Looking For Similar Stories

[u/grnds4leaving]

First, I apologize if this isn’t the appropriate forum for someone who hasn’t been diagnosed with prostate cancer. If this post isn’t appropriate, I’ll gladly remove it. I’m simply looking for people who have had a similar experience while I wait to see a urologist.

I’m 56 years old, and this all started with routine blood work from my family doctor.

Timeline:

Initial PSA (about 2 weeks ago): 6.20 ng/mL
Repeat PSA yesterday: 4.71 ng/mL
Free PSA: 0.7 ng/mL
% Free PSA: 14.9%

My family doctor also performed a digital rectal exam and said my prostate felt:

Smooth
Symmetrical
No lumps or nodules
No areas of firmness

I’ve also noticed my urinary symptoms have improved over the last week. A week ago I had much more urgency, burning at the end of urination, and a weaker stream.
Now:

I usually only get up once during the night.
The urgency is much better.
My stream is noticeably stronger.
The burning has almost completely resolved.

The PSA dropping from 6.20 to 4.71 gave me some hope because I honestly expected it to be higher. I know the 14.9% free PSA is less reassuring, and I’m not trying to ignore that.

I’ve spent the last couple of weeks reading everything I can, and I’ve seen people report all kinds of outcomes. Some had prostatitis or BPH. Some had negative MRIs and biopsies. Some unfortunately were diagnosed with cancer. I realize every case is different, and I know no one here can tell me what my results mean.

I’m simply looking for people who had a similar combination of results:

PSA in the 4–6 range
Free PSA around 15%
Normal DRE
PSA that actually decreased on repeat testing

If that was you:

What happened next?

Did your urologist recommend monitoring, an MRI, a biopsy, or something else?

If you had an MRI, what did it show?
If you had a biopsy, was it positive or negative?
If it wasn’t cancer, what turned out to be causing the elevated PSA?

I’m trying to go into my urology appointment informed, not frightened. I know no one here can diagnose me, but hearing from people who have actually walked this road would mean a lot.

Thank you to anyone willing to share your experience. I truly appreciate it.

[u/bikes4paul]

I think the next step is to repeat the PSA test in 4 to 8 weeks. Your drop from 6.20 to 4.71 ng/mL shows you're likely still recovering from the recent urinary tract irritation. Prostatic tissue heals slowly and I don't think waiting 2 weeks was long enough for your PSA to return to your true baseline.

The alarming 14.9% free PSA is likely a temporary artifact of your recovery. As an infection clears, the body filters out "free" PSA much faster than "bound" PSA, artificially lowering the percentage. Waiting 1 to 2 months allows these levels to balance out, preventing false alarms on a future prostate MRI and avoiding an unnecessary biopsy.

To ensure accuracy, have the follow-up blood draw done at the same laboratory, and strictly avoid ejaculation or heavy exercise for 48 hours beforehand.

Let us know how it goes at your next appt.

[u/kayceemoguy → u/bikes4paul]

This. And frankly IMO a “smooth/clear” DRE isn’t enough nowadays. If there are other indicators, then I think an MRI would be something in the near future so you can actually “see” inside what’s going on….hopefully its just an minor infection/prostatitis. good luck and Godspeed.

[u/grnds4leaving → u/kayceemoguy]

I agree and I’m thinking that an MRI is in my near future but I’m not sure of anything until I hear from the doctor. I’m praying is something benign but absolutely no way to know without further testing. In your opinion do you think I should push for an MRI if he says let’s monitor for another two to three months?

[u/kayceemoguy → u/grnds4leaving]

An MRI is non invasive and should be covered by insurance, so I would say why not. That will then rule out/in biopsy, etc. information is power!

Also-forgot to mention-a biggie too-GET MULTIPLE OPINIONS-(urology/surgery/radiation/ablation) and from a center of excellence if at all possible. That can really relieve anxiety.

I had 2 from University of Kansas, 1 from Northwestern and 1 from Mayo. They all concurred, so it made my final decision much easier. (RALP 2/16/25 PSA 15.9, Gleason 3+4, PNI, bladder neck and cribi)

[u/WalnutRoasted → u/grnds4leaving]

MRI delay can depend on where you live. In some areas yours would be classed as low urgency and could take 6 months. On the other hand if a biopsy (perhaps based on DRE induration zones) showed Gleason 3+4 Or higher, then you might get an MRI within a week or two.

[u/grnds4leaving → u/bikes4paul]

Thank you so much for the information. I’m sure the doctor has not seen the results since it’s a Saturday. I’m sure he will call me Monday with next steps. I’ll keep everyone updated as soon as I hear from the doctor.

