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Shocked to the core

User
Posted 13 Nov 2021 at 18:18

Hi I am Pete aged 56, I really need to know why my GP is panicking, I have just had a PSA of 7.9 and on exam he said my prostrate felt lumpy. 
I have received a letter this morning (the day after seeing the GP) from the Urology Dept. Now I am really panicking, 
Does anyone know if my results so far show something really bad?

Pete

 

User
Posted 14 Nov 2021 at 10:41

How a GP can make such statements after a DRE is beyond me but he was right to  get you an immediate appointment with the urologist who will  have a good idea after a DRE and probably request a scan to confirm while putting you on something like bicaltumide (sp?). But you must then meet an oncologist  who will define the best track for you to move along.

User
Posted 14 Nov 2021 at 10:45
Your GP seems very unprofessional (like so many of them, who refuse PSA tests to their patients who have no symptoms) to mention prostate cancer and ‘terminal’ disease.

He knows nothing, let alone if you have cancer or not, and neither will you until you have numerous tests and scans, which as I said will take weeks or months.

So unless you want to be living on tenterhooks up till Christmas and possibly the New Year, cast the ‘Big C’ to the back of your mind and wait for your NHS tests and potential treatments to take their course.

Cheers, John.

User
Posted 14 Nov 2021 at 14:57

Hi Pete, glad you are putting it into perspective. Yes tests and prods and pokes for a few weeks now. As so many have said that PSA is elevated not high. All men get prostate cancer unless they die young. Once they have it they nearly all go on to die when they are old of something else.

98% of men who are diagnosed are alive five years after diagnosis, and most of those men were diagnosed with a higher PSA than yours, so even if you have PCa you have plenty of time for treatment. Of course you don't just want five years you want 30, well if you have PCa and it is treated then living long enough to die of something else is quite likely.

Dave

User
Posted 14 Nov 2021 at 19:21

Originally Posted by: Online Community Member

As Lynn said, it is more likely than not that I have PCa, and it's unlikely to be at an early stage. 

With a PSA of only 7.9 it's EXTREMELY unlikely to be advanced, Pete. There are rare and exotic varieties of prostate cancer that metastasise without increasing PSA, but if you had common or garden adenocarcenoma (the "ordinary" variety of prostate cancer), you could expect your PSA to be in the hundreds or thousands if it were advanced. Please don't assume the worst - localised prostate cancer is an eminently treatable condition. 

Most of us here have been where you are now. It's tough, but it is just a matter of waiting, unfortunately. 

Take care of yourself,

Chris

 

User
Posted 15 Nov 2021 at 00:42
Ah; autism, learning disabilities and PMBL is part of my area of interest. No you didn't suggest that I had said anything different; I just wanted to clarify the difference between locally advanced and advanced. Let's hope that the GP was just being over-cautious and that you don't have to wait long for some answers - everything gets better once you know whether it is cancer and, if it is, have a plan in place. My husband was 50 at diagnosis and up to that point I had never been involved in any kind of forum either!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Nov 2021 at 10:29
Pete

That is good news. Its just a pity that your GP was so "over the top" with an instant ( and probably incorrect) diagnosis. Hopefully the scan on Wednesday will confirm your urologists diagnosis.

Chris

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User
Posted 13 Nov 2021 at 20:06
If the prostate feels hard or lumpy, there is a very high chance that cancer is present, and is not in the very earliest stage. It is right that you have been fast tracked to urology under the 14 day cancer pathway but at the moment, it isn't definite that you have cancer. The urologist will probably want to feel your prostate himself / herself and arrange for an MRI to see how it looks - you will probably be advised to have a biopsy after that.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 Nov 2021 at 21:30
Thanks Lynne, I am sorry about the double post, I saw that the message would go to the moderator, but when I next looked I had an email telling me I was good to go.

I am all over the place at the moment and not thinking straight, so in my zeolous thirst for reassurance I thought the other post had been deleted or that I did not do it correctly. Hence I wrote this one, then go the exact same moderator message .

Since then I have not had a chance to sit down.

