Brief Answer:
Most likely inflammation,please do free PSA and also send dates of PSA test

Detailed Answer:
Hi XXXX
Thanks for writing in to us.

I have read through your query in detail.
Glad to hear from you once again.

The last time we had a discussion, I remember you had a colonoscopy done and were having higher PSA levels due to inflammation. Since there is alternate rise and fall in PSA levels, it is almost clear that you do not have a malignancy. However it is important to evaluate the cause of continued infection if present.

Discussing further on elevated PSA levels, 1 in 4 people with high PSA levels proceed to have a cancer. Your PSA velocity (rate of change in velocity) is not indicative of a cancer. I wish to calculate your PSA velocity and doubling time and share it with you for your reference. I would like you to please update me on dates on which you got the PSA levels tested and the values mentioned alongside. That information can be used to calculate your PSA velocity and doubling time.

Discussing further about PSA, it circulates in the blood in two forms either free or bound to certain blood proteins. If you have a high PSA level but a low percentage of free PSA, then close follow up and ruling out cancer becomes important. This test is used for men with a PSA level in the borderline range between 4 and 10. Research shows that if more than a quarter (25%) of the total PSA is free, there is less chance of having prostate cancer. I recommend you also get a free PSA test done to know the risk of cancer if any.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Your PSA doubling time is 23.05 months which is a safe duration.

Detailed Answer:
Hi XXXX
Thanks for writing back with an update.

The PSA values and dates on statistical analysis give the following results

In Months
Slope Log (PSA)      0.03
Doubling Time      23.05 months
Velocity      0.08 ng/ml/mo

In Years
Slope Log (PSA)      0.36
Doubling Time      1.92 years
Velocity      0.95 ng/ml/yr

Conclusions derived show that your doubling time is 23.05 months (1.92 years). Should the doubling time be below 18 months then possibility of cancer is more.

As the free PSA is 20 to 23 therefore there is not much to worry about cancer.

However please continue to get PSA tested regularly and take treatment for any inflammation that you might be having. An ultrasound scan for prostate volume assessment is also required to know if an enlarged prostate is causing infections due to urinary symptoms.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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