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User
Posted 05 Aug 2021 at 09:28

I have made a previous post regarding epididymitis/orchitis with an abcess that was surgically treated. Following all this my PSA went up to 5, I had an MRI with a Pirads of 2.

PSA recovered to 2.7, discussion with urologist suggested that the initial condition may have been caused by a UTI due to getting dehydrated. He suggested continuing with Tamsulosin which I tolerate well, with 6 month PSA checks.

PSA as follows:-

Jan-20 - 2.7

Jul-20 - 3.2

Jan-21 - 3.3

Jul-21 - 5.3.........

Before anyone mentions it, Covid jabs done in Feb and early May.

Symptoms, particularly flow and hesitancy are getting worse, but frequency has never really been a problem (apart from very first thing in the morning when I go 5-6 times before 9). I am also suffering with fatigue.

Prostate volume from the MRI is 38ml.

Docs appt. next week (phone, so unless he has an extremely long finger no physical exam!), expecting repeat PSA and if still 5.3-ish repeat MRI?

Does this sound reasonable?

I know the PSA is not very high, but it is above the 'normal limit', and has gone from 3.3 to 5.3 in 6 months.

I am 69, otherwise in reasonable health.

Edited by member 05 Aug 2021 at 10:56  | Reason: Typo..

User
Posted 27 Apr 2022 at 19:01

Don't panic caught early very treatable I started with psa 24.9 Gleason 9 in both sides off prostate 37 lots off radiotherapy and 13months into 24 months off hormone therapy psa 0.01 and working as I have done all the way through treatment stay positive keep us informed we look out for each other on here 👍

User
Posted 06 Aug 2021 at 18:03

If my PSA was continuing to rise then I would certainly want another MRI scan and, if that found a lesion, a T.P biopsy. 

User
Posted 06 Aug 2021 at 23:30

Hi,

Your prostate is fairly large. Going to the loo 6 times before 9am is unusual.  Your PSA isn't very high but the change this year is possibly significant.  None of those symptoms prove anything, except it's unusual.

It could be an inflammation. Your PSA could rise to 100 and it could be inflammation.

It does need investigation if it carries on rising or possibly now.  The difficulty is at lowish PSA levels it can be difficult to decide whether to treat it.  Changes often reveal the best way of knowing.  Some people don't like to wait or their history may make a decision more obvious.

A biopsy is the best proof although some don't like it.  Also if you have inflammation or other condition it might make  a biopsy a bit risky in terms of infection. A doctor should advise.  Wait, anti-biotic,  MRI, biopsy are possibilities I think.  I'm not sure if anti-biotics are used for inflammation or similar.

Regards Peter

User
Posted 07 Aug 2021 at 13:43

I have a couple of their albums....

Best thing about the concert... the strippers!!!

User
Posted 08 Aug 2021 at 09:38

I believe most hospitals now do the T.P. biopsy (what I had in June) following an MRI scan.  It involves:

 

In transperineal biopsy, the urologist passes the biopsy needle through the perineal skin and into the prostate, rather than passing the biopsy needle through a potentially contaminated rectum. The biopsy needle is still guided by an ultrasound placed in the rectum.

The combination of the original MRI scan and the ultrasound image makes for a much more accurate biopsy.

User
Posted 10 Aug 2021 at 15:06

I had to listen to …… Michael Bubley!!!!

User
Posted 26 Aug 2021 at 14:15

I will leave it for now, first MRI was PIRADS 2, so low risk. I'll keep a careful check on PSA every 6 months, and watch my symptoms carefully.

User
Posted 02 Apr 2022 at 13:36

Hi Mos,

Last Autumn, I had an MRI 6th September at the Royal Berks, then 2 weeks or so had a letter for appointment for a biopsy near the end of Sept. Ten days after that in early Oct had appointment with a clinical nurse for the cancer diagnosis ( Gleason 3+4 ), leaflets to read etc. Within a week, the bone scan and 2 days later in mid October consultant meeting and Surgery 3 weeks later on 9th November. seemed a bit of a whirlwind in those few weeks, but the Royal Berks provided excellent care thru the whole process.

P.

User
Posted 02 Apr 2022 at 15:22

Mick,

My PSA  was 5 last July. Had issues with urine flow and semen which sparked all this off for me.

Yes it was robotic surgery

P.

