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User
Posted 12 Jan 2017 at 23:01

Hi all,


This is my first post here and I'm looking for some advice about what I should do.


I went to my GP a few weeks before Christmas as I was alarmed when I noticed a fair amount of blood in my semen. As a result of this and describing other symptoms of issues urinating, he did a DRE and told me my prostate was slightly enlarged. He said I should do a blood test (I found out later it was a PSA test) but did say it wasn't a good test to do as it was unreliable.


Anyway, test done, he then phoned me the same evening to say I had a raised PSA of 8.2 and he would be referring me as a fast-track case to my local hospital. Cue stress and worry that it's cancer.


So I attend the urology dept expecting all sorts of investigations (I read the leaflet thoroughly) to be met be a consultant who basically seemed cross that I had been referred (I'm 42) as I 'should not have had a PSA test below the age of 50', especially as I have no history of prostate cancer in my family. He actually told me, 'you're in the system now so we'll have to investigate further.' He has arranged flow studies (6-8 weeks wait), as I have symptoms of an enlarged prostate. He also did a DRE and said I have a 'small benign prostate'. He will follow-up in 3 months and check my PSA again then.


I was made to feel like I should not have been referred in the first place. However, I phoned Prostate Cancer UK and spoke to a lovely nurse who recommended I have a look at the BAUS website. Here my symptoms completely back up my GP's decision to refer me as fast-track (blood in semen, raised PSA, symptoms of enlarged prostate). So I'm not sure what to do now - has anyone else had a similar experience? I'm not sure if I need to be concerned or not!


Thanks

User
Posted 13 Jan 2017 at 09:11

Sorry to see you here Trigger but you've come to the right place.


There's a lot of knowledge and support on here and you'll get it all.


Shame the consultant was such a pain but let's be charitable and say he's run off his feet.


It's true you are young for prostate cancer but the younger men on here will confirm that it does happen.


It's great that your doctor was proactive and on the ball.


PSA of 8.2 is quite high but could be for reasons other than cancer. In fact a benign prostate (an enlarged prostate) can cause it, and it is said that sex and cycle riding before the blood test can raise it. (So remember that for the next test !!)


I'm sure others on here will be along to advise you but please don't feel like a time waster or start looking on the black side. There is a way to go yet before cancer is confirmed.


Best Wishes


 

Edited by member 13 Jan 2017 at 09:12  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 13 Jan 2017 at 10:11

I am frustrated for you that the urologist reacted this way - your GP would have been failing in his duty of care if he had not referred you. My husband was diagnosed with a pSA of 3.1 and we have new members on here this year diagnosed in their 30s and 40s so the urologist has made you feel bad unjustifiably.

If your PSA is still high when it is next tested in 3 months time my advice to you would be to ask for an MRI scan and biopsy (and cross your fingers that you see a more helpful doctor).

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Jan 2017 at 11:18
Trigger

Don't know how to advise you on how the urologist treated you but in light of my very different experience I'd be concerned.

I'm 46. No symptoms whatsoever. Did a random PSA test at a screening event. PSA of 6.2. To cut a long story short, I've had my prostate removed and had a T3b tumour and Gleason 9.

At the start, everybody, including my GP and specialist nurses from PCUK told me that at my young age and in the absence of symptoms, there could well be an explanation other than cancer. I was told that even if it was cancer, it would be small and slow growing in someone so young and I might have months or years of active surveillance. My GP has since told me he's very shocked things have turned out as they have.

I don't mean to worry you by telling you my case history. But I am shocked by your urologist's attitude. Second opinion from a different urologist?

I have been exceptionally lucky with speedy service.

Ulsterman
User
Posted 13 Jan 2017 at 22:52

Hi Trigger


As the others have said, the GP was right in referring you and importantly the sooner you discover anything - if it is PCa, the more options available to you. The elevated PSA coudl be caused by a number of conditions, and not PCa. However with the other symptons you definitely warrant further investigation.


It's worth investigating who the urologists are at your local hospital and trying to get an appointment with another one. Regardless of how tough a week it has been, there is no excuse for that attitude.


Don't be afraid to voice your opinion with medical professionals. Good luck.


Chris

User
Posted 14 Jan 2017 at 22:01
Hi Trigger

From what you have posted, whether it's pca or not you need the correct diagnosis obviously.

You don't appear to have had this. Only through experience am I learning more about symptoms etc. Firstly there is a simple blood urine test , did the gp do this last month ? Defining a problem uses the same logic in whatever line of work I always told our kids. Simple.

Ie is this blood from where ? How often. . When first appeared. Infection ? Recent injury ? Etc etc

I'm also surprised that a PSA test was turned around in less that 12 hours ? Although not that relevant, just a comment.

Yes revisit GP. Test strips will be sensitive to blood cells you are unable to see by the way.

Have you had any history of prostatitis or UTI's ?

Do you feel any discomfort or pain ?


All the best and hopefully you are properly assessed.

