medical techniques, there might be additional helpful tests in the future to help aid a diagnosis of probable risk of prostate cancer.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Your PSA velocity is slightly less than high risk for cancer prostate
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The following values have been calculated from your data including PSA estimation on 31 occasions.
PSA DOUBLING TIME
Months
Doubling Time 62.8 months
Velocity 0.1 ng/mL/mo
Years
Doubling Time 5.2 years
Velocity 0.7 ng/mL/yr
2. The current medical literature states the following.
(i) The XXXXXXX Longitudinal Study of Aging (BLSA) found that men with a PSA rate of change (PSA velocity) greater than 0.75 ng/mL/year were at increased risk of being diagnosed with prostate cancer and that PSA velocity was more specific than a 4.0 ng/mL PSA cutoff.
(ii) Accurately measuring PSA velocity requires three serial readings, ideally with the same assay, obtained over at least a 12- to 24-month period.
3. In conclusion, your PSA velocity through the years is slightly less than the cut off for a high risk. In that case it will be better to follow up regularly and take informed decisions concerning tests and investigations in the years to come keeeping in mind serial PSA estimations and free PSA level.
4. I have answered your query to the best of my knowledge and with newer advances in medical techniques, there might be additional helpful tests in the future to help aid a diagnosis of probable risk of prostate cancer.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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