PSA 7.3 - referred to urologist - - Page 8Worried about symptoms

User

Posted 20 Dec 2018 at 06:32

Thanks John. Not a wink of sleep last night, of course. You ever get that feeling of why me?

All the best,

User

Posted 20 Dec 2018 at 17:09

Evening all. Back from biopsy - not an overly pleasant experience I must say; felt like I was driving home with a rock wedged up my ass.

I got mixed news from consultants I spoke to. The bad news was that the MRI of course didn't come up clear (zones 1 & 2?) and I was in zone/band 3 with some weight towards 4. Basically, I was told 4 & 5 were strong indicators of Pca and 3 was pretty murky waters that could go either way. Anyway, I was also told that PCa wasn't a definite at this juncture and only the biopsy could tell with any degree of certainty.

Then I found out that the second PSA I had done at my uro appt. (3 weeks after my 7.9 at GP) had dropped to 5.8 (this was also done immediately after a DRE from uro). Not sure of any relevance here, but at least it hadn't risen.

The guy doing the Biopsy made it a hat trick of DREs and confirmed slightly enlarged but smooth (GP had said the same thing). He also said that the MRI had shown any areas of suspicion to be confined to the gland itself, which again I took as good news but probably meant little.

Results in 2 weeks. Still convinced it is PCa, but might get lucky on the Gleason, I hope.

User

Posted 20 Dec 2018 at 17:54

I do hope you turn out to be "the boy who cried wolf" and a bloody whinger, all over a false alarm, but if not, it's not the end of the world.

Try not to chew all your fingernails before the New Year, and enjoy your Christmas! I hope you sleep better tonight.

P.S. You will likely have some blood in your urine and semen for some time, and pass some lumpy blood clots - entirely normal.

Cheers, John.

User

Posted 20 Dec 2018 at 17:59

Cheers John! I feel a bit (& I really do mean "a bit") more positive about my potential outcome. Not that I don't think I have Pca, but that it might not be the worst variant that I know others here have had to somehow endure. Of course, I could be talking out of my ass (wouldn't be the first time)....speaking of which, it's still feeling pretty sorry for itself.

I almost pulled out of the biopsy at the last minute thinking I might just take my chances and run. Not sure if I did the right thing going through with it all tbh.

User

Posted 20 Dec 2018 at 18:19

Only 3 DRE’s you got off lightly 😳😳😳

User

Posted 20 Dec 2018 at 18:21

Would you be happy to play Russian Roulette with three bullets in a six-chamber revolver just on a spontaneous whim?

You have definitely done the right thing having the biopsy just as your medics have advised.

The sooner you have a diagnosis the better for us all, and then you can either bugger off and stop bothering us, you hypochondriac, or be welcomed here to s*** street.

Which in my own case, is not too shitty at all!

Others have much worse prognoses of course.

Anyway, Merry Christmas from the Red Sea, Santa is everywhere here in Egypt.

Cheers John.

User

Posted 20 Dec 2018 at 18:21

Hi Bob. :)

User

Posted 20 Dec 2018 at 18:24

I'm afraid that even if I get lucky I will still be popping in to say hello. Still believe I will be a fully paid up bona fide member of the s*** club though. Ditto on the Happy Xmas thing.

User

Posted 20 Dec 2018 at 21:52

Been googling all evening. Pi-Rads is the MRI level thing I was going on about and with mine at 3 (equivocal) and 4 (clinically significant cancer deemed "likely") my optimism bubble has well and truly popped. Crap, if only it could have remained at Pi-bloody-Rad 3 all over then I might've been hopeful. This Pi-Rad thing was never properly explained and yes, it is a radiologist's interpretation, but still, you'd expect radiologists to provide accurate info. Why not then fully explain this Pi-Rad score to patients then? PSA is always explained and that is notoriously flakey in its accuracy. All of this and nothing really from consultant using the word "likely" at any point. Crap.

User

Posted 21 Dec 2018 at 16:49

Hair, it is really daft to have PSA test immediately after your prostate has been agitated by the urologust. Get it done well away from any time of stimulating the prostate region. That includes cycling, by the way. I suspect you will find the "true" PSA level will be down a bit from what you have reported.

Stop worrying about grey areas on a scan. A radiologist will do his/her best to interpret these but it is not an exact science. Accuracy is the wrong word to use.

Have you confused a DRE with a biopsy, in which sample of prostate tissue are taken and examined off-line in a lab? Only the latter will tell whether you have PCa and give a Gleason score for it.

Relax!

User

Posted 21 Dec 2018 at 17:37

Hello AC. Yes, the DRE beforehand (this was done 2 weeks ago) may have increased the PSA, but it had dropped from 7.9 (6 weeks ago) to 5.9 in 3 weeks. No confusion over DRE/Biopsy. My point was that I sat in a nurse's office and said I wanted to speak to a consultant about my MRI result (performed the previous week) because I had no info on it before going to have my biopsy.

He came in and I sort of broke down (you can imagine) and said my MRI was not clear (I would not have been called in for biopsy had the MRI revealed PIRAD level 1 or 2) and obviously I have PCa etc etc.

