Hello doctor, My husband needs help. He is a 68-year-old male with a high PSA level of 8.65. It has gone from 5.3 to 8.65 in a year. Now, let me give you the facts. We believe at his age, he might have an enlarged prostate, but none of the two doctors he has seen in the past one year has told him so. We also believe that because of his acidosis, the inflammation in his digestive system may have also contributed to this high number. He takes a lot of herbal supplements, about 15 per day, and this too may have attributed to his high number. Because of the acidosis, he has developed gluten problems and just does not eat like he used to, so he lost 25 pounds in the year. He was tested this past year and his prostate number was 6. They did a DRE test and found a nodule for which he had a transrectal ultrasound and sonogram of his prostate, liver, and kidneys, and all were alright. They just put on the report that maybe he should have more tests run. His current doctor only wants to discuss biopsies and will not listen to the reasons we have listed below. He is healthy and has no symptoms. I just need another opinion because I do not want my husband to have unneeded biopsies. We will consider an MRI, but what we want to know is this. Does it make a difference if his free PSA percentage score is 32 % as we read if it were over 25 %, chances are he does not have cancer and does it not seem plausible with the transrectal ultrasound and sonogram that he does not have cancer? Please advise. Thank you so very much for being out there for us.
Hi, Welcome back to icliniq.com. I have gone through your query and would like to know the size of his prostate on the ultrasound scan. An increase from 5.3 to 8 in a year is significant and so is a nodule in the prostate. A free PSA (prostate-specific antigen) test can give an idea of the possibility of it not being cancer, but it is not foolproof and cannot confirm. So, I would not make a decision only on the basis of that. At your age and the given PSA levels and nodule in your prostate, you definitely need evaluation to rule out prostate cancer. An MRI initially is now becoming an option, but again a negative MRI is not sensitive enough to rule out prostate cancer. I too agree with your urologist that you need a biopsy, though it may be negative in 25 % of cases, it is for early detection of prostate cancer which gives you much better outcomes. Hope this was helpful, feel free to revert back with any questions. For further queries consult a urologist online -->