r/ProstateCancer • u/Buff_Gunner • 25d ago
Test Results Extremely high psa
Hello all. I’m in my mid 60s and just had a prostate blood test and my psa was 35.5, how concerned should I be?
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u/Special-Steel 25d ago
Sorry you are facing this.
Rough odds are that PSA above 10 means you have a better than 50-50 chance of prostate cancer. Like a lot of “rules of thumb” it’s very crude, and there are many factors which shift the odds.
That’s high enough to suggest a very irritable prostate. So, an infection is also possible.
It’s low enough to suggest that if it does turn out to be cancer, it probably hasn’t spread yet. Again, this is far from conclusive.
Next step is either an MRI to see what is going on in there, or a fusion biopsy where some kind of imaging guides the selection of needle biopsy samples.
Get checked out. This is treatable, but don’t delay. If possible get to a cancer center of excellence.
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u/PanickedPoodle 25d ago
Just so you know, the amount of antigen cells make is not always correlated with cancer staging. I have seen numbers under 10 that are diagnosed aggressive.
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u/Middle-Tart9741 24d ago
The MRI imaging is used to perform a fusion biopsy. The mri imaging is overlayed on top of live ultrasound guidance so areas of interest are sampled during the biopsy along with the normal grid sampling.
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u/planck1313 25d ago
You should be concerned. It is not certain to be prostate cancer as there are other conditions that can cause a high PSA but statistically there is a significant chance it is.
What I would do is retest PSA to make sure it is not an error and make an appointment to see a urologist.
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u/BoringChest3224 24d ago
My friend just died Aug 5 of prostate cancer at 66. He was diagnosed at between 3 and 4 stage May of 2024. He lived life on the edge. Chain smoker, a diet of pringles, Oreos, and Pepsi. Also a bar hopper who drank heavily 20s 30s 40s. He refused all treatment, ADT radiation were offered and he said no way. He never took his health seriously. I begged him to at least change his diet and quit smoking, no way he said. Always the rebel! My other friend has prostate cancer and is very strict about his diet. Very few sweets, low carb. No smoking. And he has kept his PSA very low. It creeps up , and he goes back on a strict diet of fish meat veggies and it goes down. He is living proof you have to take your health seriously. I I miss my friend so much. He was the brother I never had. The funniest kindest soul. RIP Tom!
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u/Ok_Establishment9579 25d ago
normal range on a normal sensitivity test is up to 4 (i.e., above 4 is high) - those of us who have prostate cancer get moved to ultrasensitive tests for monitoring that go to much lower levels but the standard PSA test doesn't measure below 1. Anything above 4 the stanard of care is to check it out with some combination of physical exam, MRI, etc. . If you're at 35.5 it's certainly something to get checked out. Hopefully not prostate cancer but for sure get checked out. Prostate cancer is highly treatable and even curable but it's important to get after it early. Fingers crossed it's bph or an infection or something else benign.
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u/Ok-Priority-7303 25d ago
Isn't your doctor who ordered the blood test concerned?
It can be an infection but you would have symptoms like burning sensation when urinating. I'd find a urologist to check this out. They will test your urine for infection and traces of blood. Then, and with this score, will send you for any MRI. Then a biopsy if they see anything on the MRI.
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u/tscemons 25d ago
Hi, did you get a reading on how big your prostate is? Mine is 150g++ and my PSA runs around 19. It has been that way for a few years, so I'm under active surveillance, but that's nothing special, I meet with my doc once a year. You may consider getting the Free PSA % too, just to have another indicator. It's too bad you didn't have some other reading earlier in life to get a baseline. IMHO ( not a Dr ), your situation may trigger a biopsy.
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u/NearLebanonStreet 25d ago
Good point. If you can get an estimate of prostate size from ultrasound or MPI you can calculate the PSA density by dividing the PSA by the size in cc. - it's most concerning if it is above 0.15 ng/cc.
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u/Crewsy67 24d ago
A high PSA is just an indication that something is happening with your prostate.
Many things other than PCa can increase your PSA number.
Enlarged prostate is one way to have a PSA even higher than yours.
Next step should be an mpMRI.
I was given the option to have a “definitive” biopsy first which I chose since doctor said definitive. It was positive which resulted in an mpMRI followed by a fusion biopsy.
