PSA level spikes in my bloodwork might be indicative of undiagnosed cancer.

[Dr.Chowder]

31 male here

Risks of testosterone replacement therapy in men - PMC

Testosterone replacement therapy (TRT) is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as ...

www.ncbi.nlm.nih.gov

In this study it mentions the following:

"Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy."

This is my bloodwork done before treatment and after about 7 weeks on TRT.

My blood went from 1.76 to 2.98. Almost doubling.

I will attach the rest of my bloodwork and I would greatly appreciate any insight to this. What is my next step to get checked for a possible prostate cancer?

Edit: My doctor prescribed me TRT after looking at my initial lab results and hearing me describe my symptoms of low T. I was first prescribed 160mg of testosterone once weekly, Clomid 50g on MWF and Anastrozole .5mg once weekly. After my2nd bloodwork came in that was done on week 7 of trt, my doctor chose to lower my T injection to 120mg a week. I am going to receive my 2nd dose of 120mg test today and hoping to talk with my doctor soon to see if lowering the T fixes the other bad numbers on here.

 

[rot-iron66]

TRT can raise PSA some, but you are still in safe numbers, anything <5.0 I believe...

 

[Tuffoldman]

Are you on any other medications?

You take very many NSAIDs?

Are you taking any high blood pressure medicine?


Are you on any cholesterol controlling medicine?

Do you take any diuretics?


The jump in your PSA in that short of time is something to be concerned about but there are several factors that can increase PSA before a blood test including all of the above questions. Sex/ejaculation shortly before doing a PSA test can also increase PSA levels.

There is either a lot more to this picture or you need to go see an oncologist and an endocrinologist.

 

[Dr.Chowder]

Are you on any other medications?

You take very many NSAIDs?

Are you taking any high blood pressure medicine?


Are you on any cholesterol controlling medicine?

Do you take any diuretics?


The jump in your PSA in that short of time is something to be concerned about but there are several factors that can increase PSA before a blood test including all of the above questions. Sex/ejaculation shortly before doing a PSA test can also increase PSA levels.

There is either a lot more to this picture or you need to go see an oncologist and an endocrinologist.

I take Cialis 5mg every day off an on because I have been reading about the benefits of it when in the gym. Sometimes I will take a 100mg viagra to enjoy a special evening with the wife. Would these medications affect PSA levels? Besides for the obvious that taking these medications does lead me to have more sexual activity.

besides that, no other medications and I take vitamins that I will post a picture of instead of listing them all here.

EDIT: I have taken NSAIDs like ibuprofen before but have not had any in a few years now. I never had a bad reaction to these kinds of medications
I am not on any diuretics except I drink coffee twice a day so lots of caffeine.
My sex drive has been out of absolute control since I started and it was more of a plague than a blessing because I was having sexual activity 3 to 4 times every day since a few weeks of being on TRT. Could having sex or masturbating 3 to 4 times a day leading to this test cause this?

 

[Dr.Chowder]

TRT can raise PSA some, but you are still in safe numbers, anything <5.0 I believe...

My doc did mention that it wasnt high enough to cause alarm on its own but instead its the leap to a higher level in such a short time that has him concerned.

 

[Tuffoldman]

No Viagra Cialis etc does not affect PSA. In fact I can actually help those with BPH.


Based on the information you just gave my suggestion was to call an oncologist or probably need to see your general practitioner and be referred but I would not hesitate that is a big jump and you are out of range for your age.

 

[Dr.Chowder]

No Viagra Cialis etc does not affect PSA. In fact I can actually help those with BPH.


Based on the information you just gave my suggestion was to call an oncologist or probably need to see your general practitioner and be referred but I would not hesitate that is a big jump and you are out of range for your age.

