I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

44 with a mildly elevated PSA -- worried about nothing?

Email this conversation Print this conversation
User
Posted 05 Apr 2017 at 12:20

Hi,

I'm a 44-year old male. I have some very minor symptoms of prostate enlargement -- urinary urgency/frequency and some dribbling. I recently asked my doctor if I should have my prostate checked and she said "not until 50 unless you show signs". She did a DRE on the spot and it was positive for enlargement.

She ordered a PSA and urinalysis. My urinalysis is negative for nitrates and negative for bacterial culture.

My PSA is 2.9 and I understand this is fairly low, but from what I've read this is a bit of a concern at 44? My TSAf % is 16%, which has me a little more worried.

I want to see a urologist, but I suspect my GP will fight me on that. Am I worrying over nothing? What should I ask for in terms of next steps? 

User
Posted 05 Apr 2017 at 17:36

Slightly different view to my friends above (sorry) - the free PSA ratio of 16% is reassuring but unreliable at PSA of less than 4.0. For your age, PSA of 2.9 is above referral threshold so there should be no problem getting a referral to a urologist if you live in England. It may be infection or you inherited a tendency to enlarged prostate but urgency / frequency at your age should be enough for a referral regardless of any anxiety about prostate cancer. My husband was first referred at age 35 for frequency and slow flow - his PSA was low but the urologist still wanted to find out why he was having problems (it turned out to be a bladder muscle problem for which he took tablets for 15 years). If you have any other problems such as difficulty getting an erection, dry orgasms or retrograde ejaculation do not be embarrassed - you must tell the GP that as well.

Just one query - you are not a professional cyclist are you?

Edited by member 05 Apr 2017 at 17:37  | Reason: Not specified

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

User
Posted 06 Apr 2017 at 15:24

I don't know Lola but this is Geeky's thread so perhaps your question should be on one of your threads instead?

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

User
Posted 06 Apr 2017 at 20:36
Geekything

I'm 46 and had an original PSA of 6.2. To cut a long story short, I've had my robotic surgery and with non nerve sparing suffer the delights of ED. I often wonder what my PSA would have been at age 45 when I had my well man clinic. They didn't test for PSA. Maybe the cancer would not have been in the nerve bundles, maybe the tumour would have been smaller. I'm glad you're seeing the urologist - early referral may mean better outcomes if you do have PCa.

Good luck

Ulsterman

User
Posted 05 Apr 2017 at 12:57

I Don't think your PSA is too high but since you are young and your prostate is enlarged, I'd rather see an uro.
Anyway wait until someone more knowledged than me says st. I'm still "new" in this stuff.
Best wishes
Lola.

User
Posted 05 Apr 2017 at 14:36

Hello Geekything

Is there any history of Prostate/Breast cancer in your immediate family? It may act as a lever if the answer is yes.

PSA of 2.9 seems low compared to some on here with PSA in the hundreds and thousands but we also have a few with low PSA and cancer so PSA of itself doesn't say yay or nay to cancer, it just indicates something needs investigating.

So your GP is also saying that there isn't an infection?

If you are really bothered then ask the GP to refer you to a urologist. although she may ask you to wait a while to see if your symptoms of enlargement reduce.

One thing I wouldn't do is ignore any of it and hope it all goes away.

I'm sure others will be along to advise so hang in there until then

Best Wishes

Sandra

****

We can't control the winds - but we can adjust our sails
User
Posted 05 Apr 2017 at 15:12

Hi Geekything,

Whilst it is true that most men are not diagnosed until the are 50+ some men are diagnosed well under this age - we have them on this forum. So being under 50 should not be a bar to having having a PSA/DRE which you have now had done. It also seems from what you say that an infection had been ruled out. The next step is to ask your GP to request an appointment with a urologist to try to determine whether the urinary symptoms are entirely due to your enlarged Prostate (Benign Prostatic Hyperplasia - referred to as BPH). I would not be put off just because your PSA is not high. Some forms of cancer do not show high PSA and even less symptoms than you have for a man of your age. Should it be cancer it is best to be found at an early stage where appropriate action can lead to best chance of cure.

Barry
User
Posted 05 Apr 2017 at 21:49

I think your GP is a bit out of date - fortunately the urologist should know quite a lot about the subject!

There is a familial link between ovarian cancer and prostate cancer and they are of course both hormonal cancers.

