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No symptoms but PSA 8.5 surely cancer

User
Posted 19 Mar 2022 at 23:25

Hi All,

Age: 51

PSA 8.5 both tests

Symptoms: None although 2 months ago I had what I thought was a urine infection with seman  in blood once or twice, negative urine test result x2. I now feel 100% fine though, in fact really well. Without said issues life would have continued as normal.

Physical Exam: Nothing noted except enlarged prostate, which is smooth.

Referral to urologist pending

Frustrated with myself for not recognising that 8.5 for a person of my age is high and pushing for faster referral earlier.  I am lucky enough to have private health care, although referral is for NHS because of fast track. DR says unlikely I have cancer, too young and too well. In fact two DRs did not seem to show much concern about my first score, second test was considered non urgent and referral was my as much my choice rather than being urgent necessity. I am not convinced.

Reading through the posts on here I can't seem to find any thing that gives me hope that this is not cancer given the PSA score of 8.5. Hence are my DRs convictions that I don't have cancer more hope than actually based around facts. Or maybe it's just as expected that the majority of posts on here are from positive diagnosis?

I will post some updates because my outcomes may be of help to others.

 

 

User
Posted 20 Mar 2022 at 00:08

Hi Jim,

Yes you said it yourself, this forum is mainly men or relatives of, that have had a positive diagnosis.

From what I’ve read from others on here a large prostate can produce a higher PSA. So although I would say try not to worry too much everything could be just fine, you are definitely doing the right thing in getting it checked out to be sure. Fingers crossed it’s nothing but if not, finding these things early leaves lots of options for treatment and cure.

My husband had no symptoms when diagnosed with a PSA of 8.3 but he is also quite a bit older than you. He’s had his op and so far doing really well 👍🏽

Keep us posted and best of luck 

User
Posted 20 Mar 2022 at 00:26

No this is not necessarily cancer. In fact I would probably err on the side of this not being cancer.

So, yes cancer at 51 is unlikely, but not impossible I was diagnosed at 53, there are people on this site who were diagnosed in mid forties, and just one or two diagnosed in their 30s.

If you were 70 I would be saying it is more likely that you have cancer than you don't. Also if you were 70 I'd be saying don't worry too much about it this is a very slow cancer. But you're not 70 your 51. 

So with a PSA of 8.5 your doctor should have referred you straight away for further investigation; sadly too many GPs think PC is impossible in youngish men, it is not, but it is rare.

Now I will tell you why I think you have not got cancer. If you had prostate cancer so severe that it was causing blood in your semen your PSA would be in the hundreds if not thousands.

So whatever is causing the blood in the semen is probably causing the high PSA and it is very unlikely to be cancer causing the blood in your semen.

We have definitely had people on here with higher PSA than yours who have had the all clear and if I could find a link to a thread I would post it, but I can't find one yet.

So this does need investigating, at least as far as an MRI and possibly a biopsy. There are types of prostate cancer that have a very low PSA but they are very rare. We have had people with a PSA as low as 2 who have had cancer and as high as 20 who haven't had cancer.

Please keep us informed, as you and Elaine have said this forum is biased towards the worse cases. Keep us informed and hopefully in a few years when someone else is in a similar position to you, I will be able to point them at this thread, and it will be one with a happy ending.

Dave

User
Posted 20 Mar 2022 at 11:30

Postings on sites such as these tend to report problems. I guess those who don't have any don't need to post. So here is my story;

