Refining What PSA Levels Mean

I am a 68 year old male who was diagnosed with a "boggy prostate" starting in my mid 30s. I started having PSA tests run in 1992. Only one time (7-1995) have I had a level below 4.0 w/o medication. I have had three negative biopsies in the last 14 years. I have had numerous prostate infections since my 30s. However since being on Proscar and it's generic, I have not had an infection in 2 years. There needs to be a better test for those like my self that suffer from prostatic enlargement (benign prostatic hyperplasia -- BPH) and/or chronic prostatic inflammation.

The article was interesting. But I thought I recently read something similar. So went to my Prostate file and Voila.I was right. In october 2007 the Johns Hopkins Health After 50 monthly magazine had verbatim the same article entitled Prostate Screening: Refining What PSA Levels Mean. So I ask: why was an eight month old article recycled in June of 2008?.

I was under the impression that Johns Hopkins was always on the cusp of health information. I'd appreciate a reply.

Thanks. DD

DD: You're right -- this article was excerped from an earlier Health After 50 article. We felt the information would be of great value to a wider audience, many of whom did not have the chance to read it in the newsletter -- which is why we used it as a Health Alert. And by the way, the informaton is still quite timely. Editor

I've read about a new test that was developed at John Hopkins to not only detect early prostate cancers but also how aggressive they are. It is called EPCA-2. What is the status of this test? Is it in clinical trials? If so, where and how would one enroll in a trial?

The EPCA test information is here at the site: EPCA-2 Test Article

and at the bottom of the page is all the contact information you need to find out more about enrolling in the trial.

My husband was diagnosed with prostate cancer,which had gone into some of his bones. His PSA level was extremely high at the time. He started taking treatments and his PSA went down drastically.He was also taking CASADEX. After awhile on the CASADEX his PSA went up. His doctor took him off the CASADEX,and the PSA went back down. It started going back up again,so he was put back on the CASADEX....now it us going back up. How high does his PSA have to get before we should really start worrying? Has this type of cancer ever been cured?

I have some serious reservations about Johns Hopkins and the information it disseminates about prostate cancer.

If I were to have listened to the information offered in your White Paper, I would have subjected myself to needless biopsy. As it is, there is enough hysteria in the field. You folks seems to be selling surgery at every turn.

My urologist called me in hysterics one night telling me based on my PSA (3.9, Free PSA 17%) I was at 25% risk of prostate cancer. He allowed that he would be happy to biopsy and if so much as one cancer cell was found he could do a radical prostatectomy and have me "home the next day." "Wow", I asked... "you mean you can have me home, incontinent and impotent the very next day?" He failed to see my sarcasm and issued another warning about how I was burying my head in the sand.

In reality I was suffering from prostatitis which was cured with a course of Levaquin and elimination of spicy food and alcohol. Indeed a graph I keep shows my free PSA has been in the same range +/- for the last ten years. There was no PSA velocity, and he should have known that. Needless to say I stopped seeing this doctor. But he, like so many others, is maiming men just like women were maimed years ago with needless mastectomies.

It would behoove you to remind your readers in each and every article that prostate cancer is common, the deadly form is not, the rate of growth is usually slow and most men will die with prostate cancer not from it.

Oh, lo and behold, 2 years after that hysterical call from the doctor who could not wait to do a biopsy, at age 60 my last PSA was 2.7 and free PSA was 25%. All quite normal given my history.

If you are going to provide information of people provide ALL of it and avoid fanning the flames of hysteria.

I have some serious reservations about Johns Hopkins and the information it disseminates about prostate cancer.

If I were to have listened to the information offered in your White Paper, I would have subjected myself to needless biopsy. As it is, there is enough hysteria in the field. You folks seems to be selling surgery at every turn.

My urologist called me in hysterics one night telling me based on my PSA (3.9, Free PSA 17%) I was at 25% risk of prostate cancer. He allowed that he would be happy to biopsy and if so much as one cancer cell was found he could do a radical prostatectomy and have me "home the next day." "Wow", I asked... "you mean you can have me home, incontinent and impotent the very next day?" He failed to see my sarcasm and issued another warning about how I was burying my head in the sand.

In reality I was suffering from prostatitis which was cured with a course of Levaquin and elimination of spicy food and alcohol. Indeed a graph I keep shows my free PSA has been in the same range +/- for the last ten years. There was no PSA velocity, and he should have known that. Needless to say I stopped seeing this doctor. But he, like so many others, is maiming men just like women were maimed years ago with needless mastectomies.

It would behoove you to remind your readers in each and every article that prostate cancer is common, the deadly form is not, the rate of growth is usually slow and most men will die with prostate cancer not from it.

Oh, lo and behold, 2 years after that hysterical call from the doctor who could not wait to do a biopsy, at age 60 my last PSA was 2.7 and free PSA was 25%. All quite normal given my history.

If you are going to provide information of people provide ALL of it and avoid fanning the flames of hysteria.

I am a 62 year old male who has just received a lab report indicating that my PSA level is 1.4. The VA Dr. suggested "internal testing" and I am not quite sure of how to proceed.

Is the 1.4 level cause for concern or should I have additional lab testing?

Thanks Bernie

Nowhere does this article comment that it is NOT a single PSA number, but a progression over a period of time... say, is the level increasing over 2 or more screenings... the misconception on "what to do" with the results of any one screening has led to this "controversy"... my levels kept rising for 6 years before breaching your "magic number" of 4... Since my "event",I have worked with over 900 men... have data on men diagnosed with pc as young as 32... with PSA levels in the 7's and not pc, and one at 2.85 with the disease... how many doctors advise men to avoid sex prior to having blood drawn?... the problem here is, sadly, a lack of a true understanding of the test, what the numbers mean,... and how to proceed...

When my pc was being diagnosed, my doctor, correctly, first treated me for an enlarged prostate and BHP... as well as a thorough "interview" to determine if there any other possible causes... and with antibiotics... ONLY then, when these were eliminated did he order a biopsy... proper medical procedure... and not a "rush to test"...

I also note the lack of any discussion of Free-PSA...

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