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

User
Posted 05 Apr 2017 at 22:29

My husband is 44, PSA measured at 2.7 then 3.6 12 months later then 3, 2 months later. He had biopsy and had cancer. Prostate removed 2 months later and hopefully now all clear.
It is good that you have a referral. Our Urologist was surprised by the positive biopsy result but there you go, it is unusual but not unheard of.
Julie

User
Posted 05 Apr 2017 at 23:42

John's was 3.1 and it was already spreading into his bladder. We also have members here who have been diagnosed in their 30s so the assumption that it is an old man's disease is a myth. As I said, the GP perhaps doesn't have much experience of prostate cancer - good that you have been referred.

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

User
Posted 06 Apr 2017 at 05:17

Lyn, I have to sons, 36, 39. You think it's time they checked their prostate, as their father has a PCa?

Good morning,

Lola.

User
Posted 06 Apr 2017 at 06:18

Lola, my son is 45 and has been checked. He isn't stressed about the possibility but he knows that he has to be aware.

I also have three grandsons who have been told that their granddad has had prostate cancer so they'll know for the future.

Warn your boys by all means but there is no need to panic them. There can be a familial link but it isn't always the case.

Just make them aware of the possibility. I've no doubt that they will consider it, for your sake at least and to put your mind at rest

For us mothers, our sons are now grown men. All we can do it point them in the right direction and we've done our duty. Love can only go so far but then we have to leave it up to them

We can't control the winds - but we can adjust our sails
User
Posted 06 Apr 2017 at 09:32

Lola, if it is available in Spain they should probably start getting tested from the age of about 40 - 45, just to keep an eye on things. But as Paco was not diagnosed young, it is very unlikely that there is a family gene.

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

User
Posted 06 Apr 2017 at 09:49

Thanks, Lyn.

Since the oldest one , 39, is not very prompt as far as matter of health is concerned, I'll begin already.
telling him to visit the consultant.

They can go both "Seguridad Social" (state health care) and private insurance as it's provided by the companies they work for. Do you think it's better to spare the general consultant and visit the uro directly

User
Posted 06 Apr 2017 at 15:43

Geeky, so sorry for using your thread to my own questions. Sometimes, when reading other's conversations that are someway related to your issues you forget that's not your thread.
I wish you all the best.
Lola

User
Posted 06 Apr 2017 at 17:21

No problem on the thread hijacking ;)

One question....my free PSA % is 16.....I thought this was in the "danger" territory but it appears not? Did I misinterpret the stats? I do understand it's not considered reliable < 4.0 PSA, although it does appear the Mayo Clinic think otherwise (valid > 2.5 PSA).

Thanks!

User
Posted 06 Apr 2017 at 20:01

The methods for testing PSA and fPSA vary here and in the USA so although in the US the optimum range is seen as 2.5 - 4.0 and fPSA ratio benchmark is 16%, in the UK it tends to be thought unreliable below 4.0 with a threshold of 25%. Either way, you are right on the border of inconclusive at the minute.

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

Show Most Thanked Posts
User
Posted 05 Apr 2017 at 12:57

I Don't think your PSA is too high but since you are young and your prostate is enlarged, I'd rather see an uro.
Anyway wait until someone more knowledged than me says st. I'm still "new" in this stuff.
Best wishes
Lola.

User
Posted 05 Apr 2017 at 14:36

Hello Geekything

Is there any history of Prostate/Breast cancer in your immediate family? It may act as a lever if the answer is yes.

PSA of 2.9 seems low compared to some on here with PSA in the hundreds and thousands but we also have a few with low PSA and cancer so PSA of itself doesn't say yay or nay to cancer, it just indicates something needs investigating.

So your GP is also saying that there isn't an infection?

If you are really bothered then ask the GP to refer you to a urologist. although she may ask you to wait a while to see if your symptoms of enlargement reduce.

One thing I wouldn't do is ignore any of it and hope it all goes away.

I'm sure others will be along to advise so hang in there until then

Best Wishes

Sandra

****

We can't control the winds - but we can adjust our sails
User
Posted 05 Apr 2017 at 15:12

Hi Geekything,

Whilst it is true that most men are not diagnosed until the are 50+ some men are diagnosed well under this age - we have them on this forum. So being under 50 should not be a bar to having having a PSA/DRE which you have now had done. It also seems from what you say that an infection had been ruled out. The next step is to ask your GP to request an appointment with a urologist to try to determine whether the urinary symptoms are entirely due to your enlarged Prostate (Benign Prostatic Hyperplasia - referred to as BPH). I would not be put off just because your PSA is not high. Some forms of cancer do not show high PSA and even less symptoms than you have for a man of your age. Should it be cancer it is best to be found at an early stage where appropriate action can lead to best chance of cure.

