Inflammatory process and elevated PSA

You asked for my input, so I'll do my best, but warn you that my knowledge base on this topic is limited. The PSA test is flawed and full of false positives and negatives. It is known that urinary tract infections and prostatitis can cause false elevations, as can trauma, such as a digitial rectal exam or riding a bike. If multiple tests over a period of time have been stable, I might be wary of a transrectal needle biopsy. This is mainly because even if there might be a tiny cancer in there, the odds of hitting it blindly with a needle are sort of remote. Now, if the doc felt a lump during the rectal exam, that might be another story. Doing the biopsy while there is active inflammation is probably as safeas any other time, but it might prolong his flare. I just don't know for sure one way or the other. The biopsy needle is very slender though, so don't worry about that.

Unless there is a pressing urgency, I would want to get the cuff inflammation under control, then repeat the PSA to validate it. Antibiotics are not the treatment for cuffitis. You need mesalamine (Canasa) or hydrocortisone suppositories or other UC meds. Has he been consulting with a urologist? If not, it is time.

For further reading:

http://www.cancer.gov/cancerto...tsheet/detection/PSA

http://www.everydayhealth.com/...levels-are-high.aspx

Jan

Nothing much to add except my dad had a completely normal PSA, and still had prostate cancer.  Yes, PSAs are not 100%. 

I have a history of prostate cancer in the males in my family and my PSA is checked every year.  In the past 5 years my PSA has fluctuated between 1.3 and 1.6 and my last 4 readings were either 1.3 or 1.4.  This despite having chronic inflammation in the pouch and an inflamed prostate at one point about 5 years ago. Huge PSA fluctuations is what they look for to prompt a cancer screen biopsy.  When my uncle had prostate cancer he was getting screened every 6 months due to his brother, my other uncle, having gotten prostate cancer, and he went from like a 1.7 to a 3.2 to a 5 and then they biopsied him and found the cancer in his prostate.  It hadn't spread.  They did the prostatectomy on him and he has been healthy ever since, except for some urinary incontinence after the procedure.

A jump from 2 to 9 probably warrants a biopsy but I will leave the medical judgments to the doctors.  I know my uncle never had a jump that big, and he also didn't have a J Pouch or inflammation or IBD elsewhere in his body, just a bad family history.  His PSA jumps were in like increments of 1.5-2.

Jan, thank you for all your knowledgeable information. Yes, we have an appt with urologist. Canasa did not help him, however hydrocortisone does. His PSA levels for the past two years fluctuate drastically. Definitely cause for concern to us. Again, thanks for input.

Rachelraven and CTBarrister, thank you for you input as well. Very scary PSA levels.  My husband has no signs or symptoms. Guess he'll have to have the biopsy and see what happens.

Thanks