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Raised PSA on first test

User
Posted 21 Dec 2016 at 21:08

Hi allI had a health screen around 3 weeks ago through my work PHI and was a bit shocked to be told my PSA was 9.84. I had been warned about the pros and cons but opted for a test due to suffering some mild symptoms for probably the last 3 or 4 years, lacking a bit of pressure and difficulty in completely emptying my bladder particularly when leaving going until I'm bursting. I have to get up occasionally during the night but can usually control that by not drinking anything for a couple of hours before bed.

Anyway, I contacted my GP surgery and they recommended another PSA test in a month but I wanted to get it done sooner so organised it for Monday this week. I phoned in for the results today and I was pleased to hear it has dropped to 5.61. I know this is still a high reading but would I be right in thinking this is pointing towards me maybe having an infection of some kind?

I should also add that because I didn't know in advance of my first test that I was going to have one I had broken some of the rules by going for a cycle and sex in teh 48 hours before the test so refrained from both of these "activities" in the days before the second test. Other than that, reducing some of my caffeine intake is the only change I made.

Research has told me I could insist on or get a private referral for a PCA3 or 3T MRI scan but don't feel that my current state of play really warrants it. If I could have any advice from someone with similar circumstances it would be much appreciated.

Thanks in advance

Chris

 

 

 

 

User
Posted 21 Apr 2017 at 13:13
Ok, things have moved on quite a bit since i posted this back in December. I had a further PSA test which was higher again at 8.1, lower than the first one but still very high and considerably higher than my second one. As a result of that i was sent for an MP MRI scan which came back as showing, some abnormal areas. I have been for a biopsy this morning which was not pleasant and now have a bit of an agonising wait until next Thursday when I get the results. The positive bit is that there is no spread and whatever is there is contained in the capsule, lymph nodes all ok.

I'm kind of expecting the worst now in terms of a positive diagnosis of PC but remain optimistic of dealing with it comes what may. I hope this may in some way help others in a similar situation.

Edited by member 21 Apr 2017 at 13:27  | Reason: Not specified

User
Posted 22 Dec 2016 at 09:42

Chris,

As Johsan mentions there are a number of things that can raise your PSA. 

I am a little surprised though that your GP didn't refer you to a urologist for further investigation (I was 50 when I presented with a PSA of 4.6 and my GP referred me straight away - she may have been over-cautious, but as things turned out for me, I'll always thank her for being so).

Did your GP carry out a DRE (digital rectal examination)?

Personally, I wouldn't "brush it under the carpet". Your PSA is raised and so you really need to get it checked out and establish a reason for it. 

Best

Flexi

 

 

User
Posted 21 Apr 2017 at 15:23
Hi Chris

Thanks for update. At least you will get a grading very soon and then take the next decision.

By the way I had little side effects re. Biopsy other than blood in semen for nearly 3 weeks to clear which is a bit off putting for both parties.

All the best

Gordon

User
Posted 21 Apr 2017 at 15:39

Originally Posted by: Online Community Member
Hi Chris
Thanks for update. At least you will get a grading very soon and then take the next decision.
By the way I had little side effects re. Biopsy other than blood in semen for nearly 3 weeks to clear which is a bit off putting for both parties.
All the best
Gordon

 

same here mine is just clearing now after 4 weeks but they do say upto 8 weeks

 

User
Posted 22 Apr 2017 at 17:21

Hi Chris - hope your results are ok. My original PSA was 40!! I had the painful biopsies - 11 cores. 8 came back with cancer in them. I was given bone scan which came back clear - thankfully. I was placed on hormone treatment prior to starting radiotherapy. PSA plummeted to 0.95 with hormones - after radiotherapy it dropped lower to 0.08. Lowest reading every.

Hopefully your results come back ok - but if you do have to have treatment - keep a positive attitude and say to yourself that you'll beat this. It's great medicine and helped me come through this with a good outcome.

Good luck Chris -

David

User
Posted 27 Apr 2017 at 16:58

Ok, been back to the hospital for my results and was flabbergasted to find out my 12 core biopsy came back as a a negative on all 12!! What a massive relief. I know I'm not completely out of the woods but I'm now back on a 3 month psa check to monitor and if it goes up next time I may need to have another more extensive biopsy under a general aneasthetic. But for now I think it's the best I could have hoped for!  I will now leave my gleason score homework on the backburner! PHEW!!

User
Posted 27 Apr 2017 at 17:14

Phew indeed Chris14741.

