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User
Posted 13 Oct 2022 at 08:52

Hi, I've only just registered here and am hoping for some support as I don't feel like I'm coping.

My husband is 53 years old and had a PSA test on Friday which showed a PSA level of 5.4.  It also said his free to ratio level was 0.17.  I've been googling probably too much and I'm so scared.  He's got a gp appointment this morning so I think he'll have an examination.  And then go from there.

The only symptom he can think of that he's got is "frothy urine".  He doesn't need the toilet during the night usually.

It's the free to ratio thing I'm worried about though.  I can't see much about that on here.  Am I right in thinking it might mean it's aggressive?

Please, please help as Im struggling to be strong for him.

User
Posted 13 Oct 2022 at 10:03

Your OHs PSA level has gone above the level that NICE recommends further investigation but at this stage all bets are off. Raised PSA can have many different causes and cancer is not a certainty. 

My brother has a PSA that is similar, however he does not have cancer and is on active surveillance.

Check my profile to see my journey I am a similar age 

User
Posted 13 Oct 2022 at 10:08

Frothy urine is not a prostate cancer symptom. It might be a symptom of an urinary tract infection, or even a fistula connecting the bowel and urethra (which can happen as a result of a current or past prostate infection). An infection needs to be ruled out before the PSA value is regarded as valid. If the urine is very frothy only after it lands in the toilet and not in the urine stream, that could be protein being passed by the kidneys which would also need investigating (can be caused by diabetes and kidney problems).

PSA by itself isn't able to diagnose prostate cancer. At that level, the GP will probably check for infection, feel the prostate to make sure not hard or lumpy or tender (if not already done), and repeat the PSA test in around 6 weeks (or 6 weeks after clearing any infection if relevant). Should also check for kidney function and diabetes.

Also, a PSA test within a month of a COVID jab or COVID infection is likely to read higher than it otherwise would.

Edited by member 13 Oct 2022 at 10:10  | Reason: Not specified

User
Posted 13 Oct 2022 at 10:19

It is possible to Google too much but we all do it.  The GP should feel his prostate to see if it's hard.  The psa tells you a bit as only a biopsy gives real evidence. Psa 5.4 isn't very high and free psa is an indicator but as you say it's not widely mentioned.

Being diagnosed is one of the worst times.  Prostate Cancer is a slow and treatable condition in most cases. At 5.4 you should think it should be treatable and there is well over 50% chance it isn't there.

I noticed 2 more replies while I've been writing so good luck, Peter

User
Posted 13 Oct 2022 at 11:17

His free PSA of 17% indicates a 1 in 4 chance of it being prostate cancer but he is borderline for the next group which only has a 1 in 6 chance. As stated by others, there are more likely explanations for a PSA of 5 and frothy urine

Edited by member 13 Oct 2022 at 11:19  | Reason: Not specified

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

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User
Posted 13 Oct 2022 at 10:03

Your OHs PSA level has gone above the level that NICE recommends further investigation but at this stage all bets are off. Raised PSA can have many different causes and cancer is not a certainty. 

My brother has a PSA that is similar, however he does not have cancer and is on active surveillance.

Check my profile to see my journey I am a similar age 

User
Posted 13 Oct 2022 at 10:08

Frothy urine is not a prostate cancer symptom. It might be a symptom of an urinary tract infection, or even a fistula connecting the bowel and urethra (which can happen as a result of a current or past prostate infection). An infection needs to be ruled out before the PSA value is regarded as valid. If the urine is very frothy only after it lands in the toilet and not in the urine stream, that could be protein being passed by the kidneys which would also need investigating (can be caused by diabetes and kidney problems).

PSA by itself isn't able to diagnose prostate cancer. At that level, the GP will probably check for infection, feel the prostate to make sure not hard or lumpy or tender (if not already done), and repeat the PSA test in around 6 weeks (or 6 weeks after clearing any infection if relevant). Should also check for kidney function and diabetes.

Also, a PSA test within a month of a COVID jab or COVID infection is likely to read higher than it otherwise would.

Edited by member 13 Oct 2022 at 10:10  | Reason: Not specified

User
Posted 13 Oct 2022 at 10:19

It is possible to Google too much but we all do it.  The GP should feel his prostate to see if it's hard.  The psa tells you a bit as only a biopsy gives real evidence. Psa 5.4 isn't very high and free psa is an indicator but as you say it's not widely mentioned.

Being diagnosed is one of the worst times.  Prostate Cancer is a slow and treatable condition in most cases. At 5.4 you should think it should be treatable and there is well over 50% chance it isn't there.

I noticed 2 more replies while I've been writing so good luck, Peter

User
Posted 13 Oct 2022 at 11:17

His free PSA of 17% indicates a 1 in 4 chance of it being prostate cancer but he is borderline for the next group which only has a 1 in 6 chance. As stated by others, there are more likely explanations for a PSA of 5 and frothy urine

Edited by member 13 Oct 2022 at 11:19  | Reason: Not specified

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

User
Posted 24 Oct 2022 at 11:29

Hi, many thanks to all who responded.  I thought I'd give you the update.  My partner had another PSA test done (no other tests) exactly a week after the first and the result was 1.8.  I don't know the free psa result this time.

Obviously happy it is lower but the doctor says no further action.   I'm wondering if we should be pushing for a further test especially as his free psa was originally 17%?

I would be very grateful for your opinions and thank you so much for your time.

User
Posted 24 Oct 2022 at 17:39
I don't think any further assessment is needed at the moment but make sure that the PSA is checked regularly, every 6 months, from now on so that any changes can be tracked. Ask for a referral to urology if the PSA rises significantly
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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