Had a PSA on Dec 17th that came in at 6.6. Had sex the morning of testing.
Typically my PSA is 3.5-4.0 with abstinence of 48 hrs. Re-tested 3 wks later with a 48 hr abstinence and it came back in the usual range at 3.96.
Urologist had some interesting things to say. Having sex before test can result in small or large changes in test results depending on the individual. Even though the PSA is the gold standard its really not that reliable as an indicator of getting prostate cancer. In his 15+ yrs of practice he has seen patients with very low and very high PSA scores both get prostate cancer and also not get cancer. He almost went as far as saying (but didn't) that the PSA test is a useless one ...but it's all they have to work with.
PSA + DRE is pretty much all we have right now outside of people paying out-of-pocket for MRI.
Def not "useless", but needs to be examined in context with it's rate of rise, the size of the prostate, the %free PSA, etc.
And so y'all know, there is a HUGE push from gov't bodies to end PSA screening, all based on a horribly done study that has been debunked. Ask any urologist about this and they'll know.
Yes, people may be getting unnecessary biopsies, but this is not unique to prostate cancer. If we had a PERFECT test, then biopsy would be moot.
I always tell my patients what you said above..that I see guys with low PSA and cancer, and high PSA and no cancer. And we discuss it and THEY make the decision. Most men simply want to "be sure". And even then we can't know 100% because biopsies are random.
But again...it's what we have to work with now, and it's better than chunking PSA screening out the window.