Second PSA test result query - PSA level,Heredity,Ultrasound

How far you go along the diagnostic path is something for you to decide. However, many men who have PCa don't portray any of the symptoms of it or know they have it. Some live long lives being unaware and die of something else. Unfortunately, others become aware of it when it is well advanced so that treatment is less effective than it would have been if administered much earlier. Whilst it is true that very high unexplained PSA is increasingly more likely to be PCa, there are some kinds of PCa that produce relatively low PSA or do so at certain times. A scan will not show definitively whether you have PCa or not but will often indicate a suspicious area(s) where a biopsy might be directed.

Hi Lyn, Barry & Gordon. Sorry for my late reply. I had ticked 'get email notifications', yet didn't get any, so thought no-one had replied! Sorry Gordon, I don't know how to do 'quotes', so couldn't do what you asked.

Anyway, My brother was diagnosed at 63 (in 2011) & is now 69 and has had his 'all clear' having had his prostate removed by keyhole surgery. I am 57 going on 58 (soon). My doctor said he'd refer me to a Uro like I said, but he said 'you'll have an ultrasound and then get the results from that, when they will decide whether you need a biopsy or not. (I see I've said that already, oh well). The appointment letter came today and says that I will have an ultrasound, then the biopsy either during or immediately after the scan! So who's telling the truth? As my PSA is falling and because I am still slowly recovering from two very bad bouts of something similar to Norovirus (that somehow wasn't contagious)!? I would rather wait a bit longer and have another PSA, just to see if it's fallen anymore. However, if it's in my best interest to have it there and then, so be it. Yes Lyn, I agree, it's better to have an early diagnosis, than an early death! Also, no one else in my family has had any sort of cancer to my knowledge. We are close enough, but don't speak, or see each other very often.

Right Gordon, my prostate/bladder problems are that when I had both of these bouts of illness, I was left with what I believe, was a UTI. (Slow, thin stream, pain while passing urine and many trips to the loo overnight). My doctor on that day (who I've never seen before) did a dipstick test on urine, saying that there was no need to send any off to be tested and that I didn't have any infection! He also did a DRE and concluded that my prostate was slightly enlarged, leading to the PSA. He stuck me on Tamsulosin, which I endured for three days, with daily increases of side-effects. (I already suffer from low blood pressure and that didn't help). By the fourth day following the appointment (seventh day of symptoms), my 'infection' had cleared up and my flow had returned to normal and has been so ever since. (I had identical symptoms in my 20's, which also cleared up within a week). I saw a nurse today (who my disabled partner had gone to see, but she used to work on a prostate ward apparently), who said that this seemed more like I had bad dehydration (I did), and quoted a word at me that sounds like prostatitis, but is pronounced differently? I haven't found what that is yet, so am still researching. So the test is next Tuesday (19th.), when I will update you all, unless I get replies to this, which I promise to answer much quicker next time! Many thanks for your help everyone!

Right OK then. Me back again. I had an mpMRI 8 days ago, on 12th. October. Thinking that this was enough time to mean that I was all clear, of course the inevitable phone call came from the urologist today (Fri. 20th.). She said that I will need a Template Biopsy under GA at my local hospital. Due to my questioning, she is putting some info in the post for me to read before deciding whether to have it or not. She gave me a result? score? of something that I didn't quite hear the name of, but anyway, out of a possible score of 1-5, mine was 4! Apparently a part of this high score, is due to the fact that my brother had prostate cancer. How on earth do they work that one out? I would like to have known what part of that score was derived from this point, but she either couldn't or wouldn't tell me! I suppose I should have this and having read up on this test, thought it was good that there is less chance of infection, but then noticed the bit about more chance of acute urinary retention. Swings and roundabouts I suppose. I noticed that "Some hospitals will not give you the option of a TRUS biopsy and will only offer a Template one". Mine seems to be one of those. More chance of a proper diagnosis, but more chance of keeping my pee with me longer than is required too! I have a friend who has had to have a catheter for quite a while now (unrelated condition) and it is not something he would recommend for anyone, so hopefully I am in the 64% without AUR and not the 5-36%. I shall await this 'info pack' with great interest... To be continued.

