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Abnormal prostate examination

User
Posted 23 Dec 2020 at 02:36

Hello. Does anyone have any experience of the following? I am awaiting an MRI - and then likely biopsy. I am 51 and had a few UTI like symptoms out of the blue - burning urine, fever and then a few weeks later really bad flow and just dribbling- a couple of months ago. Urine sample was negative for bacteria though. I had three courses of antibiotics over some weeks and got better so assumed all was well.  The PSA was done though and was 3.4 - so clearly a mild elevation but possibly to be expected with UTI symptoms. Repeat bloods were ordered by GP for 4 weeks later (which apparently, according to urology was too soon after apparent UTI but anyway...) at which point symptoms had alredy cleared and urine flow was back to normal BUT second PSA was 4.9 which I had not been expecting- although it was a different lab so the discrepancy was not easily comparible. Neverthless it was notably higher. I was referred straight to urology and the consultant checked the prostate with his finger. Said it was not normal - hard apparently-  and mri would be needed to check for abnormalities but now it's Christmas week so delay are inevitable, adding to the burden. I am now assuming the worst although the urologist says any cancer is likely 'in or around' prostate as PSA not very high, even despite the obvious jump and he won't even commit to it even being cancer until he sees an MRI and biopsy. I am more or less resigned to it being cancer and have read widely on everything already so I'm fairly aware of most risks and treatments etc. I have had a bad feeling about this for a while. What I am frightened of now is the likelihood it has already spread everywhere without me knowing. I am not aware of other symptoms but then I think one starts to find them if one looks- minor niggles that are probably not even there and anyway, I gather one wouldn't even know it had spread. I'm convincing myself it has already spread though and I haven't been eating well so have been losing some weight recently, which I then attribute to cancer and that makes me more convinced it has spread. Then i end up with soft stools too which I don't know if are symptoms of spread or just down to worry. I suppose everyone is different and diagnoses are all different one way or the other but does anyone have similar experience of this type of history at diagnosis stage, whether it was a positive or negative outcome in your case? I don't know if I can really trust the assumption of the urologist that it has likely not yet spread just because the PSA is not 10+ or whatever it usually is when spread is more likely. Thank you.

User
Posted 23 Dec 2020 at 07:35
Unfortunately you are going to have to wait for the MRI and biopsy result for meaningful reassurance.

Take comfort from the fact your PSA is very low. So IF (big IF!) It is cancer it is likely entirely treatable. The fractal symptoms are highly unlikely to be related to anything but the additional stress you are feeling.

My suggestion - have s drink and forget about it until you know one way or the other..

User
Posted 23 Dec 2020 at 07:55

Thank you so much for the reply. It is very helpful to get perspective at the very least 

User
Posted 23 Dec 2020 at 08:44

Mr Ed 

Give the nurses on this site a call, the number is at the top of the page. 

Thanks Chris

User
Posted 23 Dec 2020 at 08:52

Hello Mr Ed,

Like francij1 says, you are going to have to wait for the results, but I would say your symptoms are more like those of prostatitis and high anxiety than they are of prostate cancer. However, no one can assure you until you have the test results.

Urine (or semen) samples often show no infection in the case of prostatitis, and then trying arbitrary antibiotics is often not successful at treating. Momentary relief can come from antibiotics, because they often also have some anti-inflammatory properties, even when any bacterial infection isn't reached by them or isn't sensitive (killed) by them.

One of our urologists at The FOPS prostate support group recently commented on young prostates feeling harder anyway, and often being mistaken by GPs for a concerning texture.

So, unfortunately we can't tell you you don't have prostate cancer, but the symptoms you describe and the treatments you've had don't rule out prostatitis (with anxiety).

User
Posted 23 Dec 2020 at 13:44

Thanks. I chatted with one of them on the messaging actually. Very hard with medical people though as they are so reluctant to say anything they don't know is fact 

User
Posted 23 Dec 2020 at 13:47

Thank you very much for the reply and for the logic. I hadn't thought of it like that but of course one has to assume and prepare for the worst.

User
Posted 23 Dec 2020 at 15:31
Yes medical people play their cards close to their chests. I think it's because they don't want anything thrown back at them until they have, as you say, all the facts.