10 years ago age 63 during a "well man" clinic held by GP, PSA 9 was reported. I was immediately referred for further investigation. MRI and biopsy showed a small well encapsulated lesion, Gleeson 3+4 and enlarged prostate.  Consultant said enlarged prostate tended to show higher PSA. I was on the edge of op or surveilance. The deciding factor was the fact that I was full time carer for my wife who had advanced Alzheimer's. PSA test every 6 months showed little change. Further biopsies remained the same although the first trans perenial missed it altogether. Some 10 years later nothing much had changed other than some symptoms of enlarged prostate, obviously still growing. Consultant finally informed me that the size would make removal "challenging". Which I took to mean time it went. Op went ahead with spinal anasthetic, nerve sparing surgery and one day overnight stay. I can now proudly boast of having the largest prostate my surgeon has removed. Spinal anasthetic works very well and I didn't need pain meds after op. Five months post op everything is looking good. Histology good, first PSA undetectable. No incontinence problems from day of catheter removal. 28 days of self administered Fragmin injections were (I was going to say a pain but not really). ED is getting there slow but sure. So far I've been very fortunate and can only hope my good luck continues.

User
Posted 21 Mar 2022 at 11:07
A friend of mine regularly produced PSA results in the sevens and eights over a number of years. He had the usual scans and biopsy which showed he had PIN which means there is about a 50% chance that it will transition to cancer but he has been in the same situation for over 10 years now. So this is a another case where a raised PSA has not indicated PCa, at least so far.
Barry
User
Posted 20 Mar 2022 at 00:43

I concur with Elaine and Dave [I believe this is the correct medical use of words], though I'd add a couple of points from personal [74 year old] experience.

I had a DRE that gave the smooooth result, but with a psa of 11 I had a couple of occasions of traces of blood in semen. I had no other symptoms and was otherwise very healthy. I think I was probably lucky to have had the blood in semen event because it woke my GP from his slumber and I was sent on to the well trodden pathway familiar to all of us here.

It's hard to be relaxed with potential cancer hanging over you but push on and insist on further testing. With the information your Drs have at the moment they [and we] can only guess and that's not good enough.

Jules

Edited by member 20 Mar 2022 at 00:45  | Reason: incompetence

User
Posted 20 Mar 2022 at 01:29
PSA doesn't necessarily confirm that cancer is present or how bad it might be - it is just a flag that further investigation is needed. We have had a man on here with PSA of 80 who subsequently got the all clear; we have had a man with PSA of 3 and incurable cancer.

Guidelines state that the GP should refer any man in his 50s with a PSA over 3.1 I think but what's important is that you have been referred now. It's a bit early to be assuming you have cancer though.

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

User
Posted 20 Mar 2022 at 01:36
PS it is outdated for your GP to suggest you are too young for prostate cancer and perhaps at next opportunity you could advise him or her that diagnosis of men in their 30s and 40s is becoming more common. We grieve on here for members who were diagnosed young and died young, and a friend of ours recently lost his grandson to PCa at the age of 27.

But as stated above, a PSA of 8 is by no means a foregone conclusion

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

User
Posted 20 Mar 2022 at 10:34

You are doing the right thing.  You are seeing a urologist who will conduct the necessary tests and scans.  Until the results are in, all is speculation.  My PSA was lower than yours when at the age of 46 I was diagnosed with prostate cancer.  A good friend, a Nigerian, mid 50s,  PSA of 12, no prostate cancer.  We are all individuals.  Hopefully, you'll get the all clear for PCa.  It does happen.

User
Posted 20 Mar 2022 at 22:08

A friend of ours who is 60 has been refused a PSA test too, it’s ridiculous.

Don’t be too hard on yourself about not doing more. We were in the same position really….my husbands PSA in 2020 was 5.1. When we spoke to the GP he referred him but completely assured us that it was nothing to worry about and some men can have a PSA of 200 or more (so robs seemed nothing 🤦🏻‍♀️) covid came along of course and no one saw him for 12 months…by that time his PSA was 8.3….it was only then I/we realised the significance and I beat myself up for a while, if I had realised I would have pushed for the appointment and gone private straight away if need be. I always wondered if that’s when it spread to his lymph node and could we have got it before then. It is what it is though and I know we can’t go back…just feel fortunate that we had some options. Best of luck Jim and take care 

User
Posted 05 Apr 2022 at 13:27
Do not read too much into this but many men who have PCa feel fine and exhibit no outward indications that they have the disease. There can also be possible indications of PCa that can be something else. But you are having an MRI, and are being checked out in the system. So it's the waiting now for all the tests to be done and possibly biopsy to confirm whether you have PCa.
Barry
User
Posted 10 Apr 2022 at 22:43

No matter what Jim it’s great that you’re managing to do 20 mile hikes and usual gym sessions, so keep doing what you’re doing. I’ve always said to Rob that the most important thing around all the treatment is just to feel fit and well.

