What should happen?

Hi mate.

Welcome to the forum. 

You've done the right thing and got yourself checked out.

I'm not medically qualified but an enlarged prostate can be caused by many non cancerous conditions. PSA is only an indicator of cancer,  however yours is low enough not to warrant further investigation. Your aches and pains are unlikely to have anything to do with your prostate. 

Personally, I'd be satisfied with your GP's actions.

Don't go the way I did!

6 years ago at 54 I went to the doctor's because of reduced urine flow and more urinating at night. The doctor did a PSA test and DRE (still haven't got over that!) The PSA came back at 1.34 and the DRE didn't uncover anything.

Don't worry said the doctor, it's your age. Come back if anything gets worse.

Roll on 4 years and I stated getting pains in my side and abdomen. Saw the doctor and they did. Stool test. Whilst waiting for the results, the pain got so bad I wondered if my appendix was about to burst! Off to A &E I went and they did a CT scan. The A&E doctor came in looking very sheepish and said she couldn't confirm this as she wasn't an oncologist/urologist but to her it looked like I had prostate cancer that had metastasized in several sites.  This was all confirmed 3 weeks later - advanced incurable prostate cancer with an average prognosis of 2 to 5 years 

So my advice is, you have had a warning. The NHS will probably not come back every year to check progress. You should make a point of regularly checking your condition now with PSA tests. It only took me 4 years between, "Don't worry," to "Incurable!" Just forgetting it could be life shortening!

Hi everyone.  My first post and all that.  I'm 62, and after all the recent hype about prostate cancer, I thought it best to contact my GP about getting a PSA test.  He did that and a finger test.  The finger test shows that my prostate is enlarged.  The PSA test was normal.

Reading about the PSA, I believe that it misses 1 in 7 cancers, so that test is by no means conclusive.  My GP's comment then that nothing further was required seemed strange to me.  Is he right or should regular monitoring now be taking place?  

The GP did say that if I had symptoms I should contact him, but the symptoms are so vague it is difficult to know if they are due to the prostate or not.  I mean, yes, I go to the loo more at 62 than I ever did at 25, unless I was on a serious session of course!  I have been in a few motorcycle accidents in my youth, and had asked the doc about my right hip last year.  Recently, I have noticed an occasional sharp pain in my back, (right side a little below waist level) than happens when I am preparing food on our work top.  I put this down to making it to something approaching old age.  Lastly, I pretty much constantly have a feeling around the coccyx, like I have been sitting on a hard seat for too long.  All these seem too little to be worried about.....unless someone out there tells me different?

Edited by member 22 Apr 2024 at 16:54  | Reason: Not specified

Evening John,

Your journey is indeed frightening. I notice on your profile history that you don't mention this GP's visit. Do you now think it is relevant to your subsequent cancer diagnosis? Do now you feel he/she should have done more?

I was also about 54 years old when I was refered by my GP to a urologist. due to urination problems. My PSA was 3. I had a DRE, which showed an enlarged prostate. I was prescribed Tamsulosin.

I had annual PSA checks. No further DREs and no MRIs. It was not until 9 years later that there was a slight PSA rise resulting in a further urology appointment, leading to MRI, biopsy and diagnosis of Gleason 6, low volume prostate cancer.

Even then, I was told "Don't worry. Some don't even call it cancer'  Ironically,  it was whilst allegedly being closely monitored on AS,  that my disease supposedly progressed alarmingly to Gleason 9 and had breached the capsule. 

It now seems more likely the intial biopsy had missed the more dangerous cancer cells, as it is rare for the Gleason score to get higher.  I often think I wonder when I contracted the disease. Was it 2020, when I was first diagnosed or could it have been as much as 10 years earlier.

So going back to your GPs visit and the original posters GPs visit. What do think they should have done? Do you think that everyone with a below normal PSA level but enlarged prostate should automatically have regular follow PSA checks or MRIs to double check that's all in order?

I'm a great believer in all men having prostate cancer screening, but unfortunately even then, some will avoid detection.

Edited by member 22 Apr 2024 at 23:19  | Reason: Additional text

Hi Speccy

I'm fine at the moment, 2 year in to taking apalutamide. Tired, having hot flushes, but alive and working. Dreading each PSA test, every two or three months. Blood taken today, next oncologist call next Monday!😬🫣

I wish I'd contacted this forum 6 years ago, like you have, things might have been a lot different.  Reading your initial post, you're getting pains on your right side just like I did, plus your back.  Perhaps with these extra symptoms you might be able to convince the GP to order a MRI. If nothing else to rule PC out for now. However, definitely demand annual PSA tests.