Your relies have been very helpful

I

User
Posted 14 Nov 2021 at 00:00
Your GP is not panicking.

You have an above normal PSA (should be under 4 at your age) and an enlarged prostate with a rough exterior. He has correctly referred you to urology on a ‘fast’ track basis, but despite that, mark my words, you will have many weeks of waiting and tests before you get a definitive diagnosis.

So in the words of Corporal Fraser (Dad’s Army) ‘Don’t panic’!

Keep calm and carry on.

In most cases, a prostate cancer diagnosis is not a death sentence, as most correspondents here can attest to!

Best of luck.

Cheers, John.

User
Posted 14 Nov 2021 at 10:24

Hi John, 

Thanks for the reply and advice, 

I understand now that this is what happens. My problem was that my GP did not describe what I am seeing on here and on other websites.

For a start he said my PSA was very high, and after the DRE, he described what felt was an enlarged prostate which should be smooth and spongy, He said mine felt hardish, he directed me to feel my own palm and the soft skin under my little finger, apparently, that would be normal, but mine was similar to the feeling under my middle finger (again he directed me to feel this) To me this is hard and lumpy.

I know my GP really well and once he examined me his demeanour changed altogether. He began using words like terminal, and told me this was bad and serious. He did not say he suspected I have cancer, he said I have it and he suspects it is going to be bad. 

He was not calm and I walked out of there wishing for all my worth, my wife could have been there. (That's not me at all)

I would have preferred him to tell me that my PSA results were elevated and that my prostate exam had shown abnormalities (I would have  then asked what abnormalities and got the same response, but I may have taken it in more)

It was unhelpful of my GP to talk about advanced and terminal cancer at this stage, he has just placed the fear of God in me, which won't go away till I have my answers. I am nowhere near that yet.
All the good people on here are giving me sound advice, which I find has calmed me down and my wife has banned me from searching google for postate cancer at this stage. She said we will search as we know more.
Pete 


 

 

User
Posted 14 Nov 2021 at 10:41

How a GP can make such statements after a DRE is beyond me but he was right to  get you an immediate appointment with the urologist who will  have a good idea after a DRE and probably request a scan to confirm while putting you on something like bicaltumide (sp?). But you must then meet an oncologist  who will define the best track for you to move along.

User
Posted 14 Nov 2021 at 10:45
Your GP seems very unprofessional (like so many of them, who refuse PSA tests to their patients who have no symptoms) to mention prostate cancer and ‘terminal’ disease.

He knows nothing, let alone if you have cancer or not, and neither will you until you have numerous tests and scans, which as I said will take weeks or months.

So unless you want to be living on tenterhooks up till Christmas and possibly the New Year, cast the ‘Big C’ to the back of your mind and wait for your NHS tests and potential treatments to take their course.

Cheers, John.

User
Posted 14 Nov 2021 at 12:15
Thank you, I suppose like all of us I want answers and now, but those answers are going to take time and I am going to prodded and probed and biopsied. It all sounds fairly uncomfortable but necessary.

We have been on the cancer treadmill before, a bit different though because it was my wife. She went through 2 years of feeling rotten due to treatments and a couple of occasions when things looked really bad, but she is doing ok now.

I am feeling a bit better today and a bit less like the sky fell in.

Pete.

User
Posted 14 Nov 2021 at 14:57

Hi Pete, glad you are putting it into perspective. Yes tests and prods and pokes for a few weeks now. As so many have said that PSA is elevated not high. All men get prostate cancer unless they die young. Once they have it they nearly all go on to die when they are old of something else.

98% of men who are diagnosed are alive five years after diagnosis, and most of those men were diagnosed with a higher PSA than yours, so even if you have PCa you have plenty of time for treatment. Of course you don't just want five years you want 30, well if you have PCa and it is treated then living long enough to die of something else is quite likely.

