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44 with a mildly elevated PSA -- worried about nothing?

User
Posted 31 May 2018 at 00:10

So, 1-year later.

My PSA has now risen from 2,9 to 5.2 My free/total% has gone from 15% down to 7%. Bear in mind I'm only 45.

See the urologist in two weeks. Nervous.

Edited by member 31 May 2018 at 00:42  | Reason: Not specified

User
Posted 31 May 2018 at 14:46
Ask for a multi-parametric MRI. When I was first tested for PSA at 55 it was 2.2 which the system and my GP said was “normal”

When seven years later, after my second ever PSA result was 17, the urologist I was referred to said he would have recommended regular PSAs after the first one, but he did concede “I do see loads of patients with prostate cancer”.

Friends on private health plans over 50 have annual DRE and PSA tests.

Good luck!

Cheers, John

User
Posted 17 Jul 2018 at 16:53
Thanks, Bollinge. I don't have the option of an mpMRI just yet.

I saw my urologist after a bit of a wait after my PSA results. He told me my doubling time, PSA velocity and free PSA ratio (7%) are concerning. DIdn't suggest wait-and-see, didn't suggest a round of antibiotics, just said he wants to do a biopsy as soon as possible.

Now I'm in waiting hell for my biopsy mid-August. And then another couple of weeks wait for the urologist appointment and the results.

He's given me a gestalt probability of 40% to find cancer on the first biopsy. A local prostate cancer centre scored me at 36.4% based on their nomogram, so it looks like my urologist knows his stuff.

I don't think I have BPH as, from what I understand, free PSA generally increases with that. So, we're left with the option of chronic prostatitis -- not wonderful, but better than PCa.

User
Posted 25 Jul 2018 at 11:59
I'm very anxious about the biopsy, so my psychiatrist gave me a sedative to help deal with it. As strange as it sounds, I'm more concerned about doing the Bx than getting the results (the results will be what they'll be).
User
Posted 25 Jul 2018 at 19:45
Sometimes the apprehension can be far worse than the event! Being placed in position for biopsy is undignified but most men find the the sampling experience not too bad. With the TRUS biopsy you hear a 'click', usually between eight and 12 times and each of the cores taken feels like being flicked with a rubber band. (i would prefer this to having a tooth filled and I have had plenty of these done over the years.) I drove home immediately afterwards no problem and this is not uncommon. There was just a trace of blood in my urine for following two to three days and no infection, no doubt helped by the antibiotics supplied. Of course some men have an unusually low pain threshold and for them it may be somewhat painful.
Barry
User
Posted 25 Jul 2018 at 19:52

Thanks, Barry.

Unfortunately, I do have a low pain threshold :( I believe I'll be getting 12 cores. Peeing blood for a couple of days won't alarm me.

I hope with the sedative, lidocaine and perialstatic nerve block I'll be comfortable. 

It's funny: you're not the first person I've heard describe it as being a rubber band flick.

I'll report back in 3 weeks.

User
Posted 28 Jul 2018 at 16:58

@geekything...

Hopefully helpful... I've previously posted on my own experience, from which I clip:

-----------

I had a TRUS biopsy this morning... set me thinking about how when I was recently in A&E, I was asked to complete a 'how likely are you to recommend us?' questionnaire.

How likely? What... to recommend 'having a stranger shove gawd-knows-what (I didn't look) up yer poop-shute, accompanied by what sounded like the firing of a spud-gun I had when I was 8'?

Hhhmmm... let me think a bit.

The recent MRI I hugely enjoyed.
This, not so much.

Very odd feeling, uncomfortable rather than painful... quite tolerable. And, of course, very useful if you want to remain on the 'staying alive' pathway.

A bonus is perhaps that any innate latent gay tendency/curiosity has now been 'none of that for me, thankyouverymuch' firmly nuked. And all without having to sheepishly frequent 'the right bars' or that guilty morning after walk-of-shame.

