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What does my PSA test report indicate?

Answered by
Dr.
Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1897 Questions

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Posted on Tue, 23 Aug 2016 in Urinary and Bladder Problems
Question: I am a terrible hypochondriac. I read the internet, which only makes it worse. I'm concerned about recent PSA test. My PSA history............

2001 - 2009 (age 50-58) -0.4 PSA
2011 - 2013 (age 60-62) - 0.6 PSA
April 2014 (age 63) - 0.7 PSA
October 2014 (age 63) - 0.8 PSA
July 2016 (age 65) - 1.2 PSA

The increase concerned me so I had a free PSA test this week and it was about 15.4%.
I understand Free PSA may not mean much when total PSA is below 2.5.

Given the velocity is up some and the free PSA is low......but the total remains pretty low for my age, how concerning is this? How likely is it cancer. Looking for your best judgement and counsel, as I'm making myself crazy over this.

Hoping you can tell me, in your judgement, the risk is very remote.

Thank you.In addition, had a DRE at the end of 2014 and a cystoscopy (for microscopic blood in urine), and everything looked good.Saw I checked female above by mistake - obviously I'm male. Sorry.Also, I was told in 2014, I have some BPH.

doctor
Answered by Dr. Matthew J. Mangat 2 hours later
Brief Answer:
PSA is well within normal limits.

Detailed Answer:
Hello XXXXXXX and welcome to HCM.
As an Urologist,i can understand your concern.

Your PSA alone need be checked annually.
July 16 PSA is 1.2. That's the latest one.
Then you've nothing to worry about.
PSA is done as a marker for cancer prostate. Up to 4, is within normal range.
Only in doubtful cases free PSA is done.

If you've any doubts,you should get a DRE or rectal examination, by an Urologist and a
TRUS (trans rectal ultrasound scan ).

That'll clear your doubts.
Hope your query on free PSA is over.

In case you're closing this,you may rate the answer to your satisfaction.

Wish you well.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Matthew J. Mangat 8 minutes later
Thanks. Feeling relieved.
Not trying to put words in your mouth, but it is fair to say you are highly confident I don't have prostate cancer?

Again, thanks very much.
doctor
Answered by Dr. Matthew J. Mangat 1 hour later
Brief Answer:
PSA may have false negative reports.

Detailed Answer:
Hello XXXXXXX

PSA is not 100% accurate, to ruling out prostate cancer.
That's the reason, I advised you've a DRE by an Urologist.

If a TRUS scan is done, all doubts can be cleared.

Hope you understand, why you need an Urologist's examination and opinion.

Dr.Matthew J. Mangat.

Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. Matthew J. Mangat 17 days later
Hi Doctor,
One follow up question, please. Saw an urologist and shared my information with him. He was not concerned, and indicated my PSA was very consistent with BPH. Suggested follow up in 6 months or so. (As background, about 2 years ago he checked me for microscopic blood in urine and did a CAT, cytology and cystoscopy - all were normal - said it was caused by a varicose vein he saw on he prostate).
Here is my follow up question....
Shortly after I saw him, (about 10 days ago) I began to experience mild (not really burning) sensation when I urinate. I feel it only in the tip of the penis and only at the beginning of when I urinate - halfway through peeing it subsides. Feels sort of a cross between urgent feeling and very, very mild burn at most. I do have enlarged prostate and typical symptoms - urgency, frequency.
Can you give me your judgement if the feeling when I pee is consistent with BPH? Or does it sound like a more serious prostate or bladder issue.
Thank you.
doctor
Answered by Dr. Matthew J. Mangat 2 hours later
Brief Answer:
symptoms are suggestive of UTI.

Detailed Answer:
Hi XXXXXXX

Your symptoms are very suggestive of UTI.(urinary infection).
You should get the following tests done and send the reports here :

1. urine routine and culture.
2. ultrasound - KUB, with residual urine and a TRUS.

In the meantime,start a syrup Citralka,twice a day.
You can get an expert opinion here,after i see the reports.

Wish you well.
Dr.Matthew J. Mangat.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat 22 hours later
My sincere apology for bugging you. Just one more question.
This morning when i urinated I noticed what looked like a small thin dark thread floating in the toilet. Maybe 3-5mm in length and the thickness of thin thread. I rolled it between my fingers and it did not break or anything. Is it likely this was eliminated in my urine (if so what could it be), or more likely it was residue in the toilet or fell off my clothes? My strip urinalysis from ten days ago was all normal.

Sorry - please feel free to charge me for this additional question.

Thank you.



doctor
Answered by Dr. Matthew J. Mangat 1 hour later
Brief Answer:
Do the tests advised in previous reply.

Detailed Answer:
Hi XXXXXXX

You may ask any number of questions to clear your doubts.
That's what doctors are for. Never apologize for that.
Also,it's the site that collects your charges.

Your question is precisely the reason, for my previous answer.
Do those tests and send the reports here, for my expert opinion.
It'll be my privilege to answer.

Wish you well.
Dr.Matthew J. Mangat.


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Matthew J. Mangat 19 minutes later
Thanks will get the tests.....but if it were a cast, it would be delicate and not visible to the eye, and if it were a blood clot wouldn't it break up or squash if it was repeatedly squeezed.
Would you agree unlikely it would be a cast or clot. I will get the tests but looking for your judgement.
Thanks.
doctor
Answered by Dr. Matthew J. Mangat 5 hours later
Brief Answer:
A simple test will give you the answer.

Detailed Answer:
Hi XXXXXXX

You seem to be a net based patient.
At least your questions,point to that.

Both,blood clot and casts are confirmed on a urine routine microscopy.
This is a very simple test,so do that and clear your doubt.

Wish you well.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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