Elevated PSA and suspicious dre

User

Posted 10 Nov 2019 at 20:03

Hello.

My husband (59) had a psa test two months ago and it came 4.6 from 2.6 last year.

He re checked it last week and it came 4.4 with free psa 30%.

He visited a urologist who said that his prostate felt normal and small, so check psa again in 3 months.

I did not feel relaxed, so we visited a second urologist who said that he felt a slight induration on the right lobe which is suspicious and ordered mri.

He did not say anything for free PSA.

Dr Google says that the chances are 50-50.😟

We are experiencing very dark moments.

Thank you for reading.

User

Posted 11 Nov 2019 at 11:59

My husband is 51 and we are getting the biopsy results today, in 1 hr or so!

i understand fully the dark thoughts running through your mind as my mind, cannot seem able to focus on anything else ... I am cold all over ...

send you a cyber hug

User

Posted 11 Nov 2019 at 16:49

Hi Batman,

Don’t fear the worst. If there is a cancer diagnosis it is far from the end of the world, as thousands of men and hundreds on here would attest to.

Prostate cancer is about the least worst cancer to get, and there are lots of weapons to fight and even cure it.

So go through the testing regime and come back here when you know the results.

Best of luck.

Cheers, John.

User

Posted 10 Nov 2019 at 20:03

Hello.

My husband (59) had a psa test two months ago and it came 4.6 from 2.6 last year.

He re checked it last week and it came 4.4 with free psa 30%.

He visited a urologist who said that his prostate felt normal and small, so check psa again in 3 months.

I did not feel relaxed, so we visited a second urologist who said that he felt a slight induration on the right lobe which is suspicious and ordered mri.

He did not say anything for free PSA.

Dr Google says that the chances are 50-50.😟

We are experiencing very dark moments.

Thank you for reading.

User

Posted 11 Nov 2019 at 10:06

I would like to thank you for your replies.

The truth is that I feel extremely worried and I think i am living a nightmare since our last visit which showed firmness on the prostate.

Why the first doctor did not feel it? Or he did but did not evaluate it as suspicious.

Also, does anyone know if there is a correlation between hemorrhoids and prostate?

My husband has at least one for over a decade and has done nothing about it. The doctor confirmed it during the dre.

My mind is running, too many thoughts...

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User

Posted 10 Nov 2019 at 20:56

His PSA is just within the normal range for his age; although you might expect it to be a little lower with him having a small prostate, it doesn't always work like that. His free PSA score suggests that he is unlikely to have cancer but it is best to have all the diagnostic tests anyway.

In fact, 50-50 would be generous - 60% of men in their 60s have some cancer in their prostate although most will never know about it or need treatment.

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

User

Posted 10 Nov 2019 at 21:09

Dr Google, is unqualified.

The "normal" may be normal for many but abnormal for him. Do you have a series of his results to guage the figure? As an example, a 67 year friend of mine has had PSA 1.7 for several years, so seemingly all good for his age.

In 2018 PSA 1.7, but 1 PCa site found, PCa treatment deferred for other reasons, 11 months later a second site found.

RRP early November, TWOC completed last week, he is already dry.

Only you can decide if you are satisfied that there is no need for concern after taking to all the available health care professionals.

hope all goes well.

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User

Posted 11 Nov 2019 at 10:06

I would like to thank you for your replies.

The truth is that I feel extremely worried and I think i am living a nightmare since our last visit which showed firmness on the prostate.

Why the first doctor did not feel it? Or he did but did not evaluate it as suspicious.

Also, does anyone know if there is a correlation between hemorrhoids and prostate?

My husband has at least one for over a decade and has done nothing about it. The doctor confirmed it during the dre.

My mind is running, too many thoughts...

User

Posted 11 Nov 2019 at 11:59

My husband is 51 and we are getting the biopsy results today, in 1 hr or so!

i understand fully the dark thoughts running through your mind as my mind, cannot seem able to focus on anything else ... I am cold all over ...

send you a cyber hug

User

Posted 11 Nov 2019 at 12:06

I read your post this morning and I was just thinking of you.

From the bottom of my heart, even i do not know you, i send you all the best wishes.

User

Posted 11 Nov 2019 at 16:49

Hi Batman,

Don’t fear the worst. If there is a cancer diagnosis it is far from the end of the world, as thousands of men and hundreds on here would attest to.

Prostate cancer is about the least worst cancer to get, and there are lots of weapons to fight and even cure it.

So go through the testing regime and come back here when you know the results.

Best of luck.

Cheers, John.

User

Posted 11 Nov 2019 at 18:56

Excellent reply, John.

User

Posted 12 Nov 2019 at 12:10

The same is true of Wikipaedia. When I used to teach, we had a hard time convincing students that just because 'It says so on Wikipaedia' doesn't mean it is true! Anyone can change any entry at any time!

User

Posted 14 Nov 2019 at 17:02

Well, my husband had the mpmri today. We will get the results in 4-5 days.

