Hi, Dick....
At your age, you should *expect* your PSA to remain fairly constant.  Oh, it
might fluctuate by a couple of tenths... but otherwise it will probably stay
the same.  If you begin to notice regular cilimbs in the PSA, it will be
important to note the velocity at which the PSA mounts... PSA velocity can
indicate an aggressive cancer.
Basically, though, your odds of PCa are increased because your dad had PCa.
But that doesn't mean you *will* develop PCa.  And with early monitoring by
PSA, if you should see anything beginning to develop, you will have caught
it early...
It's great that you are keeping yourself checked.  I'm sure your father
would be proud to know that you are profiting from his experience in a
positive way.  But, at the same time, don't live your life with PCa hovering
over your head.  You *may* never get it!  And you could be run over by a bus
tomorrow.... just as I.  So.... monitor.... and keep copies of your own PSA
results... but don't obsess over it to the point that it prevents you from
enjoying each day!

Kind regards!
MikeH

Buy a good PCa book (e.g., Walsh, Scardino, Dummies/Lange) and read the
first half or so. It'll decrease your worries by educating you, keep you way
ahead of most GPs, and let you know when it's time to see a specialist.

I.P.

"Dick Smith" >

Hi

I started getting my PSA checked aged 38 and then every year after for the
same reason.

The first reading was about 4.5 and stayed that way for around five years
when it went to 8.0.

Biopsy showed 4 of the 6 samples with cancer.

My doctor now says they would have operated at 4.5 knowing what they know
now.

Had RP in 1995 and last PSA was still undectectable.

Cheers and good luck.

greg

The others  have pretty much covered it.   Let me just add that PSA can
vary for several reasons.  There is some experimental error in the
measurement, and at one point my urologist told me it could be as much
as 0.5 ng/ml.  But that was a few years ago, and it may be out of date.
  Also, prostatitis is a more likely explanation for a rise in PSA in a
man your age than prostate cancer is.   If your PSA does start to go up,
 your doctor will proabably want to retest you, and may decide even to
order a biopsy.   Decisions in such matters need advice from an expert,
so you should make sure you have confidence in your doctor and let him
guide you in the matter.   Meanwhile try not to worry and go about your
life.   Even aggressive prostate cancer tends to grow slowly, and you
will have plenty of time to find out what is going on and decide what to
do next.  In addition,  in the highly  unlikely event that you do get
prostate cancer at a relatively young age,  in the hands of an expert
therapist, there is an excellent chance of a cure without serious side
effects.

As a side note, let me add that sometimes I wish that my prostate cancer
had been diagnosed ten years earlier---it was diagnosed at age 67.  Then
 my chances of avoiding impotence would have been much higher.   As it
turned out,  I lucked out in that matter, and erections more or less
returned after 18 months, but it could have easily gone the other way.

And tracking PSA will help to do just that.

It is generally accepted that a PSA test result of >2.5 ng/mL requires
further investigation. But it is necessary to understand that a PSA test
result that is "high" is not necessarily diagnostic of PCa. In fact, I have
seen an assessment that PSA is diagnostic of PCa in only 43% of the cases,
and that this figure is the result of pathological examinations of prostate
glands removed in surgery. Source: Stephen B. Strum, MD, on P2P writing
about a more reliable test, uPM3.

A "high" PSA test result could quite likely be the result of BPH (benign
prostatic hyperplasia; it just grew), prostatitis, infection, ejaculation
within 24-48 hours prior to the blood draw, bike riding, a DRE, anything
that stresses the gland.

So: a "high" PSA is a headsup, nothing more. Unless, of course, it's huge.

That's why the timing of the blood draw is critical. And why, if the result
is abnormally high, a course of an antibiotic such as Cipro followed by
another test is often indicated.

As I understand it, PSA can naturally rise with age, but it's a very slow
process.

I recommend reference to the website of the Prostate Cancer Research
Institute at:
http://prostate-cancer.org/index.html
The site includes much useful information, is thorough, objective and
authoritative.

Search for "PSA doubling time" and "PSA velocity."

Regards,

Steve J

"What are the facts? Again and again and again -- what are the facts? Shun
wishful thinking, ignore divine revelation, forget 'what the stars
foretell,' avoid opinion, care not what the neighbors think, never mind the
unguessable 'verdict of history' -- what are the facts, and to how many
decimal places? You pilot always into an unknown future; facts are your
single clue. Get the facts!"
--Lazarus Long

If he died at age 74, we might guess that his cancer got out of control
(metastasized) sometime in his late 60's.  If your future is like his past,
you've probaby got 25 years before anything significant would show up.
Hopefully, by then, new detection and treatment methods will make
prostate cancer an easily detectable and treatable problem - perhaps
not requiring the slash and burn techniques used today.

As others have said, there is variation due to non-cancer causes.
My oncologist claimed that PSA can vary up to 30% day to day, though
that much variation isn't common.

Unless your GP knows more than mine did, you're right not to trust
completely him on this.  Older GPs were all trained before the PSA
era.  Younger ones probably heard about PSA in med school, but
were taught that anything below 4.0 is perfectly normal - which isn't
necessarily true.

My impression of most doctors is that they get pretty good at
diagnosing and treating the illnesses they frequently encounter -
sore throats, flu, etc., but it takes one who really stays on top of
things to be able to diagnose the more unusual illnesses.

My non-physician's, non-expert, take-it-for-what-you-paid-for-it
advice is, continue getting tested each year.  If you see a noticeable
increase in PSA, and I'm not sure what would count as noticeable,
ask for a more frequent test schedule of every 6 months.  If the
trend continues up, ask your GP to refer you to a specialist.

My understanding is that PSA does increase with age - perhaps
due to gradual enlargement of the prostate.  That's normal and
expected and shouldn't alarm you.  It's if you see something
going up faster than in the past, or getting above some cut off
point, that you need to see a specialist.  They used to say the
cut-off was 4.0, but others are now saying 2.5.

   Alan

You are well informed to get regular PSA's.  To be worried will keep you
vigilant.   My father also had Pca and I followed.  I cannot give you
any advice to your question however.

Dalej.