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Anxiety - please help

User
Posted 01 Sep 2019 at 08:16

Hubby went recently to urologist following a urine infection and problems weeing. It all seemed routine following a PSA test is 3.4 (he’s 63). The consultant did an exam an with no preamble announced he has a 40-60% chance of PC. His PSA is now 5.4.  We are waiting for MRI and biopsy. He was so shocked he then made an appointment for gp who said the PSA is in normal range and we’re confused. We also feel consultant was wrong to give such wide odds. Surely just saying he was concerned would have been appropriate at this stage? Can others give me a sense of what’s going on? Thank you.  

User
Posted 01 Sep 2019 at 09:14

Sue,

Sorry you and your husband are going through this. I could try and explain what's happened, but you haven't given enough information, which means I'd be guessing parts of it, and that could mislead you if I guess wrongly.

Could you give the dates of the PSA tests, and the dates of the visits to the urologist and the GP. The reason is that it's important to understand the length of time between the PSA tests, and assuming the urologist did a Digital Rectal Exam (DRE), exactly when this was relative to the two PSA tests. Also, was he given any antibiotics for a urine infection, and if so, exactly when that was. I'm guessing (which I don't like doing) that the urologist based the probability of Prostate Cancer (PCa) on the DRE. It might be that the rise in PSA was also a factor, but depending on the order things happened, that could have been caused by the DRE or the infection. A change in PSA over time is much more significant than the absolute values when they're down at these levels, and it's not simply a case of a normal reading means no PCa, and a higher than normal reading means PCa - too many other things cause changes in PSA.

The MRI and the biopsy will confirm or not if PCa is present, and what happened before those will become less significant at that point, but if you can give the extra detail I requested, we can try and explain better what happened so far and what each stage means.

It's useful to put the chronological list of events with dates into your profile, so people can find it when trying to answer questions.

You will get excellent support here, and of course we're all wishing that the tests show no PCa.

User
Posted 01 Sep 2019 at 09:25

Hi

urine infection (which caused sepsis) mid June - yes antibiotics given (many and different to deal with Sepsis too) - PSA early July - urologist last week - new PSA then. GP was ‘reassuring’ in that he said lots of things can impact... but I realise an increase could be an issue. Hubby is all over the place. 

User
Posted 01 Sep 2019 at 09:52

OK, one extra question. Was the DRE done before or after the blood was taken for the PSA test?

The DRE will result in a high PSA test reading just afterwards. Also having sex or riding a bike a day or two before a PSA test will result in a higher value.

Edited by member 01 Sep 2019 at 09:55  | Reason: Not specified

User
Posted 01 Sep 2019 at 10:09

The test was after....

User
Posted 01 Sep 2019 at 10:38

hi Sue,

I can't add much more than Andy. Have you downloaded toolkit ?  It's a complex disease.

Not sure those in medical profession fully understand the impact of statements they make.  Over half of men over 50 ..  from.research, will have mutation of cells in their prostate.  so the statement he/she made wasn't rocket science however perhaps needed much more explanation. 

Either you or husband gather facts and keep control, and take plenty of time.

ie what type of MRI scan ? see my profile which includes my brother.   He had PSA of 18 at one point following infection.

Why UTI may I ask ? ie a single event ?    Most men seem asymptomatic.. or at least many of the younger folk on here.

The key as you most probably realise is PSA trends, they are just a part of dx.    ie everyone unique.   please post.

have a look at some members profiles.. 

Has hubby been telling you all his symptoms by the way  ?   ie  freq . of urination etc ?  fully voiding . 

hope this helps 

Gordon 

 

 

 

 

 

Edited by member 01 Sep 2019 at 10:44  | Reason: Not specified

User
Posted 01 Sep 2019 at 10:53

If you mean the blood was taken for the PSA test immediately after the DRE, then the PSA test is not really valid, and no increase can be inferred from the result because the DRE will have increased the result.

I would try and get another PSA test before you have the biopsy (the result might influence having a biopsy or not). Avoid sex, riding a bike, and having another DRE for a few days beforehand. You might be able to get this from your GP.

User
Posted 01 Sep 2019 at 10:54

I he did have flow issues (which he seemingly ignored). One UTI ....  he got Sepsis as a result (as he had a back op a few months previous). Had a full scan in June due to Sepsis which he thinks included prostate but he’s not sure as they were looking at Sepsis damage to organs at the time. He then went for his 1st PSA which was unremarkable so what he thought was just a UTI follow up had been a complete shock. 

User
Posted 01 Sep 2019 at 11:07

A prostate cancer MRI scan is a special type known as a multi-parametric MRI (mpMRI).

Prostate cancer usually won't show up on an ordinary MRI scan (although an enlarged or misshaped prostate will).

I don't know, but I would not be surprised if a UTI which was serious enough to cause sepsis might also damage the prostate such that it generates increased PSA for a while afterwards, and that could be the cause of a higher PSA.

User
Posted 01 Sep 2019 at 11:39

Thanks for all the replies it’s a mine field of info!

User
Posted 01 Sep 2019 at 12:30
-might also be an idea to seek further clarification from his Consultant on what he/she felt when the DRE was done. An enlarged Prostate can be BHP only but it may be that part of the Prostate felt hard or lumpy and this is why chance of PCa was given. Unfortunately, an 'in normal PSA range' does not necessarily exclude PCa due to cancer type and for other reasons. Also, some men have PCa without any symptoms. Ultimately, PCa has to be biopsy proven (except in cases where PSA is in the hundreds where this can be a presumption).
Barry
User
Posted 01 Sep 2019 at 13:31
Yes, that was my thought too. Cycling and orgasm only raise the PSA by about 10% and for about 24 hours; DRE or other stimulation of the prostate can make the PSA slightly higher on a temporary basis and wouldn't explain a rise of 70%. UTI or other infection could explain the rise from 3.4 to 5.4 but if the urologist did a DRE and said there was a significant chance of cancer, I wouldn't be hanging back for further PSA tests to see whether it goes back down.

Fingers crossed for you that it is just down to the infection and / or DRE.

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

User
Posted 01 Sep 2019 at 16:47

Thanks.... MRI scan has come through for Wednesday 

User
Posted 01 Sep 2019 at 17:44
👍
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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