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PSA in 100's moving to biopsy

Posted 04 July 2017 16:27:58(UTC)

Hello All,

My father is 69 years old.  Last week he could not pee and he was in excruciating pain. He drove to the ER where they: conducted an ultrasound of his stomach; conducted a rectal exam; inserted a catheter; and conducted blood work and a urine sample.

At the ER they said his prostate was enlarged. They said depending on his blood work and urine hey would either keep him or send him home. They said since his blood work came back clear, they would discharge him with a catheter and schedule an appointment for a urologist. We later learned they did not do a PSA at the hospital, I am not sure what type of blood work they did and were looking for at the time to clear him for discharge. 

Note: For a long time my father woke regularly at night to pee.  He has also had slow flow of urine (which he only told me now). He has also felt something on his butt and though it was hemorrhoids. My dad has avoided doctors for some time, unfortunately...

My dad had the catheter in for 7 days at home while on Flomax and an antibiotic.  He said it stung while he peed into the catheter and there was some blood in his urine (that he could see in the bag).

My dad went to see the urologist 7 days later who conducts the rectal exam, removes the catheter, does another ultrasound, and THEN sends him for the PSA lab work.

Hours later my dad gets the results that his PSA was in the 100's (didn't give me the exact number) and a biopsy of the prostate and surrounding areas is scheduled for Thursday. 24 hours later he is having trouble peeing again. At first when the catheter was removed he said "I haven't peed like this since I was 40" now he said the flow starts and stops. He said he has bladder feels tender when has has to go and then feels relieved when he gets any pee out.

My dad is not goo at taking information in so I have bits and pieces. He did sign the waiver so I can call the doctor and talk to him tomorrow - I am States away from my dad so not present (for now) at these appointments.


-Everything online seems bad with a PSA in 100s almost guaranteeing cancer. What are the experiences of folks here? Could it be a severely infected prostate or is that option truly not likely?

-I've read you should wait WEEKS to have a PSA done after the DRE and Catheter removal both can cause "significant higher" PSA scores.  My dad had TWO DREs done in one week and a catheter in for 7 days and removed prior to his PSA lab - does it really carry any impact? 

-My father is scheduled to travel at the end of July with me out of the country with his grandkids (Costa Rica). The doctor is aware and actually said he wants my dad to go hence making the PSA and biopsy quickly to figure out everything prior to. I felt comfortable taking my dad but not if he is still having peeing issues. I assume him traveling is a bad idea?

-Is there any interim solution to resolve the pee issue? If in fact this is it, and his life may end in the near future this trip would mean so much to him as it would me and my family. It has been a dream of ours to do before he got "really old".

My father is my best friend, my anchor in this world. I want to help educate him, give him tools, and give him and US hope. 


Posted 04 July 2017 17:53:56(UTC)

Good Lord, I don't think he is about to die! Tests have been done - go and have the dream holiday. The retention could be due to infection and bruising in which case the tablets should make a difference soon. If the enlarged prostate is causing the retention they may start him on hormone therapy very quickly and that may reduce the tumour OR he can learn to self catheterise and you can take some sterilized catheters with you on the trip.

Being in the hundreds isn't great but it isn't a death sentence either.

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

Posted 04 July 2017 17:57:23(UTC)

PS ideally men shouldn't have a PSA test within a short time after biopsy, DRE etc but that wouldn't push a normal PSA into the hundreds. It might make a 4 come out as a 4.5 or something like that.

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

Posted 04 July 2017 18:05:37(UTC)
Lyn speaks the truth, please don't see this as game over, my hubby has been "Ill" with Prostate cancer for six and half years, we thought it was game over due to his Gleason score of ten, but it wasn't! Definitely go on holiday, take advice re the bladder emptying as it is excruciating if you cannot empty. I'm sure his doctor can advise. We know just how terrifying this all is, we've all been there and most come out the other side. The high PSA isn't the best news, it really you need to know about potential spread and the Gleason score and even then go on holiday and don't imagine that its game over yet.

Best wishes
Posted 04 July 2017 19:27:08(UTC)


He has been on Flomax for 8 days now and he is actually back at the ER right now...

He had a catheter in for the 7 days, took it out and he did good peeing on his own for hours but by night time he was having trouble getting urine out and today his bladder was in pain, likely because it isn't draining properly. He called me crying and they are heading to the ER. Waiting to hear back.

Could immediate hormone treatments help to shrink the prostate whether infection or cancer?

Posted 04 July 2017 21:30:29(UTC)

No - hormone treatment will only help if it is the tumour that is causing the problem and they will only give him hormones if the tests indicate that he needs them.

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

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