PSA test...looking for opinions?

[bb]

I need to go in for some routine blood work tomorrow, and am trying to decide whether or not to ask for a PSA test as part of it. I know prostatitis can cause elevated PSA numbers, but at the same time since I'm *mostly* symptom free at the moment I'm not sure if it will have an effect. I'm curious what everyone thinks....basically my situation is this:

- Late Nov. of '06 I had a routine physical, including my first ever DRE (what fun ) and blood work including a PSA test. DRE was normal, no real discomfort for me (aside from having someone's finger up my butt!), PSA was 1.0. At this point I had no prostatitis symptoms, and had never even heard of it before.

- Mid Dec. of '06 I developed symptoms - mainly discomfort *after* urinating, particularly in the tip of the penis, sensitivity in the tip of the penis after urinating (i.e. clothes touching it increased the discomfort). A couple of weeks later I started dribbling a bit after urinating as well (6 - 10 drops, maybe).

- Early Jan. of '07 I visited the urologist. He checked my urine and did a DRE (2 in 2 months...lucky me!!). This DRE was uncomfortable for me; the prostate felt warm/burned a bit when pressed, and just generally felt uncomfortable. Doctor said my prostate was a little inflamed, diagnosed me with a mild case of prostatitis, put me on AB and Uroxatral.

- Mid Jan. of '07 I had a follow up on my physical, including bloodwork (I'm now on Lipitor for high cholesterol and they're checking liver function). Asked for a PSA test as part of this, it's now 1.4. From everything I've read, this is expected with prostatitis, but it still worries me a bit because obviously it jumped .4 in a period of 6 weeks.

- Early Feb. of '07 I had a follow-up with my urologist; most of my symptoms have disappeared, though I still have the issue with dribbling. He did yet another DRE, no discomfort for me this time, he said my prostate didn't feel inflamed anymore, and he sent me on my way.

So that's where things stand today...basically dribbling is my only current symptom, even though supposedly I no longer have inflammation. I've got more bloodwork scheduled for tomorrow, and am trying to decide whether to ask for another PSA test or not. On the one hand, if my prostatitis symptoms are less, I'd expect the PSA number to go down if the prostatitis was in fact what caused it to go higher. On the other hand, I don't know if the fact that most of my symptoms are gone really means anything. If I do have a serious problem I'd obviously rather find out sooner than later, but I also don't want to go through a lot of extra stress and headache if in fact the number is going to be meaningless anyway.

Anybody gone down this path before?

Thanks!

[carld]

Very tough question. Sometimes this can only cause problems when you have PSA's done at an early age. My Uro said at 40 if you have a history of prostate cancer in the family. Since your 41 now and you already have a baseline now, no reason to not have it done. You know that prostate inflammation can raise the PSA. This is really something you need to go over with your general doctor.

In my case, my Father had prostate cancer so I had it done before I ever saw my Uro or ever heard of prostatitis when I was 36. My Uro told me to get it done @ 40. I have had 2 PSA's the last 2 years in my anual physicals. Pre prostatitis I was .075 and when I was full blown inflamed and discomfort I was .095. So did it go up due to the inflammation? Probably...At least I have a baseline prior to on set so I know...You know???

[JonP]

Here are a couple of links that might be food for thought.

http://www.cancercouncil.com.au/editori ... pageid=936

http://www.abc.net.au/7.30/content/2003/s796549.htm

[bb]

Carl, those look like great PSA numbers!

I know there's a lot of debate on this subject, and a lot has been written. I guess in my view it's just information, and ultimately it's up to me to decide what to do based on it. So I opted to get the PSA test done as part of this blood test. It came back 0.9, which made me happy, since in my (admittedly simple) view of the world, PSA went up when my symptoms got worse, therefore my PSA should go down when my symptoms get better. And that's what appears to have happened here...I had more symptoms in early January, and my PSA went from 1.0 to 1.4. I've got fewer symptoms now, and I've dropped from 1.4 to 0.9. So at least it seems to make some sense (which in reality is probably meaningless because there are so many factors that come in to play, but that's o.k....).