I did at one point mutter something about 'feels like you can't find fourth gear', but refrained from asking whether there was any sign of that sixpence I'd inadvertently swallowed in the 1965 Xmas pudding.

Honestly, at times it felt like someone was rowing a boat in there.

----------

 

User
Posted 28 Jul 2018 at 17:07
Thanks for making me chuckle, gulliver.

I may have the option of an mpMRI before my TRUS....trying to work out the logistics of getting that done before August 15th and having the radiology ready.

User
Posted 29 Jul 2018 at 05:38

@geekything

Thanks for your 'thanks'.

If I've helped lighten things, I'm glad.

It's natural to be worried, and I consider myself fortunate to 'not be much bothered by my own less-than-optimal health' (hence my oddly-skewed posts in this forum).

A pre-biopsy MRI is always worthwhile, in enabling better targeting of TRUS samples... I've read a doctor describing a TRUS biopsy as 'stabbing a fruitcake and hoping to spear a cherry', and it's common for them to not provide truly representative results and hence often followed by a more accurate template biopsy.

'Some do, some don't', hospitals vary in whether they provide pre-biopsy MRIs. My local hospital normally does, though in my case initially declined on the basis of the urologist's view that 'with your PSA, it'll be harder to miss the cancer than hit it'. After a firm-and-polite request from me, the MRI was offered.

And, a small point... based on personal experience...
After the biopsy you'll likely be given 'pads' to mop-up any front-and-rear fluid/lube/goo. If you're wearing your own clothes rather than a hospital gown, it may be wise to request one before they begin - and stuff it in front of your todger to catch the small amount of blood-laden fluid that may potentially be forced-out while the urologist is 'doing his audition for DynoRod'.

In the suggested 'peeing blood for a couple of days', you might want to scratch-out 'days' and add 'weeks' - along with 'tiny amounts of other goo leaking out of your willy'.

The 'wait for results' period can cause anxiety, so your 'will be what they'll be' attitude should help - and moreso if you're then subject to further tests and waiting for those and the results. (I took an immediate view of 'probably riddled with it' and so anything less than that is a potential delight.)

My best wishes and hopes to you.

User
Posted 17 Aug 2018 at 19:33

Finally had my TRUS biopsy on Wednesday. I was shocked to heat that radiologist say my prostate is 55mL. That seems massive for a 46-year old.

This is now sounding a lot more like BPH rather than PCa to me. Except for one thing: my Free PSA % is a lot lower than research suggests it would be with BPH (it's 7%).

Does anyone have any input on this?

I see my urologist on the 30th.

User
Posted 17 Aug 2018 at 20:29
I know it’s difficult, but try not to second-guess the outcome. It will be what it is. I went into my biopsy results meeting absolutely convinced I was going to be given the all-clear, because nothing had shown up on my MRI, and I was completely devastated when I was told I had cancer. Waiting is tough. Really tough. This next two weeks is probably going to seem like an eternity, but all I can advise is try to keep yourself busy and stay away from this forum until you get your results. Reading about other people’s cancer every day isn’t going to do your mental state any good. If you get the all-clear, that’ll be wonderful; if it turns out that you do have prostate cancer, it’s not the end of the world, and that’s the time to come to terms with it. Until then, try to put all thoughts of what the outcome may be out of your mind.

All the best,

Chris

User
Posted 17 Aug 2018 at 20:52
Thanks, Chris. Trying not to jump-the-gun, but going to be a long two weeks.
User
Posted 18 Aug 2018 at 09:09

Hi I think you need to get it checked out for your own peace of mind.

Click my Avatar to see my journey, my PSA was 2.19 with no symptoms apart from microscopic blood in my urine on a private medical for my 7.5 ton driving licence  renewal at 70.

Regards John.

User
Posted 11 Dec 2019 at 12:29

Hi mate,

just wondering what the outcome of this all was?

Best wishes.

 
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