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User
Posted 13 Nov 2021 at 16:30

Hi can anyone help? I have had an enlarged prostate for some years, I am 56 now, and a week ago I went to my GP because I was still having symptoms from a recent chest infection. That was clear, but I mentioned that the tablets(Tamsulosin Hydrochloride) are not working too well for about a month. 
The doc arranged a blood test .and the next day I got called in for a face to face and prostrate exam, had that on Fri 12th, and he told me there and then that I have advanced PC!!
He said he felt some lumpy bits and my PSA are extremely high. (7.9).
I have received word this morning that my hospital urology dept will phone on Monday, but if I miss them I must phone them on Tue.
Talk about an enormous shock!
Is this normal for GP to diagnose there and then?

PeteT

User
Posted 13 Nov 2021 at 20:11

I have responded on your other thread- generally, it is not helpful to have two threads running at the same time but you have provided additional info here so I am responding to that.

A GP cannot diagnose prostate cancer - that can only be done with a biopsy. However, he has felt lumps which are unlikely to be anything other than cancer. What he should have said is that he suspects you have locally advanced prostate cancer - locally advanced means that it has broken out of the gland.

Edited by member 13 Nov 2021 at 20:12  | Reason: Not specified

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

User
Posted 13 Nov 2021 at 20:29
A PSA of 7.9 is not "extremely high". 790 might be considered so, but 7.9 is merely mildly elevated. Mine was 31 at diagnosis, for comparison.

Don't make assumptions. The diagnostic process is lengthy, but you'll get there. Just take it a day at a time.

Best wishes,

Chris

User
Posted 13 Nov 2021 at 20:55

Chris and Lyn have given you good advice you need biopsy results to be given a accurate diagnosis it's tough but it's a waiting game I am afraid 

User
Posted 13 Nov 2021 at 21:46
It will depend on your hospital/area for instance I had mri, bone scan and biopsy in just over 1 week full treatment started within 2 weeks but others take 1 month or more. Try to relax (I know, its hard) and be patient.

All the best

Keith

User
Posted 13 Nov 2021 at 21:55
It'll probably take about two weeks to get a referral to urology, and then perhaps six weeks for the tests, and another wait for the results, so you're probably looking at 2-3 months all in. It's the hardest part of the whole experience, unfortunately.

Generally you'll first have an MRI scan. If the scan shows areas of suspicion you'll then have a biopsy. If the biopsy finds cancer cells you'll have a bone scan to see if it's spread to the bones (which, with your PSA it almost certainly hasn't, but it is a standard test). Each test usually takes a couple of weeks to report on, so unfortunately it all takes time.

Once all the test results are in, all the information will be discussed by experts in all the relevant fields at a weekly multidisciplinary team (MDT) meeting, and it's only at that point that treatment recommendations will be made.

About half of men in their 50s do have prostate cancer, by the way. I was diagnosed at the age of 55 in 2018. Three years on and I'm all treated and good to go.

Best wishes,

Chris

User
Posted 13 Nov 2021 at 21:57

keep positive loads off treatment options that will help you keep moving forward even bad cases are treatable even if not curable 

User
Posted 13 Nov 2021 at 23:48

Hi,

A psa of 7.9 isn't high and as said by others you need to get the complete diagnosis done.   Prostate Cancer, if it is that, is usually slow growing and there are several treatments with more being approved as time goes on.   

People often think the worst and diagnosis is a worrying time.  Survival can be many years with what is termed advanced cases.   I think your GP was wrong to say you are advanced anyway and also wrong to say you have cancer.  Theoretically a person with a raised psa at 7.9 is more likely not to have cancer.   Although the finger examination might indicate there is something wrong that might make it more likely.  There is no real evidence until the biopsy is done.  Until then it's a possibility.

In reality the whole thing is based on probability.  Even the biopsy isn't always right although if some is found it can be said you have got it.   Read up about the treatments as there are quite a few and people debate which is better for them.

All the best,
Peter

User
Posted 15 Nov 2021 at 09:33

Hi Pete,

My initial visit to GP until diagnosis was less that 1 month. That included referral to Urology for examination then back for biopsies and another 2 weeks for results of those which confirmed diagnosis.

