PSA 1.3 (2017) 4.3 (latest, this month) extreme velocity?

[u/Friburg_163]

66yo overall good health. So this is driving me crazy because I keep over analyzing and did another AI search on velocity ( it seems bad according to AI search results ) Historically PSA numbers from logs:

1.3 - 3/2017

1.3 - 11/2018

1.88 - 9/2021

2.13 - 1/2023 (63 yo mark)

2.54 - 3/2024

3.17 - 5/2024 ( second test in ‘24)

4.01 - 2/2025

4.3 - 6/2025

4.7 - 7/2025 ( Free PSA 17% function health - Quest )

4.3 - 8/2025 ( Free PSA 18.8%)

4.3 - 8/2025 ( Free PSA 21.9% - second test in August )

Most of these were done by quest, but the newer ones are from Labcorp except the one from Function Health.

Have an MRI scheduled for this coming month ( 12th ) my PCP will only refer to a urologist after the MRI results are in. But this seems like a classic overlook thru the years right?

Really upset here - thanks as always for your input

[u/planck1313]

1.3 to.4.3 in 8 years is not extreme but a slow steady rise to a PSA > 4 is concerning and you're wise to get an MRI.

[u/umri_stilno → u/planck1313]

What is the purpose of doing an MRI?

[u/Current-Second600 → u/umri_stilno]

MRI is to take a look at the prostate for lesions

[u/umri_stilno → u/Current-Second600]

It is clear that it is for searching something. And have you considered transvesical or transrectal ultrasound?

[u/runsonpedals]

I’m 64 years old and had similar psa numbers. A 4.3 corresponds to moderate bph (I’m at 4.1 and have prostate of 40cc on mri). I order and schedule my own tests at Quest. Just had mri and they found 1 pi-rad 4 lesion that is “contained” and I’m scheduled for biopsy shortly. I’ve expected this b/c my dad was diagnosed at 64 also and I have a genetic defect putting me at a 40% higher risk. I’m assuming I have cancer.

Your psa levels are on a classic age progression increase and many males have the same numbers with no cancer. It’s only when the increase moves quickly from 2 to 4 in a year and bounce around that concern arises such as yours. Mine did the same.

I’ve had many years of knowing I would have this issue and have prepared myself for it. You need to do the same. It’s likely just age progression, but if not your psa numbers are low and it’s an early stage cancer like mine.

I understand the anxiety. Come to terms with it.

Get your body ready by eating clean, good sleep, and exercise.

[u/Friburg_163 → u/runsonpedals]

Thanks for your input. Wish I was more proactive as you in keeping track of this very important test. My previous PCP, wasn’t of much help in alerting me on these levels climbing ( frustrating but bet many PCP from work health plans are similar) .. Only after I’ve started care under a Medicare Advantage plan, that my new PCP made a comment as to watch PSA levels. Now I’m kinda on a waiting mode to see how this will progress after the MRI. I feel that my urinary symptoms are typical of older man, slow flow/dribbling and sudden urge to go at times. Maybe one max two run to the bathroom at night. I’ve always been active and try maintaining myself in decent condition physically. Will try and get better with more core focus as times goes by in this diagnose process. I’ve got some cancer deaths on my dad’s side including him but I’m pretty sure it wasn’t PCa ( we heard stomach ) back then. I’m in Florida, Tampa Bay Area and have some extended family that treated cancer at Moffitt but my Medicare Adv plan isn’t in network from what understand but I’ve also heard they are accommodating to out of network as been a center of excellence I’d go there if possible. Actually I’m not sure in there are any other Centers of Excellence in this area — maybe someone could chime in. I have the MRI coming up but no access to a urologist referral until after these results tho - again really appreciate it!

[u/callmegorn]

Those results are consistent with both BPH and and cancer. If the latter, it is probably low to intermediate grade. There is no need to overanalyze it, because the MRI will tell the tale.

If the MRI comes back showing a moderately enlarged prostate, say 55cc, but no suspicious nodules, then you can pretty much relax, as a PSA of 4.3 would be within the normal range.

If the MRI comes back showing a small prostate, say 25cc, then the number would be concerning. Or, of course, if suspicious nodules are found. In that case, you'd be looking forward to a biopsy.

[u/delawaredave]

You're doing the right things. That progression could be either BPH or cancer. Doubtful aggressive type - would be spiking higher faster. Take care.

[u/Adept-Wrongdoer-8192]

As others have said, not rapid. I had my PSA go from 7 to 14 in 6 months, that was rapid! LOL

You are on the right next step with the MRI. I know it is hard to keep calm, but you will have to wait until you get the MRI results to see what is next.

[u/Friburg_163 → u/Adept-Wrongdoer-8192]

Thank you for the kind reply. I’m trying to get informed and this group has been excellent and extremely friendly. Yeah I’m nervous about the unknown at this point

[u/Friburg_163]

Thanks everyone for the valuable feedback- really appreciated

[u/Friburg_163]

Is anyone here around the Tampa Bay Area in Florida, as far as treatment option at centers of excellence or real good quality practices. I know Moffitt is outstanding but my plan isn’t in network as far as I know