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symptomatic untreated prostate cancer at 49

User
Posted 06 September 2017 08:32:39(UTC)

Hi,

I am back after posting a couple of months ago re symptoms in my husband. He has been suffering weak flow, urgency, dribbling, hesitancy and incomplete emtpying of bladder. He has had recurrent UTI's, some showing infection others showing nothing. Over the last 7 years he has been to the GP on more than one occasion and given anti biotics with no follow ups.

Fast forward to now - He had a PSA test in July which came back at 8.8. Referred to Urologist and given 2 weeks of cipro and an mri. Had a PSA at the end of 2 week cipro and a drop to 4.9  (this test was done AFTER a DRE so am thinking it may in reality have been lower). He did have a PSA which he was unaware of in June 2016 which was at 2.5 this came to light from his records on initial consultation and was done by a heamatologist as part of a complete blood work up...no correlation was made between this and his urological symptoms. In fact they stated it was normal.

Then the phone call from the Consultant to say that his MRI was not so reassuring for inflammation, which was their initial thoughts upon looking at the clinical symptoms). They say there are 2 spots on his prostate which do not look like inflammation. He cant have the TRUS biopsy due to a surgery for Ulcerative colitis and the formation of a jpouch where his colon used to be. The risk of infection and damage to his pouch is too high and so a transpereneal is being asked for....this means a longer wait.

I am now convinced in the absence of a diagnosis that this can now only mean that that he has Prostate cancer that became symptomatic oer 7 years ago. So 7 years of untreated growth. He has a pain in his hip radiating into his thigh  which starte 2 years ago (they diagnosed neuropathic something or other) and has sufferd chronic lower back pain for over 15 years so any pain in his back due to advanced cancer wouldn't necessarily be noticed.

Am just waiting the results of a PSA test yesterday and if PSA has risen will be asking for a private referral for biopsy as I am scared it may be too late already.

I really can't think it could be anything else now...the consultant ony said it didn't look reassuring..so if he doesn't think inflammation then the spots must be cancer...and if it is cancer it has become symptomatic and at the age of 49 he is staring at his own mortality because they didn't think to give him a PSA years ago when he first presented with symptoms. Sorry for the length of this post. Don't really know why I am posting other than it helps to know that people going through this awful journey are reading and may be able to offer hope/advice.

Thanks for reading.

User
Posted 06 September 2017 11:30:47(UTC)

Dear Isla

I am sorry to read of your worrying news.  I am 47 and was diagnosed last year and have had my prostate removed.  It may be cancer, it may not be cancer that your other half has.  

I don't understand as much as others do on this forum and they will be along with support.  I had a multi-parametric MRI and with that you get a PIRAD score or classification.  Mine was 5.  The definition I got was that significant cancer is highly likely to be found upon biopsy.  This link says PIRAD 5 is most probably malignant http://sperlingprostatecenter.com/pi-rads-score/.  Perhaps you could find out from your GP or urologist.  But this only applies if you had the mpMRI.

My hospital and GP were more up front with me than what seems to be the experience of many.  And without the biopsy, they cannot be 100% certain.  It's all pieces of a jigsaw.  But the urologist who did my biopsy told me he fully expected cancer to be identified based on the mpMRI and that I should prepare myself for the biopsy coming back positive for PCa.  

Going through the tests is the best thing you can do, and we have all played the waiting game, and that's not easy.  But at least you will know and will see the options available.

Others will tell you that PCa is slow growing, so try not to let your worst fears dominate your thoughts.  My doctor told me mine was probably growing over a good few years.  The other thing is, this forum offers hope.  Many of the men given pretty scary diagnosis are still around for a very, very long time.  They have inspired me and given me hope.

 

Ulsterman

User
Posted 06 September 2017 13:31:58(UTC)

The issues 7 years ago are unlikely to be related to prostate cancer - especially as his PSA was only 2.5 last year. Even with a PSA of around 5 the chance of his hip or back pain being related is tiny. If he has had longstanding urinary problems, the back pain is more likely to be ingrained kidney infection from not emptying properly.

I think you are running ahead of yourself - as difficult as it seems,best to wait until all the tests have been done and then see where you are. It doesn't seem to me that the doctors have done anything wrong and a perineal biopsy does take a little longer to organise so going private may not be much quicker but there is no harm asking. The fact that the meds reduced his PSA so quickly suggests that even if there is some cancer in the gland, the main problem was inflammation.

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


User
Posted 06 September 2017 15:14:31(UTC)

I think the reason I am so worried is because his urinary symptoms have been constant over the last 7 years...not a day of respite.... and so my thought process becomes...(early prostate cancer is usually asymptomatic from what I have read...although I am happy to be corrected) So 7 years of something causing his problems...how long was it asymptomatic for? I know rationally you are right and I am allowing my magination to run away with worst case scenarios... I dont think the doctors have done anything wrong per say...I just question (after everything I have read) why the continued pattern of anti biotics when they didn't get rid of his symptoms te first few occasions? If I had been more clued up I might have asked him to request a PSA. Although I have also read that a low PSA in a young man can indicate an agressive strain of Prostate cancer...obviously this fuels my worries and concern.

Anyway, we wait. thank you both for your words of advice and for putting a perspective on my worries. It is greatly appreciated.

User
Posted 06 September 2017 16:17:50(UTC)

Isla, as usual LynEyre is spot on. I agree with her every word.

I think the frequent UTIs are an unfortunate side effect of having a j pouch. The stools are more liquid, more easily spread and so cross infection to the penis occurs. A change in wiping technique would help prevent recurrence.

Your husband's evidently low base PSA of 2.5 is highly suggestive of no PCa. Think positively and please don't worry until and if you have real reason to. Currently, you need much more information before thinking about PCa.

Good Luck.

AC

User
Posted 06 September 2017 20:42:16(UTC)

John had symptoms like you describe from the age of 35 and after thorough tests, it was diagnosed as a bladder muscle problem. The doctors have told us that the fact that he was diagnosed at the age of 50 with prostate cancer was unrelated and all of the research I have read over the years says the same.

About 50% of men in their 50s have some prostate cancer (and 60% of men in their 60s and 70% in their 70s) but the vast majority never know and it never causes them any problems. There are a couple of rare strains of PCa which are very aggressive but do not produce PSA; however there is no research that I am aware of to suggest younger men are more at risk of those rare types than older men.

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


 
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