Since then I had bone/CT/MRI scans all within a week and I have my appointment for the results of these this Thursday. 

It's a process unfortunately and takes some time so try to switch off if you can and do things you enjoy to relax.

K

User
Posted 15 Nov 2021 at 10:24
Pete. It may be useful to get an idea of possible time line with my experience. Of course, every one is different and your process will depend on complete diagnosis (no cancer, local cancer, advanced cancer with limited (<3) mets, higher number of mets and aggressive cancer). Lets hope that you find there is no cancer. When I went to see the urologist after my MRI scan I was talking to a man who was going for his first consultation after referral from his doctor. He went in very worried and came out smiling - the urologist performed a DRE and found nothing to worry about.

20 Jan PSA blood test

22 Jan Doctor calls to say PSA 64

23 Jan DRE indicates enlarged prostate.

2 Feb first urologist appointment. DRE indicates cancer.

9 Feb MRI Scan

24 Feb Biopsy

4 March Bone Scan

11 March Second urologist appt. Start 28 days on bicalutamide.

25 March Zoladox implant.

14 April. First oncologist appt. Confirmed metastatic PC with low volume bone (3: - 2 pelvis with 1 small and 1 right scapula - small). Gleason 4 + 4.

22 April. Enzalutamide started

21 May PSA 0.33

4 June CT scan.

17 June 2nd. Zoladox injection. PSA 0.19

12 July PSA 0.11

11 August PSA 0.07

2 Sept Second oncologist consultation

07 Sept PSA 0.04

21 Sept. I st RT of 6 weekly at 6 GY

05 Oct PSA 0.03

31 October. Completed radiation course

4 November PSA Not detectable.

11 Third oncologist consultation

Show Most Thanked Posts
User
Posted 13 Nov 2021 at 20:11

I have responded on your other thread- generally, it is not helpful to have two threads running at the same time but you have provided additional info here so I am responding to that.

A GP cannot diagnose prostate cancer - that can only be done with a biopsy. However, he has felt lumps which are unlikely to be anything other than cancer. What he should have said is that he suspects you have locally advanced prostate cancer - locally advanced means that it has broken out of the gland.

Edited by member 13 Nov 2021 at 20:12  | Reason: Not specified

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

User
Posted 13 Nov 2021 at 20:29
A PSA of 7.9 is not "extremely high". 790 might be considered so, but 7.9 is merely mildly elevated. Mine was 31 at diagnosis, for comparison.

Don't make assumptions. The diagnostic process is lengthy, but you'll get there. Just take it a day at a time.

Best wishes,

Chris

User
Posted 13 Nov 2021 at 20:55

Chris and Lyn have given you good advice you need biopsy results to be given a accurate diagnosis it's tough but it's a waiting game I am afraid 

User
Posted 13 Nov 2021 at 21:16

Thank you so much. 
It's been such a shock, my wife and I care for our 2 profoundly disabled adult sons and I think the horror of leaving them or even being too ill to be useful is churning me up. My wife is trying to keep me calm but I  am realising this is a process and I just have to do whatever and try to remain calm. 
It would have been helpful if my GP had not panicked so much.
Pete

User
Posted 13 Nov 2021 at 21:19

Thanks Chris,

I am trying to keep a lid on it,  about how long do all the tests take before I get answers, do you know?

Pete

User
Posted 13 Nov 2021 at 21:46
It will depend on your hospital/area for instance I had mri, bone scan and biopsy in just over 1 week full treatment started within 2 weeks but others take 1 month or more. Try to relax (I know, its hard) and be patient.

All the best

Keith

User
Posted 13 Nov 2021 at 21:49

Thanks Gaz, that makes me feel a bit better . Nothing is going to calm my stomach yet. Hopefully I will get some news soon.
Pete

 

User
Posted 13 Nov 2021 at 21:55
It'll probably take about two weeks to get a referral to urology, and then perhaps six weeks for the tests, and another wait for the results, so you're probably looking at 2-3 months all in. It's the hardest part of the whole experience, unfortunately.