Dave

User
Posted 14 Nov 2021 at 16:36

well said Dave a voice off good knowledge like Lynn  👍

User
Posted 14 Nov 2021 at 18:55

Thanks, Dave, I am keeping my fingers crossed. I was full of anger yesterday and frustration because I have been aware of having an enlarged prostate for some years, 
My GP has never discussed a PSA test even though at 50 my prostate was enlarged a bit, but I was told it was all fine and to do with my age.
I have been back for checks 3 times since the age of 50. Twice the doc said not to worry and gave me pills to help with the waterworks, (NO Bloods) 3rd time Doc said no need to examine me he just changed the pills. TBH he made me feel awkward because I asked him if he needed to examine me. I was told it was unnecessary because I had been seen 18 months previous. Again he did not take bloods.
This time I went about a recent chest infection, to check I am clear as I have Asthma. I was seen by two students, who wanted to take a full history. They asked about my prostate and the pills I take to help me pee
I just happened to mention that the pills were not working as well and I am getting disturbed needing to pee a couple of times at night.
The students went to get my GP to sign off and so my GP said, I probably needed different pills, but to be on the safe side he should check my blood (a full MOT) he called it. 
It's a good job because things were probably missed in the past. 
As Lynn said, it is more likely than not that I have PCa, and it's unlikely to be at an early stage. 
I just have to wait and see.
Pete.

 

User
Posted 14 Nov 2021 at 19:11
The first few weeks are the most worrrying time when there are more questons than answers, Hopefully, it will be found that at worst any cancer is within the capsule. My doctor openly admitted he did nothave the experience to comment but was marvellously efficient in ensuring the appointments needed. My disappointment was the urologist who was very pessimistic without even knowing status and treatment options. My oncologists are great.
User
Posted 14 Nov 2021 at 19:21

Originally Posted by: Online Community Member

As Lynn said, it is more likely than not that I have PCa, and it's unlikely to be at an early stage. 

With a PSA of only 7.9 it's EXTREMELY unlikely to be advanced, Pete. There are rare and exotic varieties of prostate cancer that metastasise without increasing PSA, but if you had common or garden adenocarcenoma (the "ordinary" variety of prostate cancer), you could expect your PSA to be in the hundreds or thousands if it were advanced. Please don't assume the worst - localised prostate cancer is an eminently treatable condition. 

Most of us here have been where you are now. It's tough, but it is just a matter of waiting, unfortunately. 

Take care of yourself,

Chris

 

User
Posted 14 Nov 2021 at 20:57
Chris, Si_Ness had extensive bone mets and a PSA of 3.5 with common old adenocarcinoma.

PeteT - that aside, I never suggested that you had advanced cancer - what I said was that if the GP could feel a hard and lumpy prostate it is unlikely to be at the earliest stage. There is a significant difference between the two.

It seems the GP was the one who said it was advanced - without any kind of diagnostic process I assume he was imprecise with his language and meant locally advanced rather than advanced. Locally advanced PCa does not mean it is incurable or terminal.

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

User
Posted 14 Nov 2021 at 23:05
I dont think I represented what you said as anything else LynnEyre, You did not say anything to make me feel that IF I have prostate cancer, it will be advanced. I totally understood what you meant and that information made me calmer.

I am still new to all this and even this chatty thing, I am not one for social media or making posts and protestations, I am just a husband and a dad, and my area of expertise is autism and learning disabilities

I thought I was looking after myself by having regular prostate checks, and I was caught out by this overwhelming emotion. I am going to talk to my GP about what happened. He may be unaware, but I need time to calm and think so I will wait until I have a diagnosis

I have to admit I was feeling reassured by the guys on here, I am realising that: as in life, everyone is an individual with their own path to travel

I really could have done without the additional info you chose to share, right now I could be facing that. Sobering ! I feel a bit sick now.

