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Update on progress with elevated PSA

Posted 05 May 2016 12:11:16(UTC)

I thought I would give an update on progress, but my previous post was quite lengthy with replies so I thought I would start again.  I have been having urination problems for 9 years and eventually after many visits to the GP I was given a PSA test last year.  A PSA of 8.9 resulted in referral to urology and a TRUS biopsy.  Result, negative for cancer but high grade PIN in one core so followup PSA test and consultation arranged.  PSA raised to 14.7 in September, refereed for MRI scan.  MRI showed left peripheral indeterminate lesion – rated 2, probably not cancer.  Two further PSA tests showed increase to 15 so template biopsy carried out in April.

For anyone about to undergo a template biopsy, I found it was not as bad as I feared.  Done as a day case under general anesthetic.  There was some discomfort around the perineum for a few days, but nothing bad.  Worst side effect was as a result of the catheter that was used during the procedure.  It was removed before I came around and I was able to urinate OK, but because of the pain meds I had been given there was no discomfort until the evening.  When I urinated, all I can describe it as feeling like I was peeing glass, it really stung and did this for a day or so but gradually eased off.  I was peeing blood for around two weeks and there is still blood in the semen after a month but no other side effects.  

Just had my results from the biopsy today which are very uninformative:

"I am pleased to inform you that your recent prostate biopsies are normal. We have therefore discharged you back to your GP. We would suggest that you continue to have your PSA checked every 6 months which will involve you making an appointment at the GP practice to have the blood test taken. If your PSA remains elevated, your GP should refer you back to us."

So, my PSA is probably still well into double figures with no explanation for it, no mention of PIN this time.  It is probably good news, but I would have liked a bit more information.  I should be relieved, but given the significantly elevated PSA, I am still concerned although the GP and Urologist don't appear to be.  I will arrange for a follow up PSA test in July (six months after my last one and 3 months after the biopsy) and take it from there.  


Posted 18 May 2016 12:27:08(UTC)

Well that was a surprise.  This morning I received a telephone call asking if I would mind asking a few questions relating to my post operative care as they were doing a survey with a view to improving the service.  She asked about the discharge procedure and I said that it was fine and there were no post operative complications, but I said that I had real problems getting the results as I had to call twice and then get the results letter emailed as it never arrived.  I also said that the letter contained almost no information and left me feeling if anything more anxious than before as I have been given no information regarding why my PSA is so elevated.  She got my biopsy results and read them out to me and there are signs of PIN which I expected as this was found in my TRUS biopsy, but there is also signs of prostatitis which could easily explain the elevated PSA.  As mine is obviously asymptomatic prostatis (I have no symptoms) they don't treat it and I am perfectly happy with this, but just having a possible cause for the elevated PSA (BPH and prostatitis) this has made me feel a lot better.

I also received a copy of a letter my GP sent to Urology last week.  He is also obviously confused as the discharge letter says discharged back to GP, 6 monthly PSA test and refer back to Urology if PSA remains elevated.  Well with the last three test being 15, it is not going down to normal levels, so he wants to know if he refers me if it goes up or if it just stays the same, so I should get a reply to that soon as well

Posted 18 May 2016 13:04:59(UTC)

How confusing. At least they telephoned

Good news (in a way!) about the prostatitis as at least it offers a reason of sorts

We can't control the winds - but we can adjust our sails
Posted 18 May 2016 20:45:48(UTC)

You sound similar to me, I had no symptoms of any problems, but had a PSA test as my father had prostate cancer. I was very surprised when the count came back as 11.5. Two digital rectal exams were normal, as was my MRI scan and template biopsy, but they said that there were signs of inflammation.

I have been given an appointment for the PSA clinic at Bedford South Wing hospital for 6 months after my biopsy; got to have a PSA test 2 weeks before the appointment.

I spoke to a Prostate Cancer UK nurse (very helpful) who explained that they don't normally treat slight infection as there's no guarantee that antibiotics will work.