Very pleased for you

Best wishes

********

We can't control the winds - but we can adjust our sails
User
Posted 27 Apr 2017 at 17:32

Originally Posted by: Online Community Member

Ok, been back to the hospital for my results and was flabbergasted to find out my 12 core biopsy came back as a a negative on all 12!! What a massive relief. I know I'm not completely out of the woods but I'm now back on a 3 month psa check to monitor and if it goes up next time I may need to have another more extensive biopsy under a general aneasthetic. But for now I think it's the best I could have hoped for!  I will now leave my gleason score homework on the backburner! PHEW!!

 

well done 

I am expecting to get confirmation of the same next wednesday

Dave

Edited by member 27 Apr 2017 at 17:32  | Reason: Not specified

User
Posted 27 Apr 2017 at 18:36
Fingers crossed for you Dave, hopefully you will receive similar news!
User
Posted 27 Apr 2017 at 22:44
Yeh you sound very similar to me apart from you are much more confident about the outcome than I was! I was convinced I would get a positive for pc but was thinking it had been caught early.

Still buzzing about the news, was quite emotional when she told me which is pretty unusual for me!

Good luck for next week

User
Posted 27 Apr 2017 at 23:14

That is fab news .. definitely a celebration needed!

User
Posted 23 Aug 2018 at 15:26
Excellent news, Chris! I'm very happy for you.

Chris

User
Posted 23 Aug 2018 at 15:49
Great result Chris but suggest you continue to have PSA tests at regular intervals.
Barry
User
Posted 23 Aug 2018 at 18:38

Great news Chris. 

Ido4

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User
Posted 22 Dec 2016 at 09:17

Hello Chris and welcome to the site.

I would ask your GP regarding the infection. 5.61 is still a tad high.

Yes, apparently sex and cycling may have an effect on a PSA so it could have been that.

It could lso be an enlarged prostate but you really need to have the information from an expert to know for certain.

You are starting to think in terms of PC when it might be something else. Make an appointment with the GP. Rule out an infection (you may be "pleasantly" surprised to find that's what it is) and then ask to be referred to hospital. If there isn't an infection you need the 5.61 investigated anyway.

Lots of folk on here will offer advice and help. It's likely to get quiet over the Christmas period so I'm hoping that I have bumped you up the list before your post disappears.

Try not to worry too much. I know that if you hadn't gone ahead with the health screening you would probably be having a better Christmas than the one going through your mind, But look at it in a more positive light.

IF there is something there then the sooner it is dealt with the more successful treatment is.

Best Wishes

Sandra

We can't control the winds - but we can adjust our sails
User
Posted 22 Dec 2016 at 09:42

Chris,

As Johsan mentions there are a number of things that can raise your PSA. 

I am a little surprised though that your GP didn't refer you to a urologist for further investigation (I was 50 when I presented with a PSA of 4.6 and my GP referred me straight away - she may have been over-cautious, but as things turned out for me, I'll always thank her for being so).

Did your GP carry out a DRE (digital rectal examination)?

Personally, I wouldn't "brush it under the carpet". Your PSA is raised and so you really need to get it checked out and establish a reason for it. 

Best

Flexi

 

 

User
Posted 22 Dec 2016 at 13:12
Hi Chris

See my profile. Not that it's anything similar to yours ! I was asymptomatic yet my brother aged 69 has PSA 3.57 and just been dx PCa Gleason 7. He had BPH and had PSA values up to 18 and down for 5 plus years. In my opinion you need sorting etc. As others have posted. As you should void completely and no reason to get up at night at your age lol !!

As least you have a base line PSA to monitor. . That what gave me early indication. Hope this helps a little. Have a look.at other members profiles as many are very detailed. .

Best wishes

Gordon

User
Posted 22 Dec 2016 at 13:23

Hi Chris,

We are getting our diagnosis this afternoon. My husband is completely asymptomatic and had a PSA of 3.5 at his company medical

Like you we refrained from sex and no bike riding before the repeat which came in at a consistent 3.5 so more consistent than yours.

However the MRI showed abnormalities...so if I were you I'd be wanting a MpMRI sooner rather than later...

I know they are not available everywhere per the fundraising info on this site but where there's a will there is a way...

So I'd be asking for a referral to a urologist with access to a MpMRI

Regards and with hope for an infection in your case. We know it's cancer just no detail.