Everything could still be absolutely fine and fingers crossed that is the case. It’s good that you’ve had the MRI though so you will know one way or the other.

Wishing you well and hoping for the best results for your MRI x

User
Posted 12 Apr 2022 at 20:42
Hoping you get good results Jim and wishing you well x
User
Posted 12 Apr 2022 at 22:58

Best of luck for tomorrow Jim. It’s hard to tell now how information is delivered with so many post covid changes. Really hoping it is good news though x

User
Posted 13 Apr 2022 at 18:25
At least you're on the way to diagnosis now, and the MRI result isn't too bad. Do you know if the biopsy will be under local or general anaesthetic?

Best wishes,

Chris

User
Posted 13 Apr 2022 at 19:29
The average prostate is somewhere between the size of a golf ball and a tennis ball, so 1.5cm is a relatively small proportion of that. The size really doesn't matter as much as the fact that it's wholly contained within the prostate and away from the edges.

Cheers,

Chris

User
Posted 14 Apr 2022 at 10:33

By the way, a lesion on the prostate does not have to be cancerous so until you have had the biopsy you cannot be sure that you do have prostate cancer.

I had the second biopsy because  my PSA score had increased  to 6.01 and was higher than the first 2 taken earlier that year ( 5.32 03/21 & 5.76 04/21). My understanding is that the local biopsy is not as thorough as the general one and I assume that the consultant wanted to confirm the real state of play before deciding on how best to proceed. As I mentioned, the Gleason grading was the same but the volume of cancer was found to be more. It is very, very unlikely that the cancer had spread between April & September and that the increased volume of cancer found was just down to the different biopsies.

Once you know the state of play you will then be in a position to decide how best to proceed. Hopefully, you will not be diagnosed with prostate cancer but if you are there are many treatments available and your initial results suggest  that yours is in the early stages of development.

 

Ivan

 

User
Posted 04 May 2022 at 12:59

Sorry to hear that Jim. Hopefully, a new appointment will be made as soon as possible.

 

Ivan

User
Posted 24 May 2022 at 20:12

Wishing you all the best for Thursday. 

User
Posted 24 May 2022 at 20:27

All the best for Thursday Jim 👍

User
Posted 24 May 2022 at 20:42

Jim Hope all goes as well as it can. It is helpful if you take someone with you. I went alone expecting to be told it was not cancer. I only remember a couple of things one was "its cancer" the other thing was" we can help you".

Take a pad just to jot key words down. I saw the consultant for about ten minutes max and then had more than an hour with the urology oncology nurse.

Thanks Chris

User
Posted 26 May 2022 at 12:48

Welcome, you've completed the trial membership. We can now sign you up for the full package.

Actually the trial membership is the hardest bit. Once you know what you are dealing with it gets easier.

It is almost the best diagnosis you could have, so likely you will be cured and even if not cured you would have a long life ahead of you.

Good luck with the treatment decision. There is a strong emotional bias towards prostatectomy and most lay people assume it will be best, to provide balance I usually present arguments for RT, but remember none of us members are clinicians and if they show a preference then our opinions are outweighed. Also in the end you will have to live (or die) with the consequence of your decision, so again our opinions are insignificant compared to yours.

BTW the membership card is called a toilet card, you flash it at the waiting staff when you want to use McDonald's as a public toilet.

Dave

User
Posted 26 May 2022 at 13:14

I am sorry to hear that you have joined the club, Jim, but as mentioned by Dave at least you now know where you stand. And your results are similar to mine. Very treatable and likely, with treatment, to not reduce your lifespan

Show Most Thanked Posts
User
Posted 20 Mar 2022 at 00:08

Hi Jim,

Yes you said it yourself, this forum is mainly men or relatives of, that have had a positive diagnosis.