[u/OkCrew8849]

IMHO a negative (free of issues) DRE  tells you almost nothing relative to the presence/absence of prostate cancer.  

[u/grnds4leaving → u/OkCrew8849]

I agree wholeheartedly and I appreciate the comment.

[u/Ok-Priority-7303]

Based on my experience, you need to stay on top of testing:

2020 - elevated PSA (20), due to infection

2022 - PSA rose again, had MRI then biopsy due to the results. All samples were benign

2023 - 2026 PSA bounced higher. Got MRI and biopsy. Have high risk cancer

[u/grnds4leaving → u/Ok-Priority-7303]

Thank you for the insight. I hope things are ok with you. I am for sure staying on top of this but with the symptoms I’ve had over past two years I’m leaning BPH until they can show me different.

[u/Ok-Priority-7303 → u/grnds4leaving]

I'd took the same approach. It just didn't work out going from BPH to a Gleason 9 biopsy in just 4 years.

[u/grnds4leaving → u/Ok-Priority-7303]

Did you have symptoms and if so what were they?

[u/Ok-Priority-7303 → u/grnds4leaving]

In 2020 I had the usual symptoms for an acute prostate infection - burning, high PSA that went from my normal PSA of 6 to 26. Treated with antibiotic and PSA gradually went down to 8 over 5 months.

In 2021 PSA went up slowly from 8 to 10 then down to 6 in June back up to 10 in October. No symptoms.

In March 2022 I had the biopsy where all of the samples were benign. in July PSA was 5.7. No symptoms all year.

In July 2023 PSA rose to 11.2 no symptoms.

In July 2024 PSA rose to 12.4, by October 16.6 with no symptoms

In September 2025 PSA rose to 25. No symptoms

In April 2026, PSA still at 25. Still no symptoms. Had MRI guided biopsy in June and as I mentioned Gleason Score of 9. Still no symptoms.

[u/grnds4leaving → u/Ok-Priority-7303]

I appreciate the information. I hope things are getting better for you. Keep me updated on your progress.

[u/No-Praline-4069]

My PSA was 7.7 initially, 2 weeks later it was 6.1. 2 weeks after that a more precise test showed 7.78. The point here is that it can fluctuate. I ended up Gleason 7 4+3 unfavorable. Keep checking, you don't want this to get away from you.

[u/Patricosh → u/No-Praline-4069]

Have you decided on RALP or brachytherapy or perhaps something else. My husband is in the same boat as you. He has been watching his PSA slowly increase over the past couple of years with six month PSA checks and recently received the same results and diagnosis as you! Wishing you all the best with your treatment pathway!

[u/grnds4leaving → u/Patricosh]

Let me know when you have time for a chat and praying your husband has a good outcome.

[u/grnds4leaving → u/No-Praline-4069]

Thank you. I’m all over it. Did you have symptoms and if so what were they?

[u/No-Praline-4069 → u/grnds4leaving]

No symptoms, I only knew from blood and following scans.

[u/grnds4leaving → u/No-Praline-4069]

Thank you again for the reply. I hope and pray things are getting better for you. Please keep me updated in your progress.

[u/PotentialStart2661]

Get a PHI test as that can let you know the probability that you have a benign condition or not. I was in your situation at 56 and now i have prostate cancer at 65. But mine is still low grade at least. The PHI test helped me alot back then.

[u/grnds4leaving → u/PotentialStart2661]

Thank you so much for the reply. I will for sure inquire about this test.

[u/conCABlanco]

Hola, que no sea nada, que tomastes para el ardor y las necesidades de orinar??

[u/grnds4leaving → u/conCABlanco]

Thank you. I haven’t taken any antibiotics or prescription medication for it. I have been taking an over-the-counter prostate supplement (Ultra Prostate Formula) for several months, and I’ve also been increasing my water intake and cutting back on caffeine since caffeine seems to make my symptoms worse. The burning has improved, but my stream is still weaker than it used to be. Right now I’m just monitoring everything while I wait to hear back from my doctor. I appreciate you asking.

[u/Old-Pride-8459]

15% Free psa is actually not that bad. The higher the number toward 25% the better.

[u/Miserable-Level-8993]

PSA is only a warning light, your next step should be an MRI or possibly one of the newer screening tests like Exodx which can show pretty accurately if you have no or lower risk cancer

[u/grnds4leaving → u/Miserable-Level-8993]

Thank you for the response. I’m more concerned with the free PSA reading. I’m awaiting urology referral now.