Am really impressed by the level of open, frank discussion on this thread. Topics like prostate cancer and it’s side effects used to be embarrassing for way too many men to discuss. It is very encouraging to see that, at least here, that is not the case!
I am 62 1/2, and my last PSA was 5.2. The number has risen slowly and steadily over over the last 6 years. In 2013, it was 3.6. Went to the urologist, and a DR exam revealed no lumps, just enlargement. The doc offered a biopsy, but told me about the possible complications. He also told me about relatively a new blood test called the 4Kscore.
https://4kscore.com/
Had this test done, and it came back with a 7% probability of cancer. Went back for another visit, and asked how would he decide which parts of the prostate to biopsy. With no obvious targets, he ordered an MRI. That did not show any lesions or other abnormalities, so for now, we agreed to wait and see. The doc also told me that he looks for two things when insisting on a biopsy: a non-linear change in PSA level, or a PSA number that is greater than 10% of the size of the prostate. Mine is 70 grams, with is getting large, but at 5.2, am still under the 10% threshold. I suspect it’s only a matter of time, but knock on wood, am not yet having any significant issues yet from the enlarged gland.
What makes this all confusing is that there appears to be lots of exceptions to the rules. My 67 year old friend went from 1.2 to 1.5 in a year with his PSA, and his biopsy came back positive. So absolute PSA level doesn’t seem to matter. Also, as Steve above said, you can easily have a biopsy come back without finding any target cancer cells. None of the blood tests are definitive, and while an MRI can show lumps and bumps, it can not be used to rule out cancer.
Oh well, the joy of getting older. At least when we get past 70, prostate cancer is supposed to grow much slower. I try not to think about it too much - this stuff can drive a guy nuts - but I will be having another DR and blood work for PSA level before the year is up.