From what I’ve read from others on here a large prostate can produce a higher PSA. So although I would say try not to worry too much everything could be just fine, you are definitely doing the right thing in getting it checked out to be sure. Fingers crossed it’s nothing but if not, finding these things early leaves lots of options for treatment and cure.

My husband had no symptoms when diagnosed with a PSA of 8.3 but he is also quite a bit older than you. He’s had his op and so far doing really well 👍🏽

Keep us posted and best of luck 

User
Posted 20 Mar 2022 at 00:26

No this is not necessarily cancer. In fact I would probably err on the side of this not being cancer.

So, yes cancer at 51 is unlikely, but not impossible I was diagnosed at 53, there are people on this site who were diagnosed in mid forties, and just one or two diagnosed in their 30s.

If you were 70 I would be saying it is more likely that you have cancer than you don't. Also if you were 70 I'd be saying don't worry too much about it this is a very slow cancer. But you're not 70 your 51. 

So with a PSA of 8.5 your doctor should have referred you straight away for further investigation; sadly too many GPs think PC is impossible in youngish men, it is not, but it is rare.

Now I will tell you why I think you have not got cancer. If you had prostate cancer so severe that it was causing blood in your semen your PSA would be in the hundreds if not thousands.

So whatever is causing the blood in the semen is probably causing the high PSA and it is very unlikely to be cancer causing the blood in your semen.

We have definitely had people on here with higher PSA than yours who have had the all clear and if I could find a link to a thread I would post it, but I can't find one yet.

So this does need investigating, at least as far as an MRI and possibly a biopsy. There are types of prostate cancer that have a very low PSA but they are very rare. We have had people with a PSA as low as 2 who have had cancer and as high as 20 who haven't had cancer.

Please keep us informed, as you and Elaine have said this forum is biased towards the worse cases. Keep us informed and hopefully in a few years when someone else is in a similar position to you, I will be able to point them at this thread, and it will be one with a happy ending.

Dave

User
Posted 20 Mar 2022 at 00:43

I concur with Elaine and Dave [I believe this is the correct medical use of words], though I'd add a couple of points from personal [74 year old] experience.

I had a DRE that gave the smooooth result, but with a psa of 11 I had a couple of occasions of traces of blood in semen. I had no other symptoms and was otherwise very healthy. I think I was probably lucky to have had the blood in semen event because it woke my GP from his slumber and I was sent on to the well trodden pathway familiar to all of us here.

It's hard to be relaxed with potential cancer hanging over you but push on and insist on further testing. With the information your Drs have at the moment they [and we] can only guess and that's not good enough.

Jules

Edited by member 20 Mar 2022 at 00:45  | Reason: incompetence

User
Posted 20 Mar 2022 at 01:29
PSA doesn't necessarily confirm that cancer is present or how bad it might be - it is just a flag that further investigation is needed. We have had a man on here with PSA of 80 who subsequently got the all clear; we have had a man with PSA of 3 and incurable cancer.

Guidelines state that the GP should refer any man in his 50s with a PSA over 3.1 I think but what's important is that you have been referred now. It's a bit early to be assuming you have cancer though.

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

User
Posted 20 Mar 2022 at 01:36
PS it is outdated for your GP to suggest you are too young for prostate cancer and perhaps at next opportunity you could advise him or her that diagnosis of men in their 30s and 40s is becoming more common. We grieve on here for members who were diagnosed young and died young, and a friend of ours recently lost his grandson to PCa at the age of 27.

But as stated above, a PSA of 8 is by no means a foregone conclusion

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

User
Posted 20 Mar 2022 at 10:34

You are doing the right thing.  You are seeing a urologist who will conduct the necessary tests and scans.  Until the results are in, all is speculation.  My PSA was lower than yours when at the age of 46 I was diagnosed with prostate cancer.  A good friend, a Nigerian, mid 50s,  PSA of 12, no prostate cancer.  We are all individuals.  Hopefully, you'll get the all clear for PCa.  It does happen.

