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47 Years old, Worried about PCa

User
Posted 24 Jan 2024 at 13:36

Hello and thank-you for allowing me to post.

I am 47 years old, caucasian, and back in June-August I had maybe a monthly occasion where, when I peed in the morning, it would be stop start.

I put it down to getting older, but promised myself that, the next time this would happen, I would see a GP.  It was only during the morning, and only the first pee of the day, and never 2 days in a row.  In fact, never more than once in 3-4 weeks.

I come from a family where my father has an enlarged prostate (PSA score was 600), and my grandfather did also.  My sister was diagnosed with a slow form "borderline" ovarian cancer a few years ago.  They still are unable to say it was cancer, and she was told that it would split opinions with some consultants calling it cancer, others would say it wasn't.

December 25th I felt unwell, and December 26th I woke up and could only pee a small amount before stopping.  I decided to get on with the business of making my son's breakfast and then was able to complete my pee in the next visit.  December 27th, I again was unable to pee, but managed to do so by pressing on my belly.

December 28th I made a GP appointment which was on January 8th.  December 28th, I had pain in my back area - where the kidneys are located, a fever, and was able to pee without problems that morning.  I have had no other symptoms since.

On January 10th I saw a doctor, and explained all the above.  She arranged for me to take tests including PSA, Kidney, Bladder, Diabetes, Bone, Blood Count and another two I cannot remember.  I also gave a urine test which, I felt, was pointless considering the infection happened 10 days earlier.  

She offered to do a DRE but I was not prepared, I felt like I needed to poo (as I often do when nervous), so agreed to take a DRE after the PSA test (January 15th).

My PSA result came in and it was "higher than we'd expect for your age".  I pressed the doctor for the score, considering my father had a 600 reading, and explained the family history.  He gave me a score of 3.2 which is higher than the 2.6 upper limit for my age.

He performed the DRE (took about 10 seconds), and told me that it was smooth.  Of course, as you will all know, a DRE can only cover a certain percentage of the prostate.  He did say my prostate was large for someone of my age.  He said that, if the DRE uncovered something, he would refer me to a specialist straight away.  Otherwise, it would be another PSA in three weeks (four weeks after the first).

Ever since, I am in a state of panic because my understanding is that - whilst PCa is a slow moving cancer in most cases, it can be more aggressive in younger men.  I have seen similar comments on this forum.  

My gut feeling is that I had an infection, and that has peaked my PSA score which is also affected by the enlarged prostate.  Although, I am concerned the doctors seem to be going down a path that does not consider prostatitis.  My perineum is sore when sat on my office chair, almost feels like there is a stone there.  The last 2-3 days, my penis has felt uncomfortable through the day (although no problems peeing) like it is irritated.  I left a hot water bottle on it 2-3 times yesterday and it feels normal again today - but is it a sign I am suffering with infection, or something else?

However, as you know, late at night one tends to Google and find stories that set the panic racing.  I am more concerned with this having been in my system for a long time, and the chances that it has spread beyond the prostate due to the higher risk chances that younger people have more aggressive forms.  Is that a logical thought process?

I spoke to a nurse today, and she has said that - based on the above, I should not worry too much.  I almost feel like I should call the GP and ask them why they are seemingly ruling out infections - is it caution (which is fine, but creates anxiety) - the doctor called it dotting the is and crossing the ts - or is it a genuine suspicion.

I know no two stories are the same, and I'll keep reading through these forums.  I wanted to place my story here because, regardless of potential outcomes, it may help someone one day.

User
Posted 27 Jan 2024 at 21:23
I know that it's very hard especially with your OCD and the amount of information that can be gleaned from Google searches. Unless you are careful, every ache and pain (that everyone suffers from in one form or another) can suddenly come Cancer, or a Brain Tumour or any other serious illness. As an example, my wife has claimed she has caught Covid at least a dozen times in the last 3 years despite 7 vaccinations and plenty of negative tests - but every cold or ache suddenly matches what she has read.