Pete

User
Posted 15 Nov 2021 at 00:42
Ah; autism, learning disabilities and PMBL is part of my area of interest. No you didn't suggest that I had said anything different; I just wanted to clarify the difference between locally advanced and advanced. Let's hope that the GP was just being over-cautious and that you don't have to wait long for some answers - everything gets better once you know whether it is cancer and, if it is, have a plan in place. My husband was 50 at diagnosis and up to that point I had never been involved in any kind of forum either!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Nov 2021 at 00:47

Hi Pete, I too am not one for social media, this is the only social media account I have. This group is naturally biased towards people with unusual problems. The "normal" people just get diagnosed treated and move on, if they join this group they leave after a year or two when everything is ok. The people with on going problems remain, so this group is heavily biased towards the unusual prostate cancer cases. Lyn has been on this group over ten years so she remembers these exceptionally unfortunate people, but they are in no way representative of the majority of cases. 

At the moment you can only go with the tiny bit of information available to you, and statistics based on that information, "what if"s are pointless. The very few figures we have about you can be fed into a formula (called a nomogram) and they give you various survival rates for a number of years.

I was really surprised when I found out the prostate cancer specific survival rate in the first year is 101.6% . I though that is impossible! But what it means is that you have more chance of dying in the next year from something other than prostate cancer. So pay attention when you walk across the road tomorrow, that bus is more likely to kill you than prostate cancer.

Neither, me, Lyn, or your GP know anything other than your PSA of 7.9 which on its own gives you a 40% chance of having cancer, your age which gives you a 60% chance of having cancer, and the DRE which does suggest quite a high chance of cancer, but not that it is anything beyond locally advanced which is curable.

Now if you live in perpetual fear of being run over by buses, then you should worry a lot about prostate cancer, but if you have managed to come to terms with daily living, and are not petrified to step out of the door, then worry no more about prostate cancer until a urologist tells you you have something to worry about.

Apologies if you suffer from trocophobia.

Edited by member 15 Nov 2021 at 09:31  | Reason: Not specified

Dave

User
Posted 15 Nov 2021 at 08:04
Hi Pete. Really feel for you. I know it's easier said than done but try not to panic. The brain has a tendency to run through 1000 worse case scenarios but it might not be all that bad. My husband (56) has just been diagnosed. Took 63 days from referral to diagnosis. This was the worst period of our lives, the not knowing. Once we found out he had cancer, we knew what we were dealing with and could start making plans for treatment. My advice would be to phone up and speak to one of the prostate cancer nurses on this website. They are absolutely amazing. Can't speak highly of them enough. Both myself and my husband phoned them several times before diagnosis and they were very reassuring and helped to calm us down and put things in perspective. Also alerting you to the NHS "28 Day Faster Diagnosis" initiative. All NHS Trusts in England should give a diagnosis of cancer (or not) within 28 days of referral. So if things are slowing up with biopsies, scans etc, maybe give this a mention and push to be seen asap. Quoting from their latest report...

"From October 2021 cancer systems will be required to meet this standard for at least three quarters (75%) of patients."

https://www.england.nhs.uk/cancer/quarterly-report-overviews/q4-2021-q1-2122/earlier-and-faster-diagnosis/

Really wish you the best of luck with everything.

User
Posted 15 Nov 2021 at 09:36

Hi Pete,

just another voice to add what has been well expressed here. Although it may feel alarming that you have been put on a fast path, it's good that you have been given that level of attention. As has been said, it will soon slow down and you will need to get used to things edging forward in 2 or 3 week cycles. What seems to be a whirlwind right now will start to feel glacial.

My PSA was 17.9 at the start of my trip down PCa Lane, and after 18  months I still don't have a satisfactory treatment plan for various reasons. But its not the end of the world. Life doesn't end with diagnosis. I have just done my first 2 marathons, in 3 weeks: not fast, not pretty, but still up and kicking at the end of it.   

Best of luck- but the odds are that you won't need it! 

User
Posted 24 Nov 2021 at 19:03

Hello all,

I have no idea how we got through the last few days, but we did.
My first appointment with the Urologist or at Urology in Clatterbridge is on Fri, and I am hoping for some answers.
Am I really daft for wanting my wife to be with me? I did not leave her side when she was going through her cancer battles, and I just need the reassurance. 
The hospital has been unable to tell me what will happen when I arrive, just that the appointment may take 3 hours. 
My wife thinks I may see the urologist for an examination, then scan and if the scan shows something then I will have a pre-op assessment and have to wait for a biopsy. Clatterbridge said waiting lists for biopsy are a month (OMG!!!)
Anyway, thankyou to all, The fact that you even bothered to write in this chat thread, meant a great deal to both me and Shelagh. 