Clare

User
Posted 22 Dec 2016 at 21:40

Thanks all for the replies and advice. I haven't actually seen my GP yet, I have an appointment booked on 3rd Jan. My wife happened to be in the surgery on the day I got my 9.48 result and they arranged for me to have my second test this week. I already made the appointment to see the GP before getting the 2nd result. I will see what he suggests but although my 5.61 is still high, the fact my level dropped dramatically would indicate that I maybe need a third test to see the direction of travel? I am prepared to push for a 3T MRI if I feel I need to and will use my work PHI if I have to. Is that the same as a MpMRI by the way?

Thanks for all of the good wishes and words of encouragement, I am a bit concerned obviously but am a fairly laid back person and generally have a positive view on life so am not letting it trouble me too much that's good I suppose!

Oh, yes I did have a DRE on my assessment and the doctor (female doctor who appeared pretty experienced) said the prostate felt normal. My only previous DRE was about 3 or 4 years ago and it was deemed to be normal then as well.

Chris

Edited by member 22 Dec 2016 at 21:43  | Reason: Not specified

User
Posted 21 Apr 2017 at 13:13
Ok, things have moved on quite a bit since i posted this back in December. I had a further PSA test which was higher again at 8.1, lower than the first one but still very high and considerably higher than my second one. As a result of that i was sent for an MP MRI scan which came back as showing, some abnormal areas. I have been for a biopsy this morning which was not pleasant and now have a bit of an agonising wait until next Thursday when I get the results. The positive bit is that there is no spread and whatever is there is contained in the capsule, lymph nodes all ok.

I'm kind of expecting the worst now in terms of a positive diagnosis of PC but remain optimistic of dealing with it comes what may. I hope this may in some way help others in a similar situation.

Edited by member 21 Apr 2017 at 13:27  | Reason: Not specified

User
Posted 21 Apr 2017 at 15:23
Hi Chris

Thanks for update. At least you will get a grading very soon and then take the next decision.

By the way I had little side effects re. Biopsy other than blood in semen for nearly 3 weeks to clear which is a bit off putting for both parties.

All the best

Gordon

User
Posted 21 Apr 2017 at 15:39

Originally Posted by: Online Community Member
Hi Chris
Thanks for update. At least you will get a grading very soon and then take the next decision.
By the way I had little side effects re. Biopsy other than blood in semen for nearly 3 weeks to clear which is a bit off putting for both parties.
All the best
Gordon

 

same here mine is just clearing now after 4 weeks but they do say upto 8 weeks

 

User
Posted 21 Apr 2017 at 15:57
My pee starts red as expected but not thought about checking my semen yet! I look forward to that though!
User
Posted 21 Apr 2017 at 18:22

Originally Posted by: Online Community Member
My pee starts red as expected but not thought about checking my semen yet! I look forward to that though!

 

I have been emptying mine everyday for last 4 weeks,

started very red and gradually went brownish an Then gradually lighter brown

coming up to 4 weeks next monday and still very light brown colour

A bit of a long winded job, they don't tell you about lol

 

User
Posted 21 Apr 2017 at 21:38

Feel for you Chris, the biopsy to results wait was stressful. How many cores did they take? My husband had 46 and the side effects/,recovery time had not been disclosed beyond 'expect blood in the semen' which would have been better described as ' expect semen in the blood' .. it was scary! All got back to normal though.

User
Posted 21 Apr 2017 at 22:33
I had 12 cores taken. That was bad enough, 46 must have been hell! The first 3 or 4 were ok but then they got gradually more painful and counting the 12 down was horrible. My pee is improving as the day goes on, my frst one left the pan pink but now it's just the first couple of seconds that are a bit pink. Is be surprised if it takes more than a couple of days to be clear but maybe it will get worse overnight again.
User
Posted 21 Apr 2017 at 22:47

Ah - yours sounds worse - my husband had a general anaesthetic for the 46 cores!

Ihe said it was like peeing glass at first plus extensive bruising came out. Also he had weaker erections throughout the healing but that seems unusual from what people on here experience ( unless it was because the surgeon took so many cores) but Ihe fully recovered.

It sounds like you are already improving Chris.

User
Posted 22 Apr 2017 at 17:21

Hi Chris - hope your results are ok. My original PSA was 40!! I had the painful biopsies - 11 cores. 8 came back with cancer in them. I was given bone scan which came back clear - thankfully. I was placed on hormone treatment prior to starting radiotherapy. PSA plummeted to 0.95 with hormones - after radiotherapy it dropped lower to 0.08. Lowest reading every.