Your psa is low so that's a good start. Unless it was a pure form of a rare cancer, (unlikely)it would be very unlikely to have spread and remained so low. (If) you have PCa, most probably it will be organ confined and quite treatable.

But, as above, you need the test results...but remember this...you don't have it until they say so.

User
Posted 23 Dec 2020 at 18:07

John had a PSA of 3.1 and it had already spread to his bladder. Si had a PSA of 3 and it was all over his skeleton. Both were common adenocarcinomas.

However, prostate cancer is unlikely to cause such a sharp increase in your PSA and your symptoms aren't particularly associated with prostate cancer so it seems anxiety and / or infection is playing a part. The most significant part of your post is that the urologist found your prostate to be hard, which is always a concern. But he can't diagnose you without a scan and a biopsy.

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

User
Posted 23 Dec 2020 at 18:31

Thank you for replying. I take your points- just you can't help think the worst can you...

User
Posted 23 Dec 2020 at 18:37

Thanks. That's always the worry I suppose- that low PSA doesn't mean no spread. The symptoms I had were confusing I feel but it was when he found the prostate abnormal that I really began to worry and I had also expected the PSA to go down, not up, since the symptoms had got better... I'm now noticing every minor leg twinge, back twinge and everything in between and I don't know if that's because it has genuinely spread or if it's because I'm just on high alert now. I've managed to get a private scan for tomorrow so I'm at least moving forward but the thought of the results terrify me.

User
Posted 23 Dec 2020 at 18:45

Originally Posted by: Online Community Member

of course one has to assume and prepare for the worst.

That really depends on if you are a glass half full or half empty person. A friend of mine would agree with you and says that when the worst does happen at least she is prepared. I would say that she is constantly putting herself through the stress of diseases which she does not have. So I say assume the best, only worry when you know you have something to worry about. 

Dave

User
Posted 23 Dec 2020 at 18:59

Thank you! Not sure I can put it into practice though. You're right I think- depends on your personality I suppose. I am trying though...

User
Posted 23 Dec 2020 at 21:22

Originally Posted by: Online Community Member

Thanks. That's always the worry I suppose- that low PSA doesn't mean no spread. The symptoms I had were confusing I feel but it was when he found the prostate abnormal that I really began to worry and I had also expected the PSA to go down, not up, since the symptoms had got better... I'm now noticing every minor leg twinge, back twinge and everything in between and I don't know if that's because it has genuinely spread or if it's because I'm just on high alert now. I've managed to get a private scan for tomorrow so I'm at least moving forward but the thought of the results terrify me.

I think every single person on this forum understands exactly what you mean about the aches and pains and weird stuff. It is true that once there is a possibility of a cancer diagnosis the brain is a master of gameplay and every tiny thing becomes a possible sign. Take heart though, even the most rampant aggressive prostate cancer wouldn't make your PSA jump by 25% in the space of a few weeks (that kind of rise is almost always caused by infection or inflammation) and the vast majority of aggressive metastatic cancers cause no symptoms at all. I think it is sensible to mentally prepare for a cancer diagnosis but also some unrelated infection at the same time.  

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

User
Posted 23 Dec 2020 at 21:23
I hope your private scan is a multiparametric MRI and not just a basic one?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 Dec 2020 at 01:08

That is very helpful. Thank you. I'm lying in bed awake past midnight right now and I'm conscious I've had excess gas for the last week which i notice especially at night and I am naturally associating that now too. On the other hand I ran out of tea recently and drank more coffee than usual and I'm also stressed as hell so I suppose logically it could be that but obviously in my now depraved mind it's a spread of cancer to the intestines or somewhere. I've also lost some weight but I've not been eating well recently and I hardly drank any beer during the 'UTI' spells, if that's what they even were, and I ended up having one can a day afterwards anyway rather than a couple so that probably had an effect on calorie intake over a couple of months too but again I'm associating it now with the excess gas and with the odd 'pain" here and there and I just don't know what to think any more but I'm really grateful for your logical words and will try to sleep again in a minute.

User
Posted 24 Dec 2020 at 01:11

To be honest I didn't ask and I should have but I just wanted to get moving and the consultant did say it was the best scanner and I should use namely that hospital for that reason, so I have to assume he would be using a multi parametric.

 
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