I really appriciate your information and suggestions. Going to look into seeing a professional now about it. I will also talk with my trt doctor over the phone today and I will keep this thread updated

 

[Dr.Chowder]

Change in PSA Level Does Not Predict Prostate Cancer

Researchers at Memorial Sloan Kettering Cancer Center have found that change in PSA levels over time - known as PSA velocity - is a poor predictor of prostate cancer and may lead to many unnecessary biopsies.

www.mskcc.org

Another article I found discussing this but with a different perspective. Here they claim PSA levels are not accurate for determining prostate cancer.

I think a biopsy might be in my future to complete a diagnosis if thats really what is going on.

 

[Tuffoldman]

Although you are out of range you are very young to have anything close to three as a PSA.

Everybody is different but I am almost 56 I've been on trt for 20 years and mine is under 1.14

 

[Tuffoldman]

The article listed above has gone back and forth for several years that I've seen where they said PSA was the best form to check before biopsies and then they'll be other articles saying elevated PSA doesn't necessarily mean there's an issue.

With yours jumping that much in that short of time and to the level that it is based on your page not saying I would be concerned but I would be vigilant in getting an opinion from a qualified doctor that is going to look beyond just oh it's under a three it's okay. You are very young unless you have a family history of high PSA which most guys don't talk about this stuff so you may not even know.

The one thing is be very very clear with your doctor and if you go to a doctor and they say oh it's because you're on trt find another doctor. Some doctors are completely against testosterone replacement because they know nothing about it so they strike it down as the end all beat all health detriment to anybody on it.


Like I mentioned I've been on it for 20 years. My only downfall from being on trt is high red blood count and it does throw my cholesterol ratios out of whack a little bit.

 

[Dr.Chowder]

The article listed above has gone back and forth for several years that I've seen where they said PSA was the best form to check before biopsies and then they'll be other articles saying elevated PSA doesn't necessarily mean there's an issue.

With yours jumping that much in that short of time and to the level that it is based on your page not saying I would be concerned but I would be vigilant in getting an opinion from a qualified doctor that is going to look beyond just oh it's under a three it's okay. You are very young unless you have a family history of high PSA which most guys don't talk about this stuff so you may not even know.

The one thing is be very very clear with your doctor and if you go to a doctor and they say oh it's because you're on trt find another doctor. Some doctors are completely against testosterone replacement because they know nothing about it so they strike it down as the end all beat all health detriment to anybody on it.


Like I mentioned I've been on it for 20 years. My only downfall from being on trt is high red blood count and it does throw my cholesterol ratios out of whack a little bit.

Have you ever donated blood to help with red blood count? I heard this is the solution for it but is it that simple?

 

[Bigtex]

31 male here

Risks of testosterone replacement therapy in men - PMC

Testosterone replacement therapy (TRT) is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as ...

www.ncbi.nlm.nih.gov

In this study it mentions the following:

"Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy."

This is my bloodwork done before treatment and after about 7 weeks on TRT.

My blood went from 1.76 to 2.98. Almost doubling.

I will attach the rest of my bloodwork and I would greatly appreciate any insight to this. What is my next step to get checked for a possible prostate cancer?

Edit: My doctor prescribed me TRT after looking at my initial lab results and hearing me describe my symptoms of low T. I was first prescribed 160mg of testosterone once weekly, Clomid 50g on MWF and Anastrozole .5mg once weekly. After my2nd bloodwork came in that was done on week 7 of trt, my doctor chose to lower my T injection to 120mg a week. I am going to receive my 2nd dose of 120mg test today and hoping to talk with my doctor soon to see if lowering the T fixes the other bad numbers on here.

Here is some good research you might be interested in reading over. Lots of good information about TRT and the prostate

TRT and the Prostate

Testosterone Treatment and the Risk of Prostate Adverse Events (2022) Jason A. Levy, DO, MS, Arthur L. Burnett, MD, MBA, Adrian S. Dobs, MD, MHS INTRODUCTION Definition Hypogonadism is a clinical syndrome that results from failure of the testis to produce physiologic concentrations of...

www.excelmale.com