User
Posted 20 Mar 2022 at 11:30

Postings on sites such as these tend to report problems. I guess those who don't have any don't need to post. So here is my story;

10 years ago age 63 during a "well man" clinic held by GP, PSA 9 was reported. I was immediately referred for further investigation. MRI and biopsy showed a small well encapsulated lesion, Gleeson 3+4 and enlarged prostate.  Consultant said enlarged prostate tended to show higher PSA. I was on the edge of op or surveilance. The deciding factor was the fact that I was full time carer for my wife who had advanced Alzheimer's. PSA test every 6 months showed little change. Further biopsies remained the same although the first trans perenial missed it altogether. Some 10 years later nothing much had changed other than some symptoms of enlarged prostate, obviously still growing. Consultant finally informed me that the size would make removal "challenging". Which I took to mean time it went. Op went ahead with spinal anasthetic, nerve sparing surgery and one day overnight stay. I can now proudly boast of having the largest prostate my surgeon has removed. Spinal anasthetic works very well and I didn't need pain meds after op. Five months post op everything is looking good. Histology good, first PSA undetectable. No incontinence problems from day of catheter removal. 28 days of self administered Fragmin injections were (I was going to say a pain but not really). ED is getting there slow but sure. So far I've been very fortunate and can only hope my good luck continues.

User
Posted 20 Mar 2022 at 22:08

A friend of ours who is 60 has been refused a PSA test too, it’s ridiculous.

Don’t be too hard on yourself about not doing more. We were in the same position really….my husbands PSA in 2020 was 5.1. When we spoke to the GP he referred him but completely assured us that it was nothing to worry about and some men can have a PSA of 200 or more (so robs seemed nothing 🤦🏻‍♀️) covid came along of course and no one saw him for 12 months…by that time his PSA was 8.3….it was only then I/we realised the significance and I beat myself up for a while, if I had realised I would have pushed for the appointment and gone private straight away if need be. I always wondered if that’s when it spread to his lymph node and could we have got it before then. It is what it is though and I know we can’t go back…just feel fortunate that we had some options. Best of luck Jim and take care 

User
Posted 21 Mar 2022 at 11:07
A friend of mine regularly produced PSA results in the sevens and eights over a number of years. He had the usual scans and biopsy which showed he had PIN which means there is about a 50% chance that it will transition to cancer but he has been in the same situation for over 10 years now. So this is a another case where a raised PSA has not indicated PCa, at least so far.
Barry
User
Posted 05 Apr 2022 at 13:27
Do not read too much into this but many men who have PCa feel fine and exhibit no outward indications that they have the disease. There can also be possible indications of PCa that can be something else. But you are having an MRI, and are being checked out in the system. So it's the waiting now for all the tests to be done and possibly biopsy to confirm whether you have PCa.
Barry
User
Posted 10 Apr 2022 at 22:43

No matter what Jim it’s great that you’re managing to do 20 mile hikes and usual gym sessions, so keep doing what you’re doing. I’ve always said to Rob that the most important thing around all the treatment is just to feel fit and well.

Everything could still be absolutely fine and fingers crossed that is the case. It’s good that you’ve had the MRI though so you will know one way or the other.

Wishing you well and hoping for the best results for your MRI x

User
Posted 12 Apr 2022 at 20:42
Hoping you get good results Jim and wishing you well x
User
Posted 12 Apr 2022 at 22:58

Best of luck for tomorrow Jim. It’s hard to tell now how information is delivered with so many post covid changes. Really hoping it is good news though x

User
Posted 13 Apr 2022 at 18:25
At least you're on the way to diagnosis now, and the MRI result isn't too bad. Do you know if the biopsy will be under local or general anaesthetic?

