Prostate cancer runs rampant in my family. I won’t bore you with the details, but it seems like most of the guys in my family are diagnosed with the disease when they hit their 60’s or 70’s.
So as a younger guy, this definitely got my attention. What to do? For starters, I was way more vigilant in checking my PSA level than your average Joe might have been.
As you can see from the graph below, I had been experiencing a pretty-steady, but slow rise over the years – then a big jump from PSA level 3 to 7 in one year.
I had a feeling it (prostate cancer) was coming, but when it looked like it had finally arrived, I couldn’t believe it. In fact I called up the lab testing company and argued with them. “How could this number jump so much in such a short time? It has to be a mistake.” Of course, the young girl/customer service rep on the other end of the line couldn’t possibly help me. She didn’t know me from Adam.
I repeated the PSA test, and this time it came in even higher than before. Something was up. Ok, time to schedule an appointment with the doc.
SIDEBAR: PSA Velocity – When my PSA jumped from 3 to 7, that reminded me of something I had read about PSA velocity. It’s suspicious when your PSA all-of-a-sudden starts rising at an unusually fast rate and, as much as I didn’t want to believe it, that was exactly what mine was doing. PSA Velocity = “rate of rise.”
I had a needle biopsy done in my doctor’s office (see the link here for my step by step process of prostate biopsy). He inserted 12 needles into my prostate gland and – with each one – pulled out a small-cylinder, core sample, and you know what? They all came back negative – no cancer. Wow, a free pass, I had just been given a great gift, or so I thought.
Knowing what I know now, I am pretty sure that I did have prostate cancer at that time. It’s just that a biopsy does not or cannot test the whole gland. It’s not practical. So a needle biopsy is basically a “sampling” process. It’s not a 100% test. It’s the best the docs can do short of removing your whole gland in surgery and examining it under a microscope in a pathology lab. So doctors do the next best thing – they take “samples” all around your prostate gland looking for cancer.
So I was perfectly happy to sit this one out – ignorance is bliss right? My (wrong) thinking was that if I didn’t have prostate cancer at PSA 7, then I get a free pass until it moves up further. Well, it took a surprising 3 more years until it jumped again into the lower 9 range.
I waited all of those 3 years before I had my second biopsy, even though my doc had suggested I do one earlier. The second biopsy revealed some cancerous cells in one of the twelve core samples. And only 5% of that one sample contained prostate cancer.
This entire website is all about how I proceeded to treat my case of prostate cancer, but I guarantee you that every case of prostate cancer is different. Just ask your doctor.
After I elected to have prostate surgery, my PSA quickly fell to zero, or undetectable, or <.01 ng/mL and has stayed there ever since. Update: my PSA is still zero as of May 2, 2018.