 

Edited by member 02 Apr 2022 at 16:24  | Reason: forum rules correction

User
Posted 02 Apr 2022 at 16:13

Yes, quantity did reduce, with none on several occasions.

P.

User
Posted 02 Apr 2022 at 16:16
Pawmark, best to edit your post - not allowed to name medics on this forum
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Apr 2022 at 16:26

Ack.

P

User
Posted 02 Apr 2022 at 19:38

Purely for information, the volume of my semen had reduced about 10 years before I was diagnosed at age 63 with prostate cancer. Whether there is any connection I do not know.

 

Ivan

User
Posted 02 Apr 2022 at 19:44
Major marker for me at 46. Really reduced semen volume and never heard of occasional ED

If life gives you lemons , then make lemonade

User
Posted 22 Apr 2022 at 11:15

MRI scan done on Monday (yes, Easter Monday!), now waiting for the results.

As for music during the scan, they gave me a list to choose a CD! I went for 'Pulse' by Pink Floyd, but they couldn't find the CD, so ended up with Mozart.

Couldn't hear it though, ear plugs, low volume in the headset and the racket the scanner made stopped any chance of that!

User
Posted 28 Apr 2022 at 14:30

The Royal Berks like to stack the appointments like that, should they be needed. Helps speed the process, though it can make it feel like a whirlwind.

Thinking of you next week. 

P.

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User
Posted 05 Aug 2021 at 10:06

I should add that I also have a condition known as Mesenteric Panniculitis that is inflamation in the Mesentery surrounding the bowel - around the descending colon in my case. It causes a dull ache in my left-lower abdomen. I have had 2 CT scans, and scopes from both ends (not at the same time!) - all clear apart from internal piles, mild gastritis and a small hiatus hernia.

My epididymitis/orchitis are covered in another post.

I had mesh repair of an inguinal hernia a few years back. No issues since.

I also have glaucoma - but don't think that is related at all!

My Father had bladder cancer (and died from it - he basically bled to death....) and the prostate is close to the bladder.

About 15 years ago I had urinary symptoms (hesitation, frequency, poor flow), PSA was fairly low (max was 4.1), but it was before MRIs were the first stop so I had a Biopsy (gun up the bum). All negative. I discovered that an anti-anxiety medication - Citalopram - can cause the symptoms, came off it (slowly) and symptoms resolved!

Also, I am a blood donor (76 so far), at my last session (November 2020) they rejected me due to low Hb (131 on their machine). They gave me a leaflet about diet changes I could make, already eating all the things on the list (apart from Tofu... which I hate!).

Went to the doc, blood test showed Hb was lowish but not much (142), neutrophils were under 2 (should be over).

Had repeated blood tests - Hb fairly stable, neutrophils went down to 1.5 - had a blood film, nothing remarkable.

Had another test when I had last PSA (July 2021), neutrophils now 2.1, HB 150.  

Edited by member 05 Aug 2021 at 11:02  | Reason: Added FBC results

User
Posted 06 Aug 2021 at 18:03

If my PSA was continuing to rise then I would certainly want another MRI scan and, if that found a lesion, a T.P biopsy. 

User
Posted 06 Aug 2021 at 23:30

Hi,

Your prostate is fairly large. Going to the loo 6 times before 9am is unusual.  Your PSA isn't very high but the change this year is possibly significant.  None of those symptoms prove anything, except it's unusual.

It could be an inflammation. Your PSA could rise to 100 and it could be inflammation.

It does need investigation if it carries on rising or possibly now.  The difficulty is at lowish PSA levels it can be difficult to decide whether to treat it.  Changes often reveal the best way of knowing.  Some people don't like to wait or their history may make a decision more obvious.

A biopsy is the best proof although some don't like it.  Also if you have inflammation or other condition it might make  a biopsy a bit risky in terms of infection. A doctor should advise.  Wait, anti-biotic,  MRI, biopsy are possibilities I think.  I'm not sure if anti-biotics are used for inflammation or similar.

Regards Peter

User
Posted 07 Aug 2021 at 08:59

My epididymitis/orchitis was initially treated with a 2 week course of strong anti-biotics, diagnosis was by ultrasound. I was in considerable pain, the sonographer had to keep stopping, and following th ultrasound the pain made me physically sick.

