PSA-Not the only way to fly

Until sometime in the late 80s, there was a regional airline in the west called PSA. I don't remember what the letters stood for, but their slogan was, "PSA, the only way to fly."

But there's another PSA that I've been thinking about most recently, which culminated in a biopsy two weeks ago, and I know what those letters stand for: Prostate Specific Antigen. As the song goes, don't know much biology, but I do know this: PSA is specific to the prostate, and it's an antigen, meaning that it's there to do battle with some bad thing in the prostate. That bad thing is sometimes cancer.

My PSA was 13 as of two weeks ago, when I was scheduled for the biopsy at UCSF. And this was no run-of-the-mill biopsy, but one of the "Perineal Anterior" variety, and I'll spare you the anatomical specifics. I just turned 60, but for years--six or seven at least--I've had an elevated PSA level, which hovered around six or seven. In the past couple of years it's climbed to 9 and change, and then spiked to 13. One of the things that doctors look for in PSA is what they call velocity, or the pace at which the PSA level climbs. At my age, I should have a PSA from 0 to, say, 3. Thirteen is quite high, so needles to say I was worried. On a scale of 1 to 10, my worry meter registered 13.

Well, if you'll read the next post you'll see that the biopsy results were all negative, with 32 cores having been taken. My worry, while not unfounded, turned out to have been for nothing (as worry usually is). I asked the nurse, "So, why do I have such a high PSA level?"  She said, "I don't know."

But there is another piece of the puzzle, which is that I (like some 50 percent of men my age, and more who are older) have an enlarged prostate. I'm not sure why, but my urologist tells me that it shows evidence of infection from a long time ago. I think, in fact, that I've probably had some kind of prostate infection for thirty to forty years and that chronic infection--not cancer--is likely the irritant that is making the PSA level spike.

So, take heart, men. PSA was a pretty good airline, but is a notoriously unreliable indicator of cancer, as my case demonstrates.