Barry
User
Posted 05 Apr 2017 at 17:36

Slightly different view to my friends above (sorry) - the free PSA ratio of 16% is reassuring but unreliable at PSA of less than 4.0. For your age, PSA of 2.9 is above referral threshold so there should be no problem getting a referral to a urologist if you live in England. It may be infection or you inherited a tendency to enlarged prostate but urgency / frequency at your age should be enough for a referral regardless of any anxiety about prostate cancer. My husband was first referred at age 35 for frequency and slow flow - his PSA was low but the urologist still wanted to find out why he was having problems (it turned out to be a bladder muscle problem for which he took tablets for 15 years). If you have any other problems such as difficulty getting an erection, dry orgasms or retrograde ejaculation do not be embarrassed - you must tell the GP that as well.

Just one query - you are not a professional cyclist are you?

Edited by member 05 Apr 2017 at 17:37  | Reason: Not specified

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

User
Posted 05 Apr 2017 at 21:13

My GP has referred me to a urologist -- mainly because she could see I was worried. She claims that a 2.9 PSA in a 44-year old is perfectly normal and that if I had cancer it'd be much, much higher.

To answer the questions:

- No history of prostate or breast cancer that I know of. My mother died from ovarian cancer, but I understand that's completely unrelated.

- I am not a professional cyclist and had no form of prostate manipulation before my PSA test.

Thanks to everyone for the replies!

Edited by member 05 Apr 2017 at 21:15  | Reason: Not specified

User
Posted 05 Apr 2017 at 21:49

I think your GP is a bit out of date - fortunately the urologist should know quite a lot about the subject!

There is a familial link between ovarian cancer and prostate cancer and they are of course both hormonal cancers.

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

User
Posted 05 Apr 2017 at 22:29

My husband is 44, PSA measured at 2.7 then 3.6 12 months later then 3, 2 months later. He had biopsy and had cancer. Prostate removed 2 months later and hopefully now all clear.
It is good that you have a referral. Our Urologist was surprised by the positive biopsy result but there you go, it is unusual but not unheard of.
Julie

User
Posted 05 Apr 2017 at 23:42

John's was 3.1 and it was already spreading into his bladder. We also have members here who have been diagnosed in their 30s so the assumption that it is an old man's disease is a myth. As I said, the GP perhaps doesn't have much experience of prostate cancer - good that you have been referred.

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

User
Posted 06 Apr 2017 at 05:17

Lyn, I have to sons, 36, 39. You think it's time they checked their prostate, as their father has a PCa?

Good morning,

Lola.

User
Posted 06 Apr 2017 at 06:18

Lola, my son is 45 and has been checked. He isn't stressed about the possibility but he knows that he has to be aware.

I also have three grandsons who have been told that their granddad has had prostate cancer so they'll know for the future.

Warn your boys by all means but there is no need to panic them. There can be a familial link but it isn't always the case.

Just make them aware of the possibility. I've no doubt that they will consider it, for your sake at least and to put your mind at rest

For us mothers, our sons are now grown men. All we can do it point them in the right direction and we've done our duty. Love can only go so far but then we have to leave it up to them

We can't control the winds - but we can adjust our sails
User
Posted 06 Apr 2017 at 09:32

Lola, if it is available in Spain they should probably start getting tested from the age of about 40 - 45, just to keep an eye on things. But as Paco was not diagnosed young, it is very unlikely that there is a family gene.

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

User
Posted 06 Apr 2017 at 09:49

Thanks, Lyn.

Since the oldest one , 39, is not very prompt as far as matter of health is concerned, I'll begin already.
telling him to visit the consultant.

They can go both "Seguridad Social" (state health care) and private insurance as it's provided by the companies they work for. Do you think it's better to spare the general consultant and visit the uro directly

User
Posted 06 Apr 2017 at 15:24

I don't know Lola but this is Geeky's thread so perhaps your question should be on one of your threads instead?

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

User
Posted 06 Apr 2017 at 15:43

Geeky, so sorry for using your thread to my own questions. Sometimes, when reading other's conversations that are someway related to your issues you forget that's not your thread.
I wish you all the best.
Lola

User
Posted 06 Apr 2017 at 17:21

No problem on the thread hijacking ;)

One question....my free PSA % is 16.....I thought this was in the "danger" territory but it appears not? Did I misinterpret the stats? I do understand it's not considered reliable < 4.0 PSA, although it does appear the Mayo Clinic think otherwise (valid > 2.5 PSA).

Thanks!