Hopefully your results come back ok - but if you do have to have treatment - keep a positive attitude and say to yourself that you'll beat this. It's great medicine and helped me come through this with a good outcome.

Good luck Chris -

David

User
Posted 22 Apr 2017 at 18:22
Thanks David, great that you had a good outcome. Don't hear too many stories about radiotherapy though, interesting you went that route. Where are you from?
User
Posted 27 Apr 2017 at 16:58

Ok, been back to the hospital for my results and was flabbergasted to find out my 12 core biopsy came back as a a negative on all 12!! What a massive relief. I know I'm not completely out of the woods but I'm now back on a 3 month psa check to monitor and if it goes up next time I may need to have another more extensive biopsy under a general aneasthetic. But for now I think it's the best I could have hoped for!  I will now leave my gleason score homework on the backburner! PHEW!!

User
Posted 27 Apr 2017 at 17:14

Phew indeed Chris14741.

Very pleased for you

Best wishes

********

We can't control the winds - but we can adjust our sails
User
Posted 27 Apr 2017 at 17:32

Originally Posted by: Online Community Member

Ok, been back to the hospital for my results and was flabbergasted to find out my 12 core biopsy came back as a a negative on all 12!! What a massive relief. I know I'm not completely out of the woods but I'm now back on a 3 month psa check to monitor and if it goes up next time I may need to have another more extensive biopsy under a general aneasthetic. But for now I think it's the best I could have hoped for!  I will now leave my gleason score homework on the backburner! PHEW!!

 

well done 

I am expecting to get confirmation of the same next wednesday

Dave

Edited by member 27 Apr 2017 at 17:32  | Reason: Not specified

User
Posted 27 Apr 2017 at 18:32
Thank you Johsan! I hope my circumstances with a very high initial reading and good outcome will help some others in a similar situation. I won't forget I'm not out of the woods completely though!
User
Posted 27 Apr 2017 at 18:36
Fingers crossed for you Dave, hopefully you will receive similar news!
User
Posted 27 Apr 2017 at 19:04

Originally Posted by: Online Community Member
Fingers crossed for you Dave, hopefully you will receive similar news!

 

thanx Chris

my uro has already indicated that mine is due to BPE,

out of interest for you my psa in july 2016 was 5.2

waited 6 mths and retest

then risen to 8.00, so  now had the standard ultra sound biopsies

I am seeing my uro next wednesday and expect to be on regular psa checks 

much the same as you by the sound of it

good luck

User
Posted 27 Apr 2017 at 22:44
Yeh you sound very similar to me apart from you are much more confident about the outcome than I was! I was convinced I would get a positive for pc but was thinking it had been caught early.

Still buzzing about the news, was quite emotional when she told me which is pretty unusual for me!

Good luck for next week

User
Posted 27 Apr 2017 at 23:14

That is fab news .. definitely a celebration needed!

User
Posted 25 Jul 2018 at 09:04

It's been over a year since I posted my results which at the time I was obviously very happy about. things now however have tken a bit of a turn. A few weeks ago I decided to do something about my flow other than continuing taking Tamsulosin and Finasteride which I really don't like taking. I got a referral to see if I was a suitable case for a urolift procedure which involved going private through my work PHI scheme.

I had the initial referral and was then booked in for a flexible cystoscopy to check if I had a medial lobe which might prevent the procedure from being possible. That went ok but my consultant has strongly recommended that I have a trans perinial template (fusion) biopsy because he wants to satisfy himself that the TRUS biopsy results were accurate. He has indicated that with the PSA results I have been getting (between 5 and 9) and the relative size of my prostate that there is some cause for concern about the results of the previous biopsy.

I have agreed and also got the MRI image and records from the NHS hospital so that a template can be produced but I was more than a little horrified about the records which described the following.

"The prostate measures 50 x54x 30mm

36 mm maximum diameter lesion arising from the peripheral zone at the mid and base of both sidesinfiltrates the transitional zone and shows restricted diffusionin keeping with significant tumour. No extension beyond the prostate gland. Intermediate suspicion of focal prostate cancerat the mid prostate level within the transitional zone on both sides.