After 2 weeks the pain was only slightly less, and my left testicle was still inflamed. Went back to Urology, they did 2 more ultrasounds and lots of probing (they wanted to be sure I hadn't got testicular torsion). The recommended course of action was either intravenous antibiotics (which might work) or surgery (which would work). Either way I was going to be admitted, and after a discussion about possible after effects (I could loose the testicle) I decided on surgery. They found a big abscess on the testicle which was drained. Short course of antibiotics and all is well.

It has messed with my 'geometry', and I struggle to find comfortable underwear - boxers are definitely out nowadays.

No more symptoms though, and inflammatory markers were fine on my last blood test.

Doc appointment on Thursday afternoon, I think probably repeat PSA, if still over 5, then referral to urology and MRI. Just hope I get a choice of radio station to listen to at the next MRI - KissFM is pretty aweful!

User
Posted 07 Aug 2021 at 11:04
When I had my mp-MRI, there were two jolly Ethiopian guys as radiographers, so I asked them if they could play some Bob Marley over the headphones during the procedure.

Unfortunately, all they played was rap, garage, house, and grunge - just the hideous noises of the MRI scanner itself!

If I was a prisoner of war, I would divulge all secrets after listening to that torture for forty minutes!

Cheers,

John.

User
Posted 07 Aug 2021 at 11:45

After mine, I commented to the young man assistant that the sound of the machine was like being at a Hawkwind concert! It went straight over his head - wrong vintage! (and yes - I HAVE been to a Hawkwind concert!!!)

User
Posted 07 Aug 2021 at 11:49

I still have the 45 single Silver Machine by Hawkwind which I bought when I was a teenager. Their only chart entry I believe

User
Posted 07 Aug 2021 at 13:09

Good luck with your treatment, hope you get sorted out.

I asked what music they had , the miserable MRI operator replied, " this is the NHS, you don't get music"☹️. It was nearly eight years ago.

Thanks Chris

 

User
Posted 07 Aug 2021 at 13:43

I have a couple of their albums....

Best thing about the concert... the strippers!!!

User
Posted 07 Aug 2021 at 14:53

I said it was like listening to Pink Floyd, thinking it was an original comment, obviously not.

User
Posted 07 Aug 2021 at 17:20

LOL! I happen to like Pink Floyd - saw a Dark Side concert - awesome!

User
Posted 07 Aug 2021 at 19:11

Im no expert but in your position I would be asking for a Biopsy of the prostate. I had a TP template biospy but I understand there is an even better type of Biopsy you can have that the Royal Marsden ( and probably other also) now do. I don't know what its called. My urologist told me he thought my symptoms, MRI and PSA readings (6.3) pointed to inflammation and not to worry but Im glad i had the biospy as in fact 30% of my gland was cancerous with multifocal T2bN0M0. The earlier you get it the better. A biopsy is not pleasant but its bearable and the best way to see if you have a real problem or not. I had a RP recently and the other benefit apart from removing the cancerous prostate was a big improvement in my flow rate and I am getting up only once a night now instead of 3 or 4 times. Best of luck

User
Posted 08 Aug 2021 at 09:29

I think biopsy is a bit premature to be honest - I had one about 15 years ago (problem was Citalopram, not prostate).

I had an MRI 2 years ago, the analysis was PIRADS 2.

I think this will be what happens:-

- Doc appt. on Thursday (phone) - I expect him to request another PSA test. (pre-empted this and got an appt. on Friday as I am a bit busy next week).

- Results of 2nd PSA test will determine what happens next

- If lower, back to 6 monthly PSA

- If same or higher, refer to urology, I think they will do a DRE, followed by MRI. If MRI PIRADS is higher than 2 (or shows any lesions) then a (hopefully guided) biopsy.

Would the biopsy be trans-rectal or trans-pirreneal?? (and I think I spelt that incorrectly!)

User
Posted 08 Aug 2021 at 09:38

I believe most hospitals now do the T.P. biopsy (what I had in June) following an MRI scan.  It involves:

 

In transperineal biopsy, the urologist passes the biopsy needle through the perineal skin and into the prostate, rather than passing the biopsy needle through a potentially contaminated rectum. The biopsy needle is still guided by an ultrasound placed in the rectum.

The combination of the original MRI scan and the ultrasound image makes for a much more accurate biopsy.

User
Posted 08 Aug 2021 at 09:44

Thanks, that it what I thought.