User
Posted 06 Apr 2017 at 20:01

The methods for testing PSA and fPSA vary here and in the USA so although in the US the optimum range is seen as 2.5 - 4.0 and fPSA ratio benchmark is 16%, in the UK it tends to be thought unreliable below 4.0 with a threshold of 25%. Either way, you are right on the border of inconclusive at the minute.

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

User
Posted 06 Apr 2017 at 20:36
Geekything

I'm 46 and had an original PSA of 6.2. To cut a long story short, I've had my robotic surgery and with non nerve sparing suffer the delights of ED. I often wonder what my PSA would have been at age 45 when I had my well man clinic. They didn't test for PSA. Maybe the cancer would not have been in the nerve bundles, maybe the tumour would have been smaller. I'm glad you're seeing the urologist - early referral may mean better outcomes if you do have PCa.

Good luck

Ulsterman

User
Posted 08 Apr 2017 at 13:15

One other tidbit....my wife reminded me I'd had a slightly abnormal ultrasound in 2013 (it was a renal ultrasound, but I guess they checked my prostate whilst they were there). The remarks were prostate size slightly elevated. I guess this validates the DRE of "enlarged prostate".

Patiently waiting for my referral.

User
Posted 17 Apr 2017 at 22:12
Don't wait too patiently!
User
Posted 31 May 2018 at 01:10

So, 1-year later.

My PSA has now risen from 2,9 to 5.2 My free/total% has gone from 15% down to 7%. Bear in mind I'm only 45.

See the urologist in two weeks. Nervous.

Edited by member 31 May 2018 at 01:42  | Reason: Not specified

User
Posted 31 May 2018 at 15:46
Ask for a multi-parametric MRI. When I was first tested for PSA at 55 it was 2.2 which the system and my GP said was “normal”

When seven years later, after my second ever PSA result was 17, the urologist I was referred to said he would have recommended regular PSAs after the first one, but he did concede “I do see loads of patients with prostate cancer”.

Friends on private health plans over 50 have annual DRE and PSA tests.

Good luck!

Cheers, John

User
Posted 17 Jul 2018 at 17:53
Thanks, Bollinge. I don't have the option of an mpMRI just yet.

I saw my urologist after a bit of a wait after my PSA results. He told me my doubling time, PSA velocity and free PSA ratio (7%) are concerning. DIdn't suggest wait-and-see, didn't suggest a round of antibiotics, just said he wants to do a biopsy as soon as possible.

Now I'm in waiting hell for my biopsy mid-August. And then another couple of weeks wait for the urologist appointment and the results.

He's given me a gestalt probability of 40% to find cancer on the first biopsy. A local prostate cancer centre scored me at 36.4% based on their nomogram, so it looks like my urologist knows his stuff.

I don't think I have BPH as, from what I understand, free PSA generally increases with that. So, we're left with the option of chronic prostatitis -- not wonderful, but better than PCa.

User
Posted 25 Jul 2018 at 12:59
I'm very anxious about the biopsy, so my psychiatrist gave me a sedative to help deal with it. As strange as it sounds, I'm more concerned about doing the Bx than getting the results (the results will be what they'll be).
User
Posted 25 Jul 2018 at 20:45
Sometimes the apprehension can be far worse than the event! Being placed in position for biopsy is undignified but most men find the the sampling experience not too bad. With the TRUS biopsy you hear a 'click', usually between eight and 12 times and each of the cores taken feels like being flicked with a rubber band. (i would prefer this to having a tooth filled and I have had plenty of these done over the years.) I drove home immediately afterwards no problem and this is not uncommon. There was just a trace of blood in my urine for following two to three days and no infection, no doubt helped by the antibiotics supplied. Of course some men have an unusually low pain threshold and for them it may be somewhat painful.
Barry
User
Posted 25 Jul 2018 at 20:52

Thanks, Barry.

Unfortunately, I do have a low pain threshold :( I believe I'll be getting 12 cores. Peeing blood for a couple of days won't alarm me.

I hope with the sedative, lidocaine and perialstatic nerve block I'll be comfortable. 

It's funny: you're not the first person I've heard describe it as being a rubber band flick.

I'll report back in 3 weeks.

User
Posted 28 Jul 2018 at 17:58

@geekything...

Hopefully helpful... I've previously posted on my own experience, from which I clip:

-----------

I had a TRUS biopsy this morning... set me thinking about how when I was recently in A&E, I was asked to complete a 'how likely are you to recommend us?' questionnaire.

