Alan J. Wein, MD
Last Modified: February 3, 2002
Dear OncoLink "Ask The Experts,"
I am 53. My PSA has been in the mid 2's for several years. Last test jumped from a 2.3 to 7.1. Digital Rectal Exam (DRE) is normal. My question is: In prostate cancer, is it typical that a PSA would rise that fast in six months, or is this more likely something else? I will follow through with my doctor, but I need a better understanding of the pattern of PSA acceleration in a progression to prostate cancer.
Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine and Chief of Urology at the Hospital of the University of Pennsylvania, responds:
Normally, the PSA level should not rise more than 0.75 units per year or more than 20% of the previous value. Any rise over this is abnormal. So, a rise from 2.3 to 7.1 in six months would indeed be unusual. In a situation such as yours, we recommend antibiotics for 2 weeks because an infectious process involving the prostate is possible. Thereafter, a repeat PSA would be recommended with no ejaculation or exercise 2 days prior. If the PSA remains elevated a prostate needle biopsy is generally recommended.