15 years ago it was trans-rectal (TRUS?) 18 samples on a grid. Felt like someone flicking an elastic band up my bum!!

Blood in bowel motions and semen for a couple of weeks.

User
Posted 08 Aug 2021 at 09:59

Re your blood comment, in my case I only had a little blood in my urine for a day, no blood in my stools but still have a little blood in my semen. Apparently, this can occur up to 12 weeks after the biopsy.

Edited by member 10 Aug 2021 at 16:15  | Reason: Not specified

User
Posted 10 Aug 2021 at 15:06

I had to listen to …… Michael Bubley!!!!

User
Posted 12 Aug 2021 at 14:44

Just spoke to Doc (GP), urgent referral to Urology at Royal Berks (Reading).

Repeat PSA blood tomorrow (pre-booked in anticipation of it being requested!)

User
Posted 17 Aug 2021 at 10:28

Got my PSA results (test on 13/8) - it is 2.8, it was 5.3 on 29/7....

So, over the past year it has gone: 2.7 - 3.1 - 3.3 - 5.3 - 2.8....

The question is, which is incorrect, the 5.3 or 2.8 or is this variation normal? I have had no change of symptoms or life-style between the 29/7 and 13/8 tests..

I'm assuming urology will still want to see me, and another PSA test will be the first action.

Ho-hum.....

 

User
Posted 17 Aug 2021 at 11:06
Seems fairly indicative of inflammation / infection. If it was prostate cancer it wouldn't fall as well as rise
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Aug 2021 at 14:10

Urology appt. next Thursday....

User
Posted 26 Aug 2021 at 11:49

Back from urology.

 

Flow rate is poor, but prostate is smooth, no other issues.

So, possible prostatitis caused the spike.

Continuing with Tamsulosin and 6 monthly PSA check.

 

Good luck everyone.

User
Posted 26 Aug 2021 at 12:18

Excellent news

 

Just one thing, my prostate was nice and smooth when I had a DRE but the MRI scan I had found a lesion. Have you had a MRI scan?

User
Posted 26 Aug 2021 at 12:20

I had an MRI scan 2 years ago after a previous spike (caused by other problems, I had epididymitis/orchitis and a hydrocele) in PSA.

User
Posted 26 Aug 2021 at 12:47

Ok

 

I think though, if it was me, just to be sure, I would want another MRI scan.

User
Posted 26 Aug 2021 at 14:15

I will leave it for now, first MRI was PIRADS 2, so low risk. I'll keep a careful check on PSA every 6 months, and watch my symptoms carefully.

User
Posted 08 Mar 2022 at 15:48
6 months later and here I am again! Did you miss me?

PSA 5.3, text message to phone the doc, currently on hold for the gatekeeper (sorry, receptionist!).

5.3 Jul 21, 2.8 Aug 21, 5.3 Mar 22.

I think it might be time for another MRI.

User
Posted 22 Mar 2022 at 17:19

Result of the chat with Doc was repeat PSA test. Did this last Friday, got the result today....

15.0 (18 March) - it was 5.3 on 3rd March.

Urgent referral to urology at Royal Berks. (doc updated me by text, URGENT was capitalised).

Bit of a bombshell.

My flow rate has been getting really slow, but no other problems in that area.

 

Ho-hum....

User
Posted 22 Mar 2022 at 20:53

Your PSA is up and down, the sudden spike is very unusual, more like an irritation rather than cancer.  I'm not an expert though.  Regards Peter

User
Posted 26 Mar 2022 at 08:39

Appointment with urology next Thursday.....

Should I be pressing to have another MRI? I know I will have a DRE, but should I have an MRI as well??

Royal Berks Hospital.

User
Posted 31 Mar 2022 at 18:55

Back from Urology - prostate enlarged, but feels smooth.

MRI in the next 2 weeks, if clear, then PSA every 3 months until they figure out why PSA is varying.

Appt. letter said arrive with a full bladder - I did - but doc didn't want to do flow rate so I had to find a loo before the DRE! 

User
Posted 02 Apr 2022 at 09:21

MRI booked for Easter Monday!

Anyone know how long Royal Berks would take to produce the results?