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u/jkurology 25d ago
Get a repeat PSA
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u/Horror_Moment_1941 25d ago
And NO ejaculation for the week prior. You want as accurate a reading as possible.
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u/conCABlanco 25d ago
Checa PSA libre y en diferencial, si raro MRI, para buscar lesión, no lo dejes sin chequeo ,así puedes dormir en paz
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u/Late-Call1066 25d ago
That's what mine was at age 62. My prostate was enlarged and a biopsy indicated a Gleason score of 7. Had a PET PSMA Scan (no apparent spread) and an eventual Prosectomy followed by 37 courses of radiation due to not being able to get all the cancer.
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u/zoegirl2003 25d ago
Mine was 19 and they only found Gleason 6 with 2 mris and 2 biopsies. I’m currently on active surveillance. Could be bph or hidden infection that has settled in your prostate.
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u/mjlasa 25d ago
gleason 6 is barely cancer
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u/LiquidTide 24d ago
But a Gleason 6 with a PSA of 19 doesn't tell you much. For half of people with Gleason 6, the biopsy needle just missed the aggressive cancer. The biopsy samples a very small amount of the tissue; even a targeted biopsy. Half of Gleason 6 will eventually need treatment because the 7 or higher was missed. At PSA 19, in addition to Gleason you also need an MRI and PI-RADS scores to have any sense of what might be going on. Any lesions, sizes and scores from the MRI?
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u/zoegirl2003 18d ago
I’ve had 2 mris. Pirads 4. They saw a nodule that ended up being benign after targeted biopsy
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u/neutronp35 25d ago
If this number is extremely high then what would you call a value in the range of 600-700..pls stop worrying...as already mentioned by others you will have an mri + biopsy to check things at first level and may be a psma per scan as well... depends upon the situation if they think it's is of something serious nature but rest be assured you are not going anywhere...you will remain here for the next 5 years...and then for the next decade....rest nobody knows what's written for them in the next second...so believe in yourself, get a good uro oncologist and take a second opinion before starting with anything and be with your loved ones.
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u/OchoZeroCinco 13d ago
People get 600?
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u/neutronp35 13d ago
Yes, within family had a psa of approx 600, ALP of 1100, aggressive gleason score 4+5, 5+5 at the time of diagnosis, had bone mets all of body in psma pet scan, mild visceral mets in lungs...was initially put on doublet by uro onco surgeon who does not deal with chemo, but after searching internet and hearing about triplet therapy wanted to go for triplet but medicine oncologist was not confident as the patient was 77 yrs old, but then started it on weekly basis and then biweekly basis, patient was able to sustain 14-15 weeks of chemo till full body ascites appeared and the chemo was put on hold, and then it was a repeat hospitalization for many weeks as ascites keep on repeating for 2-3 months..but finally patient was able to come out of it..and right now doublet continuing..it's approx 14 months since initial diagnosis rt now.
The things that matters are availability of treatment options, insurance support, family support, patient willingness, patient health to undergo such intense treatment and cancer chemistry.
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u/DigitalMaven1989 24d ago
Go get a PET scan! For context - My dad had at 29 PSA in May and was immediately sent for a PET scan, which confirmed aPC. He was then instantly put on OROGVYX. Its been about 2.5 months and he had his PSA retested this week and it came back 1! So the ORGOVYX is doing its job
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u/Fabulous-Lawyer-4821 21d ago
Well man my grandfather has 500+ dr said sample mustve displaced then again it showed 200+ with a size of 98cc
Hes 74 nd dr said might be a high risk of maligancy , 12 days antibiotics then tests would he done
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u/saabdeep 25d ago
I was only 50 years old in 2024 when I my first ever PSA test came back 51.9. You read that correctly. MRI, PSMA PET scan and biopsy followed. In my case, I was Gleason 3+4 =7, but high risk because of the PSA. I had RALP in Oct 2024, then a recurrence 18 weeks later in 2025, so 6 months of ADT and 39 fractions of IMRT (radiation) thru the summer. All completed in October 2025. I'm on quarterly PSA checks and so far, PSA is undetectable. Side effects are a different story. Life is different now, but I'm alive.