PSA high but steady.... don't panic!

[simon43]

I'm in Thailand right now, but going back to Myanmar in a week or so.  Therefore, I decided to have a PSA and urine culture test.

 

I post these results to demonstrate that a high PSA number doesn't always mean that you have prostate cancer, although any increasing value or value above the norm needs to be investigated.

 

Here are my PSA numbers tested in the same lab since 2022.

 

October 2022 = 11.234 H ng/mL
September 2023 = 11.313
June 2024 = 8.927
February 2025 = 10.702

 

The October 2022 number prompted me to have a prostate MRI and then a 24-sample biopsy, to identify the cause of this high value.  2 benign prostate stones and a lot of ESBL (resistant to antibiotics) E.Coli bacteria were found, but no cancer cells.

 

Since 2022, the E.Coli UTI has been present throughout, and this, plus my mild BPH, plus the calcium stones, all result in what could be an alarmingly high PSA number.  However, you can see that the PSA number does not have an increasing trend, but fluctuates around a value of 11.

 

The UTI doesn't cause me too much discomfort.  I have previously discussed on this forum about getting the UTI treated with suitable (expensive) drugs, but unless there is a serious medical reason to do this, I guess I'll 'hang fire' on that 🙂

[Card]

25 minutes ago, simon43 said:

I'm in Thailand right now, but going back to Myanmar in a week or so.  Therefore, I decided to have a PSA and urine culture test.

 

I post these results to demonstrate that a high PSA number doesn't always mean that you have prostate cancer, although any increasing value or value above the norm needs to be investigated.

 

Here are my PSA numbers tested in the same lab since 2022.

 

October 2022 = 11.234 H ng/mL
September 2023 = 11.313
June 2024 = 8.927
February 2025 = 10.702

 

The October 2022 number prompted me to have a prostate MRI and then a 24-sample biopsy, to identify the cause of this high value.  2 benign prostate stones and a lot of ESBL (resistant to antibiotics) E.Coli bacteria were found, but no cancer cells.

 

Since 2022, the E.Coli UTI has been present throughout, and this, plus my mild BPH, plus the calcium stones, all result in what could be an alarmingly high PSA number.  However, you can see that the PSA number does not have an increasing trend, but fluctuates around a value of 11.

 

The UTI doesn't cause me too much discomfort.  I have previously discussed on this forum about getting the UTI treated with suitable (expensive) drugs, but unless there is a serious medical reason to do this, I guess I'll 'hang fire' on that 🙂

Why did u have a biopsy after your MRI? Was the MRI inconclusive. I've had 3 prostate MRI and none gave rise to a biopsy recommendation.

[John49]

Quote from my recent post on 5 Feb.:

 

"Recently, my PSA stated to creep up to 5, then 6, then 7.

I had a prostate MRI that was inconclusive.

This was a mistake, the wrong test, as this test lacks accuracy.

I followed up with the more accurate mpMRI – cancer indicated."

 

 This may be relevant here.

My first prostate MRI was done on the wrong kind of machine (I wish they had told me).

I waste several months of possible treatment, until I was tested on the more modern and expensive machine (Tesla 3).

 

Another quote:

"MRI scans produce pictures from angles all around the body and shows up soft tissues very clearly.

The multiparametric MRI (mpMRI) is a special type of MRI scan that produces a more detailed picture of your prostate gland than a standard MRI scan does."

[simon43]

3 hours ago, Card said:

Why did u have a biopsy after your MRI? Was the MRI inconclusive. I've had 3 prostate MRI and none gave rise to a biopsy recommendation.

I had the biopsy because the MRI that was performed at Bumrungrad showed 2 'lumps' still contained within my prostate.  The doctor suspected that these were cancerous growths and a biopsy was advised.  However, the biopsy found no cancer cells but 2 benign calcium stones, (which are not cancerous, but still do affect my PSA values, BPH, UTIs etc)

[Card]

8 minutes ago, simon43 said:

I had the biopsy because the MRI that was performed at Bumrungrad showed 2 'lumps' still contained within my prostate.  The doctor suspected that these were cancerous growths and a biopsy was advised.  However, the biopsy found no cancer cells but 2 benign calcium stones, (which are not cancerous, but still do affect my PSA values, BPH, UTIs etc)

My MRI showed various anomalies but the computer program (PI-RADS) that analyses the scans gives a score from 1-5 as to the probability of cancer, 1= very low, 2=low,3=intermediate,4=high and 5=very high. In all cases my score was 2 and since 2 docs did not recommend about a biopsy I assume they are clear. They were done on a 3T machine which I think means from 3 different angles.

What was your score?

 

 

[simon43]

2 hours ago, Card said:

What was your score?

 

 

T3a, but the Thai doctor wasn't sure if the lumps that the MRI found were absolutely likely to be cancerous and therefore advised a biopsy.  My UK doctor who performed the biopsy said - on first looking at the MRI scans provided by Bumrungrad, that he thought that they were not cancerous, and he was correct.

[Thailand J]

5 hours ago, John49 said:

My first prostate MRI was done on the wrong kind of machine (I wish they had told me).

I waste several months of possible treatment, until I was tested on the more modern and expensive machine (Tesla 3).

Using 3 Tesla MRI to investigate prostate cost 63,000B at Bumrungrad, 32,000B at bangkok Pattaya Hospital. Using 1.5T cost a lot less at Payathai Siriraj.

 

1.5 T with endorectal coil is good enough for prostate examination:

https://ajronline.org/doi/10.2214/AJR.04.1584