Normal seminal vesicles, No enlarged pelvic lymph nodes, No malignant bone marrow signal change

Conclusion

Strong suspicion of significant tumour within the peripheral zone on both sides with intermediate suspicion of transitional zone tumour on both sides

biopsy is recommended. If biopsy confirms carcinoma the provisional radiological staging would be T2c NO MX"

This was before the TRUS biopsy which was the 12 cores and came back on the Histology report as No malignancy, Plan: PSA surveillance

My PSA has remained "stable" within a range of 5-9 since my first high level around 20 months ago but I now feel pretty concerned about the above which is probably why they didn't tell me exactly what was contained in the results. I was keen to get a further PSA test done before the biopsy and am due to go for that later this morning and have the biopsy booked for 10th August. I can see why my current private urologist wants to investigate this further but I do feel a bit angry that the biopsy I had to endure really doesn't seem fit for purpose and I now have to give my poor old prostate another battering. I'm also concerned another year+ has gone by and if there was malignancy then this will presumably worse now.

 

If anyone can offer any advice or share their similar experiences it would be appreciated!

Thanks

 

 

User
Posted 25 Jul 2018 at 15:49
Presumably the 12 cores were taken from the grey area? If you are not sure, your new uro should be able to check in your records. Your previous uro already had it in mind to keep you on close monitoring, you posted in April 17 that the plan was 3 monthly PSA and possible template biopsy. Decision now for the template biopsy I suppose is do you stick with the new uro or go back to the one who has all your previous data.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 25 Jul 2018 at 17:41

Hi LynEyre and thanks for the response.

 

I was certainly under the impression that the cores were taken from the "grey area" but my new uro who is very highly respected because I did my research before choosing him has indicated that a TRUS rectal biopsy is a bit of a lucky dip compared to a template fusion biopsy and he is concerned about doing a urolift procedure whilst not entirely convinced that my first biopsy is a conclusive result. It does seem unlikely that a lesion measuring up to 36 mm could be missed in a prostate sized 50mm x 54mm x 30mm but I kind of share his concern about the initial view that there is a strong suspicion of a significant tumour.

I think I need to have the biopsy again just to if nothing else get my initial result validated. I had the blood test earlier so at least I will have the result of that back before I have the procedure and that if not raised further should hopefully reassure me I don't need to expect the worst. If it is negative again then at least I can look forward to the urolift which apparently can be done on me as I don't have a significant medial lobe. Fingers firmly crossed!

User
Posted 25 Jul 2018 at 18:10
36mm was such a big area to go at; it would be shocking if it turned out that none of the 12 cores were taken from that area. But it does seem from your post last year that the first uro was also a bit incredulous at the result so absolutely right to have another biopsy now.

If it comes back clear again, you will count yourself a very lucky man I think.

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

User
Posted 25 Jul 2018 at 18:45

I would indeed. I am generally a positive person but do fear the worst. I will post by PSA result when I get it early next week. That's the bit I can't get my head around, if there is such a significant lesion then why has my PSA not been ever increasing? If the PSA isn't a reliable factor in determining whether or not my lesion was getting any worse then why was active surveillance the suggested course of action?!

Also, it could have grown significantly bigger in the 15 months since I had the MRI and may not now be contained. Or I suppose if it is still the same size and benign then that would explain a similar PSA.

 

So may questions whirring around in my head!

User
Posted 23 Aug 2018 at 14:58

Well I feel I should update this thread with the latest news. I had my template fusion biopsy nearly 2 weeks ago which wasn't particularly pleasant but not horrendous as it was under a general. The symptoms afterwards were not as bad as my first trans-rectal biopsy a year ago although my perineum resembled a tetley tea bag!

The wait since then has been a bit agonising and I made a telephone appointment with the urologist for this afternoon because he had nothing available face to face before September and I couldn't bear waiting that long. Anyway, the conversation was quite brief and to the point, all samples were negative and I'm all clear!! I can't quite believe it, he said he is sure he got samples from all of the suspect areas and can confidently say all were benign!

 Now for the Urolift or rezum, yet to be decided. Hopefully medication free soon!

I hope this ending gives someone else some hope and comfort, good luck everyone!!

 

User
Posted 23 Aug 2018 at 15:26
Excellent news, Chris! I'm very happy for you.

Chris

User
Posted 23 Aug 2018 at 15:49
Great result Chris but suggest you continue to have PSA tests at regular intervals.
Barry
User
Posted 23 Aug 2018 at 18:38

Great news Chris. 

Ido4

User
Posted 23 Aug 2018 at 20:36

I will Barry, thanks. I have my normal NHS appointment coming up as well so will be getting monitored there.

 
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