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Comprehensive diagnostic list for younger men

User
Posted 25 Oct 2016 at 19:41
My husband was diagnosed June this year aged 46. Post op Gleason 4+3.Now receiving RT and HT. All guns blazing it seems. He started thinking something was wrong after an unexplained bout of cystitis four years ago. Doc thought nothing of it. Several high temperature episodes over the years and groin pain. Three years ago at October fest he had some urinary pain and mild burning. Again gp discounted it. That same year he stopped ejaculating fully. Again GP said nothing to worry about. Last year, urinary flow weakened. New GP performed DRE. Nothing abnormal to report. Husband not content. Just felt something wasn't right. Finally demanded something more serious needed investigation. Another DRE confirmed firmness of prostate. PSA test showed 24. This was in May. What happened next is now just a blur of fear and anguish that we have no idea what the future holds. My concern is that the listed symptoms they check are synonymous with enlarged prostate. We think that a more comprehensive list of some of the more subtle symptoms long before enlargement sets should be investigated. A possibility is that if you asked younger men if they had any earlier signs apparently unrelated symptoms that may have indicated Pca, there may be some common signs not currently being used as diagnostic criterion that younger men may experience that older men do not. Any thoughts? I am new here so apologies if this is previously discussed.
User
Posted 25 Oct 2016 at 22:34

Hello missus and welcome.

Just out of curiosity, at what stage was the PSA done. Was the 24 the only one he had and was the DRE by the new doc the first time it was done?

I'm not sure that a younger age age should have had a relevance given the things your husband was concerned about. However, you only have to listen to some on here to know that GPs are often dismissive of a patient's fears

I can't help with your query as my husband will soon turn 76 and was diagnosed at 72/3 so circumstances are different but I hope that I have bumped your post.

Sandra

********

Edited by member 25 Oct 2016 at 22:34  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 25 Oct 2016 at 23:25

Hi missus, one of the problems is that many men have very few or even no symptoms, even with late stage cancer while others have signs which could be down to a number of causes. Urinary tract infections and cystitis / burning on urination are not indicators of PCa. As you now know, loss of ejaculation is an indicator but lots of men would not be happy to mention that to a doctor.

My husband had difficulties urinating from the age of 35, multiple night-time loo visits and sometimes extreme pain in what we now know was the prostate area. However, thorough tests at the time suggested that his problem was with the bladder valve and sphincter, for which he took tablets until he was diagnosed with PCa at the age of 50. His PSA was normal. Since treatment (RP, RT & HT) he has no problems weeing at all and rarely needs to get up at night.

I can't think of any signs or symptoms that are only applicable to younger men; although we have on occasion had discussions on here about indicators that people feel in hindsight might have been relevant I don't recall anything cropping up that isn't already well documented.

What a few of us do feel though is that there should be better training for GPs - it does exist but doctors aren't forced to attend or take any notice of the prostate cancer risk assessment guidance. Too many, it seems, still believe that PCa only happens to old men and/or are reluctant to agree to relevant tests. On the other hand, there are also some great and knowledgeable ones - it seems more men are now being diagnosed in their 30s & 40s.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Oct 2016 at 06:59

I had zero symptoms from 44 to 48 except for occasional uncharacteristic ED and a sharp decline in volume of ejaculation. And my PSA was bimbling around 4 then 6 then 4

Un -ideally they then decided Testosterone replacement therapy was the way forward ............

User
Posted 09 Nov 2016 at 07:58

I was 44 when diagnosed with Pca, I had hot and cold fevers ,head felt sore , and had lower back pain and hip pain , and out of breath when I was excercising which wasn't normal for me

Should younger men be treated in the same way bearing in mind there age ,does testosterone play a part in recurrence in younger men

I feel there almost like a average path doctors follow for Pca .

Edited by member 09 Nov 2016 at 08:25  | Reason: Not specified

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User
Posted 25 Oct 2016 at 22:34

Hello missus and welcome.

Just out of curiosity, at what stage was the PSA done. Was the 24 the only one he had and was the DRE by the new doc the first time it was done?

I'm not sure that a younger age age should have had a relevance given the things your husband was concerned about. However, you only have to listen to some on here to know that GPs are often dismissive of a patient's fears

I can't help with your query as my husband will soon turn 76 and was diagnosed at 72/3 so circumstances are different but I hope that I have bumped your post.

Sandra

********

Edited by member 25 Oct 2016 at 22:34  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 25 Oct 2016 at 23:25

Hi missus, one of the problems is that many men have very few or even no symptoms, even with late stage cancer while others have signs which could be down to a number of causes. Urinary tract infections and cystitis / burning on urination are not indicators of PCa. As you now know, loss of ejaculation is an indicator but lots of men would not be happy to mention that to a doctor.

My husband had difficulties urinating from the age of 35, multiple night-time loo visits and sometimes extreme pain in what we now know was the prostate area. However, thorough tests at the time suggested that his problem was with the bladder valve and sphincter, for which he took tablets until he was diagnosed with PCa at the age of 50. His PSA was normal. Since treatment (RP, RT & HT) he has no problems weeing at all and rarely needs to get up at night.

I can't think of any signs or symptoms that are only applicable to younger men; although we have on occasion had discussions on here about indicators that people feel in hindsight might have been relevant I don't recall anything cropping up that isn't already well documented.

What a few of us do feel though is that there should be better training for GPs - it does exist but doctors aren't forced to attend or take any notice of the prostate cancer risk assessment guidance. Too many, it seems, still believe that PCa only happens to old men and/or are reluctant to agree to relevant tests. On the other hand, there are also some great and knowledgeable ones - it seems more men are now being diagnosed in their 30s & 40s.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Oct 2016 at 06:59

I had zero symptoms from 44 to 48 except for occasional uncharacteristic ED and a sharp decline in volume of ejaculation. And my PSA was bimbling around 4 then 6 then 4

Un -ideally they then decided Testosterone replacement therapy was the way forward ............

User
Posted 26 Oct 2016 at 08:20
Hi Folks thanks for responses and welcomes. Amazingly speedy!

Firstly, the initial DRE was done and GP said nothing to worry about. Second Gp seen performed DRE and was somewhat alarmed and as a result gave psa test immediately. The results were 24.

As you say Chris, Sandra and Lyn, no recognised symptoms of Pca. But what if the early signs are very different? The cystitis is part of prostate issues in younger men. Low grade fever and pelvic pain points to chlamydia and prostatitis. The reduction of ejaculate over time and occasional ED as well as other very minor pelvic pains and aches that my husband would have after a night out or exercise. All of which are attributable to other things.

Taken together surely the diagnostic criteria might be expanded or given more careful exploration when a courageous male actually goes to see a doc about any pelvic issue?

There must be more options for early detection???

Anyway, I guess it's just fingers crossed for everyone here going through the process of treatment whatever age, stage or action they are at.

The Missus

User
Posted 09 Nov 2016 at 07:58

I was 44 when diagnosed with Pca, I had hot and cold fevers ,head felt sore , and had lower back pain and hip pain , and out of breath when I was excercising which wasn't normal for me

Should younger men be treated in the same way bearing in mind there age ,does testosterone play a part in recurrence in younger men

I feel there almost like a average path doctors follow for Pca .

Edited by member 09 Nov 2016 at 08:25  | Reason: Not specified

 
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