How likely? What... to recommend 'having a stranger shove gawd-knows-what (I didn't look) up yer poop-shute, accompanied by what sounded like the firing of a spud-gun I had when I was 8'?

Hhhmmm... let me think a bit.

The recent MRI I hugely enjoyed.
This, not so much.

Very odd feeling, uncomfortable rather than painful... quite tolerable. And, of course, very useful if you want to remain on the 'staying alive' pathway.

A bonus is perhaps that any innate latent gay tendency/curiosity has now been 'none of that for me, thankyouverymuch' firmly nuked. And all without having to sheepishly frequent 'the right bars' or that guilty morning after walk-of-shame.

I did at one point mutter something about 'feels like you can't find fourth gear', but refrained from asking whether there was any sign of that sixpence I'd inadvertently swallowed in the 1965 Xmas pudding.

Honestly, at times it felt like someone was rowing a boat in there.

----------

 

User
Posted 28 Jul 2018 at 18:07
Thanks for making me chuckle, gulliver.

I may have the option of an mpMRI before my TRUS....trying to work out the logistics of getting that done before August 15th and having the radiology ready.

User
Posted 29 Jul 2018 at 06:38

@geekything

Thanks for your 'thanks'.

If I've helped lighten things, I'm glad.

It's natural to be worried, and I consider myself fortunate to 'not be much bothered by my own less-than-optimal health' (hence my oddly-skewed posts in this forum).

A pre-biopsy MRI is always worthwhile, in enabling better targeting of TRUS samples... I've read a doctor describing a TRUS biopsy as 'stabbing a fruitcake and hoping to spear a cherry', and it's common for them to not provide truly representative results and hence often followed by a more accurate template biopsy.

'Some do, some don't', hospitals vary in whether they provide pre-biopsy MRIs. My local hospital normally does, though in my case initially declined on the basis of the urologist's view that 'with your PSA, it'll be harder to miss the cancer than hit it'. After a firm-and-polite request from me, the MRI was offered.

And, a small point... based on personal experience...
After the biopsy you'll likely be given 'pads' to mop-up any front-and-rear fluid/lube/goo. If you're wearing your own clothes rather than a hospital gown, it may be wise to request one before they begin - and stuff it in front of your todger to catch the small amount of blood-laden fluid that may potentially be forced-out while the urologist is 'doing his audition for DynoRod'.

In the suggested 'peeing blood for a couple of days', you might want to scratch-out 'days' and add 'weeks' - along with 'tiny amounts of other goo leaking out of your willy'.

The 'wait for results' period can cause anxiety, so your 'will be what they'll be' attitude should help - and moreso if you're then subject to further tests and waiting for those and the results. (I took an immediate view of 'probably riddled with it' and so anything less than that is a potential delight.)

My best wishes and hopes to you.

User
Posted 17 Aug 2018 at 20:33

Finally had my TRUS biopsy on Wednesday. I was shocked to heat that radiologist say my prostate is 55mL. That seems massive for a 46-year old.

This is now sounding a lot more like BPH rather than PCa to me. Except for one thing: my Free PSA % is a lot lower than research suggests it would be with BPH (it's 7%).

Does anyone have any input on this?

I see my urologist on the 30th.

User
Posted 17 Aug 2018 at 21:29
I know it’s difficult, but try not to second-guess the outcome. It will be what it is. I went into my biopsy results meeting absolutely convinced I was going to be given the all-clear, because nothing had shown up on my MRI, and I was completely devastated when I was told I had cancer. Waiting is tough. Really tough. This next two weeks is probably going to seem like an eternity, but all I can advise is try to keep yourself busy and stay away from this forum until you get your results. Reading about other people’s cancer every day isn’t going to do your mental state any good. If you get the all-clear, that’ll be wonderful; if it turns out that you do have prostate cancer, it’s not the end of the world, and that’s the time to come to terms with it. Until then, try to put all thoughts of what the outcome may be out of your mind.

All the best,

Chris

User
Posted 17 Aug 2018 at 21:52
Thanks, Chris. Trying not to jump-the-gun, but going to be a long two weeks.
User
Posted 18 Aug 2018 at 10:09

Hi I think you need to get it checked out for your own peace of mind.

Click my Avatar to see my journey, my PSA was 2.19 with no symptoms apart from microscopic blood in my urine on a private medical for my 7.5 ton driving licence  renewal at 70.

Regards John.

User
Posted 11 Dec 2019 at 12:29

Hi mate,

just wondering what the outcome of this all was?

Best wishes.

 
Forum Jump  
Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.




MenuTop ▲
©2024 Prostate Cancer UK