Gordon
User
Posted 15 Jan 2017 at 17:34

Hi Andy


Good.  GP appears very switched on.  Provide him/her with complete update.  I'm not medical guy, just learnt a little both about urology in general over last couple of years (see my profile).


I never had blood in urine that I knew off and only in semen (post biopsy for about 3 weeks ).  My colleague was diagnosed incorrectly with bladder cancer when he actually had PCa.  Blood in urine.


So at 42, age irrelevant ;   something is not functioning as it should.    


I read your posts re. flow tests.   My GP told me over 10 years ago, very simple stuff I always remember.   Very broadly speaking you should be able to expel / void  10 ml per sec at my age (60) and as a teenager   double that (ie 20 ml / sec +).  Bladder size changes also.  (ie decreases).   Post op I tend to pass 300ml in 30 seconds or less (obviously you can force increase pressure).  The problems with infection is lack of complete voiding (in both men and women) and concentration of urine if you don't hydrate enough.


Although you can't accurately get the start and end 'flow' times yourself, just wee into a marked container and time yourself for a few occasions  (with full bladder etc) its gives rough flow average  time and obviously an accurate bladder potential capacity.   


  I had robotic RP and my flows have increased slightly (ie no prostate and shortened urethra)  - ie about 25 secs  at loo to void 250 / 350 ml).  I no longer can hold 400 or 500 ml  like the teenage days , when I could fill a pint glass ? lol .


By the way not something I practice on a regular basis.


Looking back I now realise I should have spoken a lot more with father in law who I was very close, hindsight is a wonderful thing as they say.  He used to takes absolutely ages going to loo and everyone said,  its an old mans disease. (he actually died at 72 of a heart attack, and only a few years back, so we have no  idea if he has issues with his waterworks, maybe BPH which he wouldn't  have understood, he was 'old school' and kept away from GP's ! )  


 


All the very best and hope your sorted ASAP


 


            


      

Edited by member 15 Jan 2017 at 17:44  | Reason: Not specified

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User
Posted 13 Jan 2017 at 09:11

Sorry to see you here Trigger but you've come to the right place.


There's a lot of knowledge and support on here and you'll get it all.


Shame the consultant was such a pain but let's be charitable and say he's run off his feet.


It's true you are young for prostate cancer but the younger men on here will confirm that it does happen.


It's great that your doctor was proactive and on the ball.


PSA of 8.2 is quite high but could be for reasons other than cancer. In fact a benign prostate (an enlarged prostate) can cause it, and it is said that sex and cycle riding before the blood test can raise it. (So remember that for the next test !!)


I'm sure others on here will be along to advise you but please don't feel like a time waster or start looking on the black side. There is a way to go yet before cancer is confirmed.


Best Wishes


 

Edited by member 13 Jan 2017 at 09:12  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 13 Jan 2017 at 10:11

I am frustrated for you that the urologist reacted this way - your GP would have been failing in his duty of care if he had not referred you. My husband was diagnosed with a pSA of 3.1 and we have new members on here this year diagnosed in their 30s and 40s so the urologist has made you feel bad unjustifiably.

If your PSA is still high when it is next tested in 3 months time my advice to you would be to ask for an MRI scan and biopsy (and cross your fingers that you see a more helpful doctor).

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Jan 2017 at 11:18
Trigger

Don't know how to advise you on how the urologist treated you but in light of my very different experience I'd be concerned.

I'm 46. No symptoms whatsoever. Did a random PSA test at a screening event. PSA of 6.2. To cut a long story short, I've had my prostate removed and had a T3b tumour and Gleason 9.

At the start, everybody, including my GP and specialist nurses from PCUK told me that at my young age and in the absence of symptoms, there could well be an explanation other than cancer. I was told that even if it was cancer, it would be small and slow growing in someone so young and I might have months or years of active surveillance. My GP has since told me he's very shocked things have turned out as they have.

I don't mean to worry you by telling you my case history. But I am shocked by your urologist's attitude. Second opinion from a different urologist?

I have been exceptionally lucky with speedy service.

Ulsterman
User
Posted 13 Jan 2017 at 22:52

Hi Trigger


As the others have said, the GP was right in referring you and importantly the sooner you discover anything - if it is PCa, the more options available to you. The elevated PSA coudl be caused by a number of conditions, and not PCa. However with the other symptons you definitely warrant further investigation.


It's worth investigating who the urologists are at your local hospital and trying to get an appointment with another one. Regardless of how tough a week it has been, there is no excuse for that attitude.


Don't be afraid to voice your opinion with medical professionals. Good luck.


Chris

User
Posted 14 Jan 2017 at 20:25

Thanks for the swift replies, much appreciated - I think I will phone my GP on Monday to see what he can do re a second opinion, especially as this evening I've noticed blood in my urine for the first time. I don't really want to wait another 8 weeks to be told something which seems to be gathering more evidence.