One question, they asked for the last psa tests and some blood tests. I noticed in his last urine tests that there were traces of hemoglobin in his urine

Does anyone know what that means?

Nobody mentioned anything about this but it was marked on the paper.

Thank you.

User

Posted 18 Nov 2019 at 18:24

Hello all! Need your help!

We got the results from mpMRI

60yo

PSA 4.4-free PSA 30%

DRE-slightly induration

I apologize for my english (translated from greek)

- hyperplasia 4.8cm * 3.8cm*4.9cm

-suspicious area at the left side 8mm*3mm (on the periphery) PIRADS4

-no other suspicious areas in the gland/on the periphery

-spermatic vesicles: normal

-bladder:normal

-prostate gland:integral

Here, no one explains the exams. You have to arrange an appointment with your doctor....

Thank you

User

Posted 18 Nov 2019 at 21:42

Your prostate is enlarged (but this could be benign enlargement) and there is a small area on the left hand side close to the edge which is likely to be cancerous. What will probably happen next is that they will take samples from the area on the left in a biopsy. Being PIRADS 4 is indicative of cancer but it cannot be confirmed without a biopsy; someone else here recently had a PIRADS 4 but ultimately got the all clear.

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

User

Posted 18 Nov 2019 at 21:44

PS I don’t think you had mentioned before today that you are in Greece - it would be useful to add this to you4 profile to remind us all that your diagnostic process and treatment options maybe different to the UK

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

User

Posted 19 Nov 2019 at 17:30

Thank you.

I have edited my profile.

According to some researches, the chances of having cancer is up to 70%, with a Pi rads score of 4.

Is there a connection with the gleason score?

We will arrange the biopsy. in your opinion, what kind of biopsy is concedered the best option?

Thank you again!

User

Posted 19 Nov 2019 at 17:49

The people that developed the PIRADS scale didn’t allocate % values to the likelihood so 70% is a random number and in many ways irrelevant to you. In your particular case, the radiographer has viewed the suspicious area and determined that it is likely to be cancer; this now needs to be explored further with a biopsy.

I don’t know what types of biopsy are available to you in Greece but as they have a specific area to target, I don’t think a template biopsy offers you many advantages over a TRUS ... apart from a slightly lower risk of infection. On the other hand, a TURP will be quicker and does not require anything other than a local anaesthetic. I believe template biopsy is fairly standard on mainline Greece though.

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

User

Posted 19 Nov 2019 at 17:50

PS no there is no obvious link between PIRADS score and Gleason grade.

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

User

Posted 11 Dec 2019 at 16:19

Hello!

Today we got the biopsy results.

negative😊

We haven't met with the doctor yet.

I assume that he will recommend a psa test in a couple of months.

Thank you all!

User

Posted 29 Nov 2021 at 15:45

Hello.

2 years after the negative biopsy of 18 cores, the new PSA test is 5.3! (4.4 in October of 2019)

So confused, should the psa be the same or lower?

The volume of the gland was 47cc.

I do not know....did the biopsy missed the cancer or he has bph?

Ps: i know that he should recheck his psa much earlier

User

Posted 29 Nov 2021 at 20:34

Forgot to include free PSA: %fPSA 39%

User

Posted 29 Nov 2021 at 21:00

The free PSA is a very strong indicator that there is still no cancer. The rising PSA seems to correlate with the increasing size of the prostate.

It is beyond me that he has waited 2 years to have another PSA test; he should be making sure he gets this done every 6 or 12 months.

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

User

Posted 30 Nov 2021 at 14:01

Yes, I know that 2 years is too much time.

For some reason he delayed the test ( quarantine, GP told that he had to wait for two months after a covid vaccine-don't know why!)

So, now we will arrange an appointment with the urologist.

I assume that he will order a new mpMRI?

Here, in Greece you have to pay for this and it is quite expensive.

I was wondering if there are other tests reliable. I have the impression that free psa is not that common nowadays.

is it consider still reliable though?

One more thing regarding the mpmri, the psa density was 0.09 (back in 2019)

My question is if there is a correlation between free psa and psa density.

Should a new mpmri be scheduled? Just to check the previous lesion Pi rads 4?

Thank you very much in advance.

I apologize for any grammar mistakes🙂

User

Posted 30 Nov 2021 at 15:08

I am not sure why they would arrange a new scan - the free PSA measurement suggests that there is no cancer.

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

User

Posted 09 Dec 2021 at 20:45

Hello again.

Well, the uro ordered a new mpmri.

He wants to see the pi rads lesion to appear smaller or to disappear.

Anything else means a new biopsy.

He did not evaluate the free psa but said that the density is good.

The dre is in the grey zone, not normal, not abnormal. He thinks that the one lobe seems to be a little firm. He described it as unconlusive.

Also, he noted that some cores from previous negative biopsy showed prostatic atrophy.

That's all!!!

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