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Urology/Rise in PSA from 1.3 to 1.8

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Question
I am now 67 years old, and have gradually developed some symptoms which I believe suggest BPH. [not on Proscar etc.].
However, my PSA is now 1.8 [risen 0.5 over 18 months]. I have had retrograde ejaculation for 8+ years.

Prior PSA:
05/11 =1.3
11/10= 1.1
04/10= 1.1
04/09= 1.2
10/08= 1.1
01/08= 0.9
11/07= 0.8
07/07= 1.1
12/05= 0.8
01/05= 0.6
07/04= 0.7
10/02= 0.9
08/02= 0.9
05/98= 0.9
What is the liklihood of this as an indication of my having developed cancer?
Thanks!

Answer
Steven:

You've had a small but significant % rise in PSA since your last testing.  I would try a 30 day course fo antibiotics like Cipro and repeat the PSA test.  If it remains elevated, then consider a biopsy.  If it goes back down to within 25% of 1.3, then continue monitoring.  We generally get a little concerned when we see a persistent rise of more than 25% per year that is not reducible with antibiotics.

The fact that you have symptoms suggests you need treatment such a finasteride or alfuzosin.  Talk to your physician about this.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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