User
Posted 02 Apr 2022 at 13:36

Hi Mos,

Last Autumn, I had an MRI 6th September at the Royal Berks, then 2 weeks or so had a letter for appointment for a biopsy near the end of Sept. Ten days after that in early Oct had appointment with a clinical nurse for the cancer diagnosis ( Gleason 3+4 ), leaflets to read etc. Within a week, the bone scan and 2 days later in mid October consultant meeting and Surgery 3 weeks later on 9th November. seemed a bit of a whirlwind in those few weeks, but the Royal Berks provided excellent care thru the whole process.

P.

User
Posted 02 Apr 2022 at 14:20

Thanks 'P',

Real name here is Mick!

Very useful information, seems like a quick reaction.

What was your PSA? Was it rising?

I was bumbling along at 4-5, tested every 6 months, then the last was 5.3, retest was 15.. bit of a shock to have such a rapid rise in just over 2 weeks. I have no symptoms of prostatitis, and no UTI (urine test confirmed this).

Have you had a robotic radical prostatectomy???

Any other tips?

So far, the system is working OK for me, 9 days from GP referral to initial consultation, just over 2 weeks from consultation to MRI.

Thanks again,

 

Mick

 

User
Posted 02 Apr 2022 at 14:25
You may have prostate cancer but it is unlikely to be the cause of such a sharp rise - that is much more likely to be the result of a deep-seated infection. When you say a urine test has confirmed that you don't have UTI, was that just a dip test by the GP? A proper test done at the hospital may provide a different result as there are some UTIs that don't show up on the dip test. Prostatitis doesn't always have symptoms (apart from a rapid rise in PSA).
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Apr 2022 at 14:34

It was a test done in the hospital, I don't know what type of test, they phoned the following day with the result.

Hopefully the MRI will clarify things a bit more.

User
Posted 02 Apr 2022 at 15:22

Mick,

My PSA  was 5 last July. Had issues with urine flow and semen which sparked all this off for me.

Yes it was robotic surgery

P.

 

Edited by member 02 Apr 2022 at 16:24  | Reason: forum rules correction

User
Posted 02 Apr 2022 at 16:07

Was the semen issue lack of quantity? I have noticed mine has considerably reduced.

I'm hoping it is all asymptomatic prostatitis in my case....

Edited by member 02 Apr 2022 at 19:00  | Reason: Typo (fat fingers!)

User
Posted 02 Apr 2022 at 16:13

Yes, quantity did reduce, with none on several occasions.

P.

User
Posted 02 Apr 2022 at 16:16
Pawmark, best to edit your post - not allowed to name medics on this forum
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Apr 2022 at 16:26

Ack.

P

User
Posted 02 Apr 2022 at 19:38

Purely for information, the volume of my semen had reduced about 10 years before I was diagnosed at age 63 with prostate cancer. Whether there is any connection I do not know.

 

Ivan

User
Posted 02 Apr 2022 at 19:44
Major marker for me at 46. Really reduced semen volume and never heard of occasional ED

If life gives you lemons , then make lemonade

User
Posted 22 Apr 2022 at 11:15

MRI scan done on Monday (yes, Easter Monday!), now waiting for the results.

As for music during the scan, they gave me a list to choose a CD! I went for 'Pulse' by Pink Floyd, but they couldn't find the CD, so ended up with Mozart.

Couldn't hear it though, ear plugs, low volume in the headset and the racket the scanner made stopped any chance of that!

User
Posted 27 Apr 2022 at 17:01

Phone call today with MRI results.

Suspicious area in left of prostate, PIRADS 4.

Transperenial biopsy to be done in the next 7-10 days, waiting for the appointment.

Bit of a bombshell, I had convinced myself it was prostatitis and/or enlarged prostate. 

Getting radiology report in the next day or so.

 

User
Posted 27 Apr 2022 at 19:01

Don't panic caught early very treatable I started with psa 24.9 Gleason 9 in both sides off prostate 37 lots off radiotherapy and 13months into 24 months off hormone therapy psa 0.01 and working as I have done all the way through treatment stay positive keep us informed we look out for each other on here 👍

User
Posted 28 Apr 2022 at 14:21

Biopsy set for Friday 6th May.

Also got appointments for biopsy results, and if required follow-up with consultant.

Trying to be positive I have written the consultant appointment in pencil!

User
Posted 28 Apr 2022 at 14:30

The Royal Berks like to stack the appointments like that, should they be needed. Helps speed the process, though it can make it feel like a whirlwind.

Thinking of you next week. 

P.

User
Posted 28 Apr 2022 at 14:40
Thanks!
 
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