Concerned about my PSA / %fPSA results

Hi there! I'm a 40 year old white male and concerned about my recent PSA test results. I'm waiting on a followup urologist appointment July 13 (and losing my mind in the meantime). My PSA is 19.77 and %fPSA is 3% (0.03). Prostate size is 45.1mL in volume based on an ultrasound I had done last December. These numbers are terrifying me based on everything I'm reading online. My father passed away at 66yrs old from prostate cancer, and 2 of my cousins have had their prostates removed in their 30's. What is the likelihood that this is cancer, and not just prostatitis or BPH...? The more I'm reading, the more the (very) low %fPSA is worrying me the most. Any thoughts...? 

It is good to have it checked but why at 40 are you having PSA checked  Are you having a problem.  Please relax  there could be other reason that it is up A infection prostatitis sex before the blood test or just stress.  Just relax  But most of all don't let any doctor start telling you that you need your prostate out until you have all the test to see if it is the prostate  Please let me know what happens  I am here for you if you need to talk  Ken

Contrary to some opinions you will read and given your family's unfortunate history with prostate cancer, having a PSA check was a wise decision. You might have only an infection or a very enlarged prostate, but at least you and your urologist can work together to find a suitable solution for you. If it is cancer you have options. Do your research, talk openly with your urologist and don't get too wrapped up in advice from people who tend to play doctor.

Hi Shawn,

The Urologist will probably put you on an antibiotic and then have you retest in 30-60 days. If the scores go down then you might be ok. If you get similar results then the uro will most likely recommend a biopsy. I'm not a fan of biopsies but you will need to find out if you do or do not have cancer. Not knowing is the worst way to live your life. Once you know if you do or do not have cancer, then you can determine an action plan. It may be to do nothing or to choose a procedure that will be best for you.

If the recommendation is to have a biopsy, insist on an MRI 3T guided biopsy.

If it is determined that you do have cancer, the good news is the medical community has made great strides in treating prostate cancer and there are many options with less to almost no side effects.

I'm speaking from experience as is was diagnosed with prostate cancer and underwent the HIFU procedure. I have all sexual functions and no longer have the symptoms of an enlarged prostate. My life is normal again. Just had a follow-up MRI and everything looks good. It's now been 10 months and it's almost like it never even happened. I'm not out of the woods as 10 months is not enough time but I have my life back and should the cancer rear its ugly head, I can repeat the procedure or opt for something else if needed.

Good luck to you and don't stress until you know what you do or don't have.

There are many reasons why  PSA can be elevated. For example, did you have a digital exam just before taking a blood sample? Sex, pressure, etc. can elevate your PSA. Your prostate is mildly enlarged but not particularly so. Do you have a healthy lifestyle? 

Excellent response. We need more guys like you sharing positive information. Thanks for sharing.

Thanks Ken smile Because of family history (my father's passing from prostate cancer, early onset in cousins, etc.) and for the "typical" symptoms I was having - urgency, frequency, up all night to go to the bathroom...pressure, burning. DRE & Ultrasound suggested BPH – but the Flomax meds stopped working, so had a cystoscopy and PSA / free PSA test done...that's where the scary numbers popped up.

Thanks so much smile

Thank you so much for the excellent advice, and reassurance. So happy to hear you're doing well!! Waiting seems to be the worst "side effect" so far LOL!!!

Yes You need to have it checked because of your history but try to relax  stress is not good for you.How long ago did your father pass.  My father has been gone for 15 years he had liver cancer  we have come along way with different treatments.  I was told by a doctor when I was 47 that I needed surgery.  Turned out to me a prostate infection  Good luck  Ken  

Thanks smile Sorry to hear about your father sad My Dad passed in 2012, so it'll be 5 years this November. It was detected at stage 4 and his PSA was 1600+ when it was discovered. There's definitely something to be said for early detection...!

He should check with his doctor which he is doing.  But he needs to relax  stress is not good for him.  It can make things worse.  And no one is playing doctor.  Many things can cause your PSA to go up.  He is doing what he needs to do  Have a good week  Ken

Yes there is Do what you have to. mine was 426  did every test  Take care

Sorry, Ken, but when you question him as to why he had a PSA check, that IS playing doctor. His family history is sufficient to warrant it.

I know his history but I did not know he was having problems  I have mine checked one a year and I have a colon check because my father died of liver cancer.  They told me it starts in the colon.  We do what we have to to survive. No worry we are all on here to hope if we can  Ken

mine age 49 with a 22cc (22g) prostate was 16.9 (same LUTS symptoms as you brought me in) with %free PSA 5%.  Repeated 4 days later, 9.66 and 4%.  3-T MPMRI gave 4 out of 5 on Liekhart scale.  But it was inflammation, biopsy was clear so was HOLEP samples and now it is 0.66 and longer term milder LUTS symptoms all gone.  Yours may be just inflammation too.  But given family history you should do what they say I think. 

NB adjusting for prostate size my 16.92 out of 22cc "beats" your numbers ... yet was benign.   I was scared at the time. 

paul i got prosratisus uro said i got inflammation how do you get rid of it

Thanks...no I didn't have a digital exam prior to the blood sample (nor ejaculated or excercised excessively within 24 hrs of the sample). Very healthy lifestyle. Frustrating! LOL

Hi Paul,

16.9 and 16.92 ? Are they PSA readings ? Hank