Any advice/thoughts

Hi JDS,

We just had someone else post who did online psa tests, his were about 30% higher than the NHS ones. So don't read too much in to the 3.5 result. I think most people with bone mets have psa in the 100s or at the least well above 50. So i think you need to keep an eye on the psa. You probably have something wrong with your prostate, you probably even have cancer because most men have by your age, but based on those psa readings I don't think you have cancer that needs treatment. 

Nothing could be further from the truth. Same sample tested twice could produce a slightly different result, same sample tested on two machines in same lab could give a slightly different result, machine noise can be significant at these low levels, acceptable tolerance range is around 5%

Your PSA may be higher in the morning than in the afternoon.

Having an orgasm in the previous 24 hours / prostate massage / a hard cycle ride in the preceding 4 hours can all temporarily raise the PSA.

Paying for a private test in between the NHS tests that are critical to identifying any trends is just wasting your money and potentially, NHS resources. Apart from anything else, your PSA drop to 2.8 will have been because you had started on Tamsulosin - it is perfectly normal for it to have now risen back up because the Tamsulosin was stopped. Your GP should have picked that up.

Edited by member 13 May 2021 at 00:08  | Reason: Not specified

Discomfort sitting on hard furniture is likely to simply be due to a bruised tailbone (which could be a result of cycling). Curiously enough I had an MRI scan last week for the same issue, in my case because having been treated for both prostate and kidney cancer there was a concern about bone mets. Got the results back yesterday: no bone mets, just evidence of "wear and tear". On my GP's advice I bought a donut cushion and that's helped enormously.

Best wishes,

Chris

Hi Chris and Lyn,

Thank you both.

I’ll keep the cycling going, I’m certainly not doing high mileage. 

Good idea re the doughnut cushion. 
If you don’t mind, I was going to ask about prostatis, do you know the main symptoms and does it show on any scans or how do they diagnose that, is it mainly by urine tests? 

Cheers

John

Yes, it was me that reported that my online blood prick tests were recording readings that were 30% plus higher than those taken by the NHS via  a needle. The nurse suggested that pin prick tests were not as accurate as those taken by needle.

Afternoon John

The NHS don't seem to calculate "free psa" and neither do some online blood test companies. My G.P. didn't know anything about it either.The first online pin prick test I took in 03/18 did and my free psa was over 30 % of the total psa reading, which apparently is a good sign. My psa with that company was 6.26, hence why I went to the doctors for a second opinion. They took a needle blood test in May 18 and my psa came out at 3.58. When I was phoned with the result I asked about the free psa, but was told by the GP that was the only information she had. My second online pin prick test, with a different company, was on 06/01/21 and that came out at 7.54. When I was phoned with the information I asked what the free psa score was but was told that they didn't test for that. I again went back to the doctors and my needle blood tests came out with a psa reading of 5.32 on 10/03/21 & 5.76 on 12/04/21. Hence my referral for an MRI scan and my subsequent referral for a biopsy.

My research back in 2018 suggested that a low free reading as a percentage of total psa was a further suggestion that cancer was present, but whether it, since the NHS don't bother to calculate it, means anything is anybody's guess.

Yes, nothing, including the psa readings, is straightforward when you enter the prostate cancer world

Ivan

Edited by member 14 May 2021 at 15:51  | Reason: Not specified

The free to total psa ratio is hyped as of some use when diagnosing but the NHS don't seem to be aware of it.

My psa tests were marked as "free psa" I asked my GP and clinical nurse, and the consultants secretary if I should be having "total psa" tests (I never got to ask the consultant himself). No one seemed to know there were two tests. The GP was good enough to chase up the lab, and eventually it was identified as a computer error which had been going on for years but no one noticed (except me). Anyway it turned out they were doing the correct tests just printing the wrong labels on them. I'm glad they don't make any other mistakes!

Interesting though that my G.P. and some of the hospital doctors I spoke to did not seem aware of free psa as part of an overall psa test. And, both private tests I had were only offering what I actually got: the first one total psa with free psa  & the second one total psa only. And the second test I had was some £15 more expensive than the first.

To further comment on free psa, the USA medical system (my brother lives in LA) usually tests for free psa where somebody's total psa is less than 2.4 but there is,nonetheless, some evidence (going to the toilet a lot etc) that the patient may have prostate cancer. A low free psa reading in such a case, though not evidence in itself  of prostate cancer, would then usually result in a biopsy being performed.