Well thanks again Lyn. Would you know what that score is called please? It sounded something like a 'rad' score? As it was not a good line. The bit I don't understand is how they got a score by counting my brother's PC within it. So I suppose it could maybe have been 2 or 3, but added a bit on to count family history within it? I'm glad that the lady said that there was nothing outside my prostate, meaning whatever it was hadn't spread, but when I asked "Is that definitely cancer then" she replied that she didn't know, that it could be or might be. I wish there was a way that someone could tell me if I have it or not, without having to give myself far more health risks, by having a 'maybe completely unnecessary' biopsy. I saw a thing on an American website, saying that a lot of these tests are very nasty, invasive things and mostly can't tell you whether you have cancer or not. (probably not a very reliable site though). I suppose I'd better have it, due to my brother's trouble. I just think that, if I hadn't had those two very serious bouts of some undiagnosable sickness in the summer, I wouldn't have gotten on to this prostate train in the first place. Like one doctor told me, it's a funny thing and once you're on it, it's very hard to get off again!

Hi Gordon & everyone. Sorry for my late reply (again!) I had a nurse ring me up the other day. She said "I'm ringing about booking you in for this biopsy that you need to have". I said "Steady on, I'm awaiting a letter with information to turn up, so that I can decide whether to have this biopsy or not". She said "Well I don't know about that, I've been told to book you in for a biopsy as soon as possible, if you don't have this one, I don't know when we can book you for a later one. So I'll book you in today, then you can read all about it, but you shouldn't cancel it, or you may not get another chance"! I don't think she can have been doing this job long somehow, but I decided, having talked to others (and on here) to have the darned thing and get it over with. So it's this Thursday (2nd. Nov).

My brother never said anything about his Gleason or Staging. He just said that they took seven needles in his TRUS biopsy and four were positive and three negative, whatever that means. When he was offered surgery, he decided to have his prostate out as soon as possible. I can't seem to get hold of him at all at the moment, though he asked me to keep him updated. He seems to have dropped off the world! I haven't had another PSA yet.

So I'm hoping for a good result, with (hopefully) none of the side-effects like AUR. I think that's my biggest worry actually. It says that there's less chance of infection with a template biopsy, though I don't like having to have a GA.  Hopefully it's not cancer, but if it is, then I will cross that bridge when I come to it. I'm a full-time carer for my disabled partner, so I don't really have time to be ill. If anything happens to me, she would have to (probably) go into a home, leaving her beloved garden and everything else behind. Her garden is her life and I think I feature somewhere in there too. But these things supposedly have a good outcome with treatable symptoms, so either something slow-growing or even non-existent would be good. I suppose my best bet is my age. My brother having his DX at 63 means that I'm five years ahead of him, so chances should be slightly better for me, though you never know. I had hoped that the MRI would be the end of it. Ho hum...

Okay, so I've now had my biopsy & result only 6 days later due to being on some 'fast track pathway' as a medical secretary said to me. The biopsy was fairly painful, once the anaesthetic and pain relief had worn off. The best bit of waking up afterwards was the tea and toast! How simple things can bring such pleasure... Anyway, I didn't get AUR, although I did have a reduced stream. I'm still getting pain, especially when I sit on something pointy, like the edge of a car seat! http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-yell.gif

So now today (Wednesday 8th. November), I have had my results. I DO have cancer, although the doctor confused me a little. He said that I have a significant amount of cancer within the prostate, but it's not such a bad one, giving me a score? grade? of 3+4 or 7 if you rather. He said that treatment or Active Surveillance would both/either be as good for me at this point so, having heard what some other people have gone through following treatment (ED/Incontinence etc), I opted for Active Surveillance with PSA tests every three months, seeing the Uro every six months and maybe another biopsy in 12 - 18 months. Does everyone think that's OK? He said that I can choose to change my mind and opt for treatment if I want to, but I think this should be OK. I hope.

I keep reading and hearing horror stories everywhere, as people LOVE to discuss their or their family and friends cancers at every opportunity! The Uro also said that I could try to change my fortune by following a healthy lifestyle, losing weight, exercising regularly and eating healthily. That seems to be the same for any and everything you get these days! I already lost over a stone in the summer with all my bouts of illness, but I will try to be a better me from now on. And I used to enjoy real food so much! (What I mean is, as a type 2 diabetic, I'm never full and always feel that I need to eat, even immediately right after meals!) I don't put much weight on though thankfully.

Well my Urologist still hasn't got back to be following increased PSA blood test result. His secretary said that he would, as this was the second time I had rung to ask. But maybe 5.8 to 6.4 isn't such a jump, so he's probably not worried about ringing, if he has nothing significant to say d'you think???