Generally you'll first have an MRI scan. If the scan shows areas of suspicion you'll then have a biopsy. If the biopsy finds cancer cells you'll have a bone scan to see if it's spread to the bones (which, with your PSA it almost certainly hasn't, but it is a standard test). Each test usually takes a couple of weeks to report on, so unfortunately it all takes time.

Once all the test results are in, all the information will be discussed by experts in all the relevant fields at a weekly multidisciplinary team (MDT) meeting, and it's only at that point that treatment recommendations will be made.

About half of men in their 50s do have prostate cancer, by the way. I was diagnosed at the age of 55 in 2018. Three years on and I'm all treated and good to go.

Best wishes,

Chris

User
Posted 13 Nov 2021 at 21:57

keep positive loads off treatment options that will help you keep moving forward even bad cases are treatable even if not curable 

User
Posted 13 Nov 2021 at 23:48

Hi,

A psa of 7.9 isn't high and as said by others you need to get the complete diagnosis done.   Prostate Cancer, if it is that, is usually slow growing and there are several treatments with more being approved as time goes on.   

People often think the worst and diagnosis is a worrying time.  Survival can be many years with what is termed advanced cases.   I think your GP was wrong to say you are advanced anyway and also wrong to say you have cancer.  Theoretically a person with a raised psa at 7.9 is more likely not to have cancer.   Although the finger examination might indicate there is something wrong that might make it more likely.  There is no real evidence until the biopsy is done.  Until then it's a possibility.

In reality the whole thing is based on probability.  Even the biopsy isn't always right although if some is found it can be said you have got it.   Read up about the treatments as there are quite a few and people debate which is better for them.

All the best,
Peter

User
Posted 15 Nov 2021 at 09:33

Hi Pete,

My initial visit to GP until diagnosis was less that 1 month. That included referral to Urology for examination then back for biopsies and another 2 weeks for results of those which confirmed diagnosis.

Since then I had bone/CT/MRI scans all within a week and I have my appointment for the results of these this Thursday. 

It's a process unfortunately and takes some time so try to switch off if you can and do things you enjoy to relax.

K

User
Posted 15 Nov 2021 at 09:41

Hi Pete,

I was diagnosed in the summer of 2020 and I had a PSA of over 213 so much higher than yours.  I have an autistic disabled son and can relate to the emotions you are going through.   Stay positive and don't google too much like I did.  This forum will offer you great comfort and support, there are some extremely knowledgeable people who can help.

Jay

User
Posted 15 Nov 2021 at 10:24
Pete. It may be useful to get an idea of possible time line with my experience. Of course, every one is different and your process will depend on complete diagnosis (no cancer, local cancer, advanced cancer with limited (<3) mets, higher number of mets and aggressive cancer). Lets hope that you find there is no cancer. When I went to see the urologist after my MRI scan I was talking to a man who was going for his first consultation after referral from his doctor. He went in very worried and came out smiling - the urologist performed a DRE and found nothing to worry about.

20 Jan PSA blood test

22 Jan Doctor calls to say PSA 64

23 Jan DRE indicates enlarged prostate.

2 Feb first urologist appointment. DRE indicates cancer.

9 Feb MRI Scan

24 Feb Biopsy

4 March Bone Scan

11 March Second urologist appt. Start 28 days on bicalutamide.

25 March Zoladox implant.

14 April. First oncologist appt. Confirmed metastatic PC with low volume bone (3: - 2 pelvis with 1 small and 1 right scapula - small). Gleason 4 + 4.

22 April. Enzalutamide started

21 May PSA 0.33

4 June CT scan.

17 June 2nd. Zoladox injection. PSA 0.19

12 July PSA 0.11

11 August PSA 0.07

2 Sept Second oncologist consultation

07 Sept PSA 0.04

21 Sept. I st RT of 6 weekly at 6 GY

05 Oct PSA 0.03

31 October. Completed radiation course

4 November PSA Not detectable.

11 Third oncologist consultation

 
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