I can only suggest to take a break from reading about symptoms and listen to your GP. Changing your office chair may well help your perineum pain or getting up more frequently for a walk around and try and not worry about your erections - a disturbed mental state will certainly stop them in their tracks, but maybe watch a little adult video to see if that helps. DRE will certainly not cause any issues - you would be amazed what some people push up their rectums and still get very strong erections!

I think I said earlier, you are probably 10 years away from prostate cancer becoming an issue and even then it is fully treatable/curable.

User
Posted 24 Jan 2024 at 13:36

Hello and thank-you for allowing me to post.

I am 47 years old, caucasian, and back in June-August I had maybe a monthly occasion where, when I peed in the morning, it would be stop start.

I put it down to getting older, but promised myself that, the next time this would happen, I would see a GP.  It was only during the morning, and only the first pee of the day, and never 2 days in a row.  In fact, never more than once in 3-4 weeks.

I come from a family where my father has an enlarged prostate (PSA score was 600), and my grandfather did also.  My sister was diagnosed with a slow form "borderline" ovarian cancer a few years ago.  They still are unable to say it was cancer, and she was told that it would split opinions with some consultants calling it cancer, others would say it wasn't.

December 25th I felt unwell, and December 26th I woke up and could only pee a small amount before stopping.  I decided to get on with the business of making my son's breakfast and then was able to complete my pee in the next visit.  December 27th, I again was unable to pee, but managed to do so by pressing on my belly.

December 28th I made a GP appointment which was on January 8th.  December 28th, I had pain in my back area - where the kidneys are located, a fever, and was able to pee without problems that morning.  I have had no other symptoms since.

On January 10th I saw a doctor, and explained all the above.  She arranged for me to take tests including PSA, Kidney, Bladder, Diabetes, Bone, Blood Count and another two I cannot remember.  I also gave a urine test which, I felt, was pointless considering the infection happened 10 days earlier.  

She offered to do a DRE but I was not prepared, I felt like I needed to poo (as I often do when nervous), so agreed to take a DRE after the PSA test (January 15th).

My PSA result came in and it was "higher than we'd expect for your age".  I pressed the doctor for the score, considering my father had a 600 reading, and explained the family history.  He gave me a score of 3.2 which is higher than the 2.6 upper limit for my age.

He performed the DRE (took about 10 seconds), and told me that it was smooth.  Of course, as you will all know, a DRE can only cover a certain percentage of the prostate.  He did say my prostate was large for someone of my age.  He said that, if the DRE uncovered something, he would refer me to a specialist straight away.  Otherwise, it would be another PSA in three weeks (four weeks after the first).

Ever since, I am in a state of panic because my understanding is that - whilst PCa is a slow moving cancer in most cases, it can be more aggressive in younger men.  I have seen similar comments on this forum.  

My gut feeling is that I had an infection, and that has peaked my PSA score which is also affected by the enlarged prostate.  Although, I am concerned the doctors seem to be going down a path that does not consider prostatitis.  My perineum is sore when sat on my office chair, almost feels like there is a stone there.  The last 2-3 days, my penis has felt uncomfortable through the day (although no problems peeing) like it is irritated.  I left a hot water bottle on it 2-3 times yesterday and it feels normal again today - but is it a sign I am suffering with infection, or something else?

However, as you know, late at night one tends to Google and find stories that set the panic racing.  I am more concerned with this having been in my system for a long time, and the chances that it has spread beyond the prostate due to the higher risk chances that younger people have more aggressive forms.  Is that a logical thought process?

I spoke to a nurse today, and she has said that - based on the above, I should not worry too much.  I almost feel like I should call the GP and ask them why they are seemingly ruling out infections - is it caution (which is fine, but creates anxiety) - the doctor called it dotting the is and crossing the ts - or is it a genuine suspicion.

I know no two stories are the same, and I'll keep reading through these forums.  I wanted to place my story here because, regardless of potential outcomes, it may help someone one day.

