PSA High - is this always bad news?

Hi, my other half (70 years young), has recently had a psa prostate blood test of 16 and is being referred for an mri. No other health problems and still active. Of course always fearing the worst - being so high is this likely to be cancer or could it be anything else?  He had an examination (rectal exam) 5 years earlier but showed nothing. Sorry I know that nobody has a crystal ball but any feedback would be appreciated x

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  • Hi sandwich.

    I was diagnosed with early stage prostate cancer back in 2010, and had surgery to remove it. Since then, I've had no further problems (touch wood!). I was 56 then, 64 now. 

    PSA is a good indicator for prostate problems, but not a good indicator for prostate cancer. For instance, I know someone whose PSA is around 20, and despite lots of tests, no cancer can be found.  However, my own PSA barely went over 5 and cancer was found in me. Another friend has a PSA slightly higher than mine, but again no cancer. 

    This is the problem with PSA. It's not very specific for cancer.  Still, in practice, once your PSA rises above 4 or 5, the doctors will want to exclude cancer as a possibility. When I had my diagnosis, the first step was a prostate biopsy, followed by an MRI if the biopsy was positive.  Today, the first step is a "multiparametric" MRI scan which might be followed by a biopsy if the MRI shows anything that needs checking. The advantage of this is that it can avoid the biopsy if the MRI looks ok, but also can inidicate the best place to take a biopsy sample. 

    So, to answer your question, a high PSA isn't necessarily bad news.  And in fact, prostate cancer caught early needn't be bad news either.  Obviously, no one actually wants cancer but prostate cancer caught early is very curable, and sometimes it's growing so slowly that it doesn't need treating at all. 

    I hope your other half is ok, but please let us know of any developments. 

  • This is useful. Thanks for posting. I went for an MRI back in June after a PSA test of 11.3. They mentioned that there was a small anomoly on the results but my PSA reading subsequently came down to 4 or 5 so they didn't do a biopsy. A recent test produced a result of 16.8 alongside a CRP OF 28. This is a worry; I wonder if anyone else has had a similar experience in relation to blood test ?

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  • This is useful. Thanks for posting. I went for an MRI back in June after a PSA test of 11.3. They mentioned that there was a small anomoly on the results but my PSA reading subsequently came down to 4 or 5 so they didn't do a biopsy. A recent test produced a result of 16.8 alongside a CRP OF 28. This is a worry; I wonder if anyone else has had a similar experience in relation to blood test ?

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