Best wishes,

Chris

User
Posted 13 Apr 2022 at 19:29
The average prostate is somewhere between the size of a golf ball and a tennis ball, so 1.5cm is a relatively small proportion of that. The size really doesn't matter as much as the fact that it's wholly contained within the prostate and away from the edges.

Cheers,

Chris

User
Posted 14 Apr 2022 at 09:43

My prostate was 50 cc in size ( the average size is around 30 cc) and my lesion was 1.5 cm.

Re local or general anaesthetic biopsies, I had both ( the local in June and the general in September) and I had no problem with recovery with either. In fact I found that the general biopsy created less blood in the urine and semen afterwards. What I would say is that the general one found that the cancer was spread throughout my prostate (still the same Gleason score mind: 3 + 4=7) whereas the local one suggested it was only in one side of my prostate. I can only assume that the local biopsy took less samples and did not go as deep into the prostate.

 

Ivan

User
Posted 14 Apr 2022 at 10:33

By the way, a lesion on the prostate does not have to be cancerous so until you have had the biopsy you cannot be sure that you do have prostate cancer.

I had the second biopsy because  my PSA score had increased  to 6.01 and was higher than the first 2 taken earlier that year ( 5.32 03/21 & 5.76 04/21). My understanding is that the local biopsy is not as thorough as the general one and I assume that the consultant wanted to confirm the real state of play before deciding on how best to proceed. As I mentioned, the Gleason grading was the same but the volume of cancer was found to be more. It is very, very unlikely that the cancer had spread between April & September and that the increased volume of cancer found was just down to the different biopsies.

Once you know the state of play you will then be in a position to decide how best to proceed. Hopefully, you will not be diagnosed with prostate cancer but if you are there are many treatments available and your initial results suggest  that yours is in the early stages of development.

 

Ivan

 

User
Posted 04 May 2022 at 12:59

Sorry to hear that Jim. Hopefully, a new appointment will be made as soon as possible.

 

Ivan

User
Posted 24 May 2022 at 20:12

Wishing you all the best for Thursday. 

User
Posted 24 May 2022 at 20:27

All the best for Thursday Jim 👍

User
Posted 24 May 2022 at 20:42

Jim Hope all goes as well as it can. It is helpful if you take someone with you. I went alone expecting to be told it was not cancer. I only remember a couple of things one was "its cancer" the other thing was" we can help you".

Take a pad just to jot key words down. I saw the consultant for about ten minutes max and then had more than an hour with the urology oncology nurse.

Thanks Chris

User
Posted 26 May 2022 at 12:48

Welcome, you've completed the trial membership. We can now sign you up for the full package.

Actually the trial membership is the hardest bit. Once you know what you are dealing with it gets easier.

It is almost the best diagnosis you could have, so likely you will be cured and even if not cured you would have a long life ahead of you.

Good luck with the treatment decision. There is a strong emotional bias towards prostatectomy and most lay people assume it will be best, to provide balance I usually present arguments for RT, but remember none of us members are clinicians and if they show a preference then our opinions are outweighed. Also in the end you will have to live (or die) with the consequence of your decision, so again our opinions are insignificant compared to yours.

BTW the membership card is called a toilet card, you flash it at the waiting staff when you want to use McDonald's as a public toilet.

Dave

User
Posted 26 May 2022 at 13:14

I am sorry to hear that you have joined the club, Jim, but as mentioned by Dave at least you now know where you stand. And your results are similar to mine. Very treatable and likely, with treatment, to not reduce your lifespan

User
Posted 26 May 2022 at 18:28

Sorry to hear that you’ve had the diagnosis Jim, but glad it is contained and you have the treatment options.

Strange how they said 15 years! If they get rid of the cancer and cure you then I’m not sure why it should alter life expectancy….and besides if we look at the past 15 years and how treatments for PCa have developed, it only leaves us very optimistic for the next 15. 

Best of luck with making your decision, more information on my profile with regards to my husbands choice of RP and just please al if you have any questions.

Take care x

 
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