The more I think about my first appointment at the hospital, the more disappointed I am, as I feel like I'm caught in a disagreement of protocol between professionals, rather than a patient with troubling symptoms. I might add that before my first PSA I certainly didn't have sex or ride a bike; in fact, I was advised not to by my GP. My consultant at the hospital stated very clearly in the letter to the GP, 'This patient is not on the fast-track.' Do GPs have the time to phone patients and say, 'I think the consultant is wrong, so I'm recommending a second opinion.'?

User
Posted 14 Jan 2017 at 22:01
Hi Trigger

From what you have posted, whether it's pca or not you need the correct diagnosis obviously.

You don't appear to have had this. Only through experience am I learning more about symptoms etc. Firstly there is a simple blood urine test , did the gp do this last month ? Defining a problem uses the same logic in whatever line of work I always told our kids. Simple.

Ie is this blood from where ? How often. . When first appeared. Infection ? Recent injury ? Etc etc

I'm also surprised that a PSA test was turned around in less that 12 hours ? Although not that relevant, just a comment.

Yes revisit GP. Test strips will be sensitive to blood cells you are unable to see by the way.

Have you had any history of prostatitis or UTI's ?

Do you feel any discomfort or pain ?


All the best and hopefully you are properly assessed.

Gordon
User
Posted 15 Jan 2017 at 11:56

Thanks for your comment Gordon, I'll be making an appointment with my GP first thing in the morning. Blood test and urine tests were done last month and nothing came up in my urine test then so a bit worrying to suddenly have it visible now. (It's darker brown this morning) Other than the symptoms of an enlarged prostate and the blood in semen I mentioned in an earlier post, I've had no other symptoms whatsoever. No pain when urinating or any other aches, no other history of relevance (these are my first dealings with urological problems!)


I just hope I can get back on the fast track to get this properly checked out promptly.


Andy


 

User
Posted 15 Jan 2017 at 17:34

Hi Andy


Good.  GP appears very switched on.  Provide him/her with complete update.  I'm not medical guy, just learnt a little both about urology in general over last couple of years (see my profile).


I never had blood in urine that I knew off and only in semen (post biopsy for about 3 weeks ).  My colleague was diagnosed incorrectly with bladder cancer when he actually had PCa.  Blood in urine.


So at 42, age irrelevant ;   something is not functioning as it should.    


I read your posts re. flow tests.   My GP told me over 10 years ago, very simple stuff I always remember.   Very broadly speaking you should be able to expel / void  10 ml per sec at my age (60) and as a teenager   double that (ie 20 ml / sec +).  Bladder size changes also.  (ie decreases).   Post op I tend to pass 300ml in 30 seconds or less (obviously you can force increase pressure).  The problems with infection is lack of complete voiding (in both men and women) and concentration of urine if you don't hydrate enough.


Although you can't accurately get the start and end 'flow' times yourself, just wee into a marked container and time yourself for a few occasions  (with full bladder etc) its gives rough flow average  time and obviously an accurate bladder potential capacity.   


  I had robotic RP and my flows have increased slightly (ie no prostate and shortened urethra)  - ie about 25 secs  at loo to void 250 / 350 ml).  I no longer can hold 400 or 500 ml  like the teenage days , when I could fill a pint glass ? lol .


By the way not something I practice on a regular basis.


Looking back I now realise I should have spoken a lot more with father in law who I was very close, hindsight is a wonderful thing as they say.  He used to takes absolutely ages going to loo and everyone said,  its an old mans disease. (he actually died at 72 of a heart attack, and only a few years back, so we have no  idea if he has issues with his waterworks, maybe BPH which he wouldn't  have understood, he was 'old school' and kept away from GP's ! )  


 


All the very best and hope your sorted ASAP


 


            


      

Edited by member 15 Jan 2017 at 17:44  | Reason: Not specified

User
Posted 15 Jan 2017 at 19:35

Just as well GP was proactive. They are the ones to be more inclined to refuse even a PSA test because patients are considered too young to be affected. Though not a case of refused PSA, this sad story is indicative of the attitude of some GP's who base action on age rather than the patient. http://www.dailymail.co.uk/news/article-4108688/Graduate-died-diagnosed-cervical-cancer-just-21-begged-doctors-smear-tests-told-young.html

Barry
User
Posted 19 Feb 2019 at 08:14

Well, it's been a while since I've posted here and I'm still on the diagnosis journey. Had my second template biopsy yesterday as my PSA has risen to 28. Nothing suspicious was found on my recent MRI (unlike my first, where they did find suspicious areas) but in light of rising PSA 2nd biopsy was advised.


It's been over 2 years now since my first symptoms appeared and whilst I'm hoping that the consultant is right in thinking that it is BPH caused by recurrent mild UTI's the worry is still there. 


I wondered if anyone else has had a similar diagnosis journey, possibly including any ongoing tussles with GP/hospital over which one is going to be responsible for monitoring PSA levels. It's been frustrating at times!


 


Andy

 
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