NB. I had discomfort from the catheter for my biopsy, but I was taking Naproxen (non steroidal anti-inflammatory pain killer) and Zapain (30mg Codiene/500mg paracetamol) pain killers for an injured finger, which may have masked the pain.

Posted 18 May 2016 21:05:06(UTC)

At least they told you that there were signs of infection as this explains the elevated PSA with no signs of cancer.  I was given no information until today, I have BPH, my prostate measures 58cc which is roughly twice normal size, but that would only account for a PSA of around 7, the prostatitis could account for the rest.  I have no symptoms of the prostatitis, so it is asymptomatic which they don't attempt to treat as it is not causing any problems, I do have mild problems relating to the BPH but I can live with these

Posted 19 May 2016 17:54:57(UTC)

They only told me after I asked and there was no reference in the letter they send to my GP. Sadly, you need to know the questions to ask and I've found this forum to be quite good at explaining things.

Posted 19 May 2016 18:08:34(UTC)

So exactly the same position as me.  For some reason they appear to only want to provide the bare minimum of information, when a little bit more would help to reassure people that they don't have cancer.  I have been worrying about this for months, when they could have easily put my mind at rest by actually telling me what they had found

Posted 20 May 2016 08:08:27(UTC)

This is why I have used the nurses on here, I have both chatted with them and called them, they will either answer your question or help you know what you need to ask.

Posted 02 July 2016 17:23:06(UTC)

Hi Guys, wonder if you can help me out here....I have had a PSA spike from 3.1 to 7.5 in 14 months.....Used to get tested every 6 months and then stupidly waited 14 months for the recent one...that has come in at 7.5....if that is something sinister then I may be in trouble...Doc has ruled out urine infection.....so it's either BPH (which I don't think could cause a spike of that magnitude in 14 months)....It's Prostatitis (or something else).....I have symptoms of Prostatitis (Pain in back, hips achy groin and testicles and have had wee wee problems for years)...but all these things can be symptomatic of Cancer too......going for a cystoscopy on 12th July so at least things are happening (PSA test only 10 days ago)

 Question I wanted to ask was about the prostatitis ache in back.....is it a dull ache or something else....Alan you say you don't have the symptoms but if you have any info or anyone reading this does I'd be obliged

    Dr DRE     Tony

Posted 02 July 2016 18:13:06(UTC)
Tony, have you had a DRE and have you been referred to urology. I would think an MRI and or a biopsy would be the first steps. Prostatitis is difficult to diagnose and difficult to treat. A PSA of 7.5 could be as a result of BPH. There is a formula you can use and with my prostate which was 58cc 7.5 would be the top end but within normal boundaries. Unfortunately mine was 9 and then 15 so more than just BPH.
Posted 02 July 2016 18:26:51(UTC)

Hi Alan, thanks for the prompt reply.....Had a DRE at the docs this week, because of the PSA spike. Doctor said prostate felt enlarged but couldn't feel anything out of the ordinary....As Shania Twain sang "That don't impress me much" Our GP is pretty good but he's not a urologist, plus apparently the maximum amount of the prostate that can be felt is about 30%.....So plenty can be missed.....I know that BPH could cause the high reading but don't think it could be responsible for the time scale....BPH from what I read is fairly slow growing so to cause that jump in 14 months?  There's only so many answers on the net.....It's the back and hip pain that's the real kicker because I know they are symptoms of prostatitis, but also PCa.....Had a letter today and have been referred to the Urology Unit of my local hospital for a flexible cystoscopy.....(Camera up the Winkie) Should be fun......

    Are you still waiting for a definitive answer to your raised PSA ?


   Regards   Tony


Posted 02 July 2016 20:39:55(UTC)
I am surprised they are not going for mri or biopsy. Not really got any answers regarding my psa which wad at 15 the last time it was checked. I am due another psa test in a few months so will have to see which way it is going
Posted 02 July 2016 21:07:18(UTC)
I'm guessing that there's a standard protkcol they follow, maybe the cydtoscopy is the cheaper option......I'm hoping that the prostate will show up as enlarged and benign.....The C word terrifies me.....
Good luck with your tests
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