He then said that I should calm down (sounded like John on here) and that yes, my PIRAD was showing level 4 with some overlap (or something like that) with PIRAD 3. I sort of knew that PIRAD 4 and 5 were bad news so I broke down again with the sort of "what's the point" blubbering. He said that sometimes it didn't mean PCa and I countered that 4 and 5 were "given" as being cancer. He got a bit annoyed at this point and almost implied that I thought I was some kind of amateur urologist. He said it was good that the PSA had dropped rather than having risen and he also said that the MRI had shown the areas of suspicion to be contained within the prostate.

So, I did the biopsy (with a different urologist) and he said PIRAD 3 or 4 did not necessarily mean cancer. I didn't believe him on the Level 4 and I then googled it all to death (Harvard journals, PIRAD 4 false-positives, Cancer forums, basically any data I could find). On forums, some said PIRAD 4 was 80% likely cancer and on one journal that came down to one study (of over 1000 men) of 55% Pca and 34% clinically significant PCA.

To conclude, I am now beside myself having convinced myself that PIRAD 4 means definite (I shall ignore that stupid word "likely") clinically significant cancer. These MP-MRI scans are supposed to be the business and the radiologist has deemed me PIRAD 3 and 4 (probably separate lesions) and now I am back to my diazepam with a bang.

Sorry for the essay AC & it is good to hear from you again.

User

Posted 21 Dec 2018 at 19:20

What is it that you’re so upset about, Haig? You said yourself that the MRI showed “the areas of suspicion to be contained within the prostate” - in other words, it’s localised. You know by now that localised PCa is a treatable condition and is extremely unlikely to kill you. Ok, it’s obviously not great to be diagnosed with it, but would you be getting yourself so worked up if you’d been told you probably have a curable medical condition that wasn’t called “cancer”?

All the best,

Chris

User

Posted 21 Dec 2018 at 19:48

Hi Chris. As usual, you are right. I dunno why I have been like I have. I kept hoping too much, I guess. I am in a slightly better place now that I have (almost) conceded that I have PCa. I will want to go down the RP route, although I know survival rates are pretty identical with the other treatments. I am in the "I just want it out" camp and I just hope that I can 'get it up' at a later date and that nappies these days don't cost too much. I hope that my optimism about it being localised isn't premature, but with the MRI scan showing this and the PSA at 5.9, I think it is.

Good to hear from you again, H.

User

Posted 22 Dec 2018 at 06:43

I do sometimes chuckle when I read posts here (I sometimes cry too).

Stop diagnosing yourself and consulting Dr Google and wait until you have a professional diagnosis and a plan for the way forward.

Oh, and keep taking the tablets if they are of some help to you.

Your biopsy results can't come soon enough for all concerned! ;-)

Cheers, John.

User

Posted 22 Dec 2018 at 09:26

Morning John, up early again I see. Anyway, I have stopped diagnosing myself - I have made my final diagnosis. My results' day will be mere confirmation tbh. Always good to hear from you old bean.

User

Posted 22 Dec 2018 at 12:19

Hi Haig

I said the other day that my husband was awaiting biopsy results. They are now in and he does not have cancer. His PSA was 30 and he was PIRADS 4. We were entirely ready for the worst, but were hoping for contained, we got a nice surprise.

You won't know until you know.

My very best to you and hope you can settle a bit while you wait.

Kindest regards

Janet

Edited by member 22 Dec 2018 at 12:20 | Reason: Not specified

User

Posted 22 Dec 2018 at 12:22

Thank you Janet. So pleased for your husband - wonderful news. I guess the PIRAD 4 may have been in the transitional zone rather than the peripheral zone, which can make a difference. Either way who cares for you guys - brill! It helps my mind to know there might still be a smidgen of a chance even with the PIRAD 4 score.

Haig

User

Posted 22 Dec 2018 at 17:37

John, don't shout at me for this next question, but if I am diagnosed with PCa (I can hear you sighing), I am already worried about recurrence rates, which I see are at around 30%. Does this worry you in your case and if not, why not?

Best,

User

Posted 22 Dec 2018 at 18:18

Hi Bob. Did you see my latest question? How do you deal with it?

User

Posted 22 Dec 2018 at 19:55

Hi H

To be absolutely honest although i have briefly thought about the chances of reacurrance i am not worried.

As you stated the is a 30 percent chance but that also means that there is a 70 percent chance that i will be clear after treatment.

From what i can gather from your posts is that if you get the worst outcome i.e. you do hav PCa you will be going down the RP route, I have made my decision and have opted for HT/RT.

Like you i am new to all this and the consensus seem to be that if you go for RP and it reacurs you can then have RT after, wereas if you have RT and have a reaccurance you can then not have surgery, this does not bother me as i do not want surgery to start with.

I am assuming, and there may be further post to correct me, that if i get a reacurrance after RT I would be able to have more RT or they can control it with HT.

In a nut shell the answer to your question is i have accepted i have PCa i will do what i can to treat it but i am not going to get stressed and let it ruin my life. I just wish that you were able to adopt the same philosophy.

Bob

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PSA 7.3 - referred to urologist

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