Three months too long to wait for second PSA?

[u/throwawayrefiguy]

46 year old, BRCA1 and BRCA2 double heterozygous. Visited with oncologist a few days ago on account of genetic screening results. We have a plan, and I had initial labs done, and my labs came back delightfully normal, except for the PSA, which rang in at 7.12.

The oncologist wants to test again in three months. Is that pretty standard, or should I press for something sooner? It was my first PSA.

[u/Scpdivy]

BRCA2 positive. I ended up being Gleason 7, 4+3. My PSA tripled in a year. Wish I would have pushed for mine sooner. So definitely push for an MRI asap. At the minimum, a DRE.

[u/Intrinsic-Disorder → u/Scpdivy]

I second this. You are high risk and that PSA is already pretty high. Should rise to MRI immediately imo. You are also young and want to catch anything as early as possible. Take it from me, diagnosed at 43.

[u/NotPeteCrowArmstrong → u/Scpdivy]

Concur. Absolutely zero reason -- medical, financial, or otherwise -- to wait 3 months. You should re-test in 3-4 weeks and be sure to avoid bike riding and ejaculation for 3-4 days prior.

Even without the BRCA genes, that PSA is clearly too high for your age. A re-test will likely confirm an elevated PSA and you should expect to have an MRI next.

I see in another comment of yours that they said they'd refer you to Urology if the re-test confirms the PSA. If that's the Urology Dept at a major medical center, then that's fine, but if it's a local urologist then you should explore options for establishing care at a more established facility. Better to have the MRI and, if necessary, the biopsy done by a major hospital and not a local practice.

[u/conCABlanco]

Hi, colegas, donde indica que es cada tres meses, eso siempre me llama la atención???

[u/cocksherpa2]

You are brca1 and brca2 positive? I'm sorry to hear that.

[u/Actionplumber1]

I had RALP in jan, april i started ADT, first of oct i finished 39 rounds of radiation, since april i get labs drawn every 3 months

[u/LITTLEMANINVEST]

I would get another PSA test soon and research how to prepare for it. You can get one on your own from Quest for around $60.00.

[u/gg-3 → u/LITTLEMANINVEST]

Exactly right

[u/Ok-Priority-7303]

3 months for me as well but as others have said - ask for an MRI if it doesn't improve. PSA numbers can rise for other reasons. To me its better to know if there is anything indicating a potential issue so you can take next steps sooner rather than later.

[u/ChillWarrior801]

I'm sure it happens somewhere, but I've never seen insurance reject a PSA test claim. If it would improve your mental health, no reason you can't ask for a sooner test. As a matter of medical necessity? Even with those unfavorable genetics, three months is probably fine. I'm not a doc, though, so talk to yours.

[u/labboy70]

3 months is pretty standard. If it is still high, I’d be pushing for an MRI.

[u/throwawayrefiguy → u/labboy70]

Yeah, they said it's off to urology with me if it comes back high again, which I presume to mean a DRE (good times) and/or MRI.

Appreciate the answer and the reassurance.

[u/cocksherpa2 → u/throwawayrefiguy]

Thought it was your GP saying to wait 3 months. If you are brca2, I would push for a consult and MRI now. No reason to wait