User
Posted 24 Nov 2021 at 19:34
You are very unlikely to have a biopsy at that appointment - if it is a template biopsy or image guided TRUS it will only be arranged after the results of the MRI have been analysed because it is done in an operating theatre. Try not to agree to a routine biopsy with local anaesthetic before the MRI has been done (there's only a small number of NHS trusts that still do that) because you would then have to wait a few weeks for the prostate to recover before the scan could be done.

On Friday, the urologist may do a digital examination and you could be asked to do some bladder function tests - measuring how strong your flow is. They are supposed to talk you through the risks and benefits of going through the diagnostic tests and then some hospitals would do the MRI there and then while others will send you another appointment for that.

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

User
Posted 24 Nov 2021 at 20:00
Thankyou for the information Lynne, I have been trying to find out from my hospital what will be expected, I have had to pay a local respite centre to care for my sons whilst I am at the hospital, and it puts them both at risk as they are very vulnerable, but the hospital are not giving out much info,

I have not been asked to bring urine or to stop my tablets, therefore my flow will be ok, I was hoping at least to see the consultant and have an MRI so I get some answers.

I went back to see a different GP, same practice, and told her about my experience with my GP, she laughed and said he loves a bit of drama!

These past two weeks have been horrible anxiety fuelled weeks, on top of which my wife has been told her liver is very damaged by her treatments and her own autoimmune. Thats been a shock too. BBloomin eck we have plans and dreams and they seem to be dust.

Thanks for the reply tho

User
Posted 24 Nov 2021 at 20:15
Clatterbridge is, as I'm sure you know, the regional specialist cancer centre. I had my treatment there. You'll be in excellent hands.

Best wishes,

Chris

User
Posted 27 Nov 2021 at 09:53

Hi all,

after all that worry, it looks like I just have BPH
My Urologist could not detect anything other than an enlarged prostate.
My flow test revealed I had more than 220ml retained in my bladder after emptying, which was revealing, 
My wife was with me the whole time which was of great comfort to me.
I am having an MRI on Wed, there is a very slight chance it could flag something but my urologist is not worried. She also thinks the nerves to my bladder were probably damaged during a major traumatic spinal injury and surgery some years ago, from which I fully recovered very quickly.
My journey is far from over I know that, but I can at least relax for now.
Thank you all for your support, advice and listening ears.
You made a great deal of difference to me and really helped me through.
Thank you so much.
Pete
  
 

User
Posted 27 Nov 2021 at 10:29
Pete

That is good news. Its just a pity that your GP was so "over the top" with an instant ( and probably incorrect) diagnosis. Hopefully the scan on Wednesday will confirm your urologists diagnosis.

Chris

User
Posted 27 Nov 2021 at 14:05

Glad to hear it is not cancer. 220 ml is quite a lot of retention, average bladder can hold 500ml, but most people feel they need a pee at 250 ml so you don't have a lot of spare capacity. If anyone starts talking about catheters read my post near the bottom of this thread.

https://community.prostatecanceruk.org/posts/t22995-Escaping-the-Catheter

 

Dave

User
Posted 29 Nov 2021 at 00:07

Thanks, Dave, I am actually dreading the MRI result. even though my urologist seemed optimistic, and Shelagh, my better half, assures me that if there is something it is unlikely to have spread,
The Doc did not talk about catheterisation,  she spoke a little about pills to shrink the prostate or some surgical options, although they have not yet fully been explained.
Thanks for all your support
Pete.

Edited by member 29 Nov 2021 at 09:33  | Reason: moderator asked me to ananomise dr

User
Posted 29 Nov 2021 at 00:41
Hi Pete, edit your post to remove the name of the urologist.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 29 Nov 2021 at 09:34
Ok Lynne, Done that.

Cheers

Pete

 
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