Thanks TLS Guy. They told me that 4.0 is as high as you can go. Anything over that needs to be looked at.
To be honest accurately diagnosing prostate cancer is still short of the mark. PSA Ultrasound, MRI and clinical exam is the state of current care.
The problem is that there is a huge overlap in PSA between BPH and cancer. That is a problem as the imaging studies are not as good as they need to be.
So yes, anything over 4.0 should be investigated, but then where to you set the threshold to repeat the MRI if it goes on rising, I guess 10 is a reasonable, or a doubling of the PSA.
There are better approaches on the horizon with some hopeful articles very recently with recent trials of more novel approaches being reported.
There is one other confounding factor. Quite a few patients with BPH are on finasteride. In which case threshold for investigation is 50% lower. That was my issue, my local doctor phoned me with my PSA, and said it was fine. I told her it was not as I was on Finasteride for BPH. So I insisted on an MRI and it identified a prostate cancer. I had proton beam therapy at Mayo, and my PSA has been followed every six months. It has been rising again in the last three months, so I am now on PSA draws every three months. Of course when PSA rises after surgery or radiation, there is always the possibility the recurrence may be at a distant site, (usually bone) and not in the prostate.