User
Posted 24 Jan 2024 at 14:04

Hello mate,

Welcome to the forum.

From what you've said you've nothing to worry about. Wait for your next PSA test and take it from there. If your doctor has any concerns you'll probably be referred to as urologist.

Best of luck.

Adrian.

 

 

'

User
Posted 24 Jan 2024 at 22:06
The sore perineum has nothing to do with PCa and as you say, probably from the Docs fat fingers (fortunately my urologist is a lady with delicate hands LOL).

A UTI or prostatitus is likely your problem at this stage. I had slow pee for 15 years before my first PSA due to a slightly enlarged prostate and the bladder would never fully empty - always having a short dribbles after the main pee.

Get that sorted and I think you will feel a lot better :)

User
Posted 24 Jan 2024 at 23:19

Originally Posted by: Online Community Member
Although, I am concerned the doctors seem to be going down a path that does not consider prostatitis

I don't think the two doctors have ruled it out - simply that GPs cannot diagnose prostatitis. So the advice to test again in 4 weeks and then decide whether to refer seems very sensible; the next PSA reading will determine whether you are referred to urology on the cancer pathway (2 weeks) or the chronic care pathway (sometimes very long waiting lists).

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

User
Posted 25 Jan 2024 at 08:36

Originally Posted by: Online Community Member
 Does prostatitis also run in families?

It appears there are genetic implications but there have been no studies confirming this.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592774/#:~:text=Genetic%20factors%20have%20been%20implicated,other%20prostatic%20and%20urinary%20co

Adrian

 

Edited by member 25 Jan 2024 at 08:37  | Reason: Not specified

User
Posted 25 Jan 2024 at 10:34
Based on your father's other medical conditions, I suspect that any PCa went to the end of the list given that it is extremely slow growing and his other conditions far outweigh it.

I would probably answer Yes to the history question as on the evidence given, it is highly likely that he has PCa present - just not formally diagnosed or treated.

User
Posted 26 Jan 2024 at 10:46
OK - just as an update.

I called the GP today, spoke to a different one to the first two, to check all my other test results because they have been bugging me.

He said the only other one that came back as not normal was my inflammation marker. He explained that the inflammation markers can suggest many things, from infection to cancer.

This GP called my 3.2 score "borderline", the other GP called it "above expected" so I am not putting to much hope or despair on either comment.

My calcium tests were fine, and the GP explained an elevated score might suggest spread if there is a cancer, but a normal score is good but not conclusive.

I mentioned to him about the DRE results showing a smooth prostate - which he said was good.

I mentioned to him about prostatitis, and he said the water and kidney tests would have highlighted that. However, he did say chronic prostatitis is a possibility. He did say it was pointless for him to prescribe antibiotics because of all the above - and I've previously refused antibiotics anyway when prescribed by a doctor without proper tests.

Generally, whilst overall I am concerned and nervous - moreso about something that could be "aggressive" - I am glad I made the GP appointment, and I am glad I called them today. The above is a bit of a mixed bag, which is all that can be expected considering how early I am in the diagnosis process.

Apart from the perineum pain and the penis discomfort (which I explained to the doc today) - I've had no recurrences of the symptoms on Dec 26th and Dec 27th (1 month ago).

I've been advised to stay from rigorous exercise, intercourse, and something else for 72 hours before the next PSA test. I am just going to try to take it easy until Feb 12th when I get my PSA test. Hopefully the score has come down - I'm not sure how much these things can fluctuate in a 4 week period - but if not I guess it is onto the Urologist and something more definitive. If my score has come down, I will ask about a regular PSA test, considering all this.

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User
Posted 24 Jan 2024 at 14:04

Hello mate,

Welcome to the forum.

From what you've said you've nothing to worry about. Wait for your next PSA test and take it from there. If your doctor has any concerns you'll probably be referred to as urologist.

Best of luck.

Adrian.

 

 

'

User
Posted 24 Jan 2024 at 21:30
As a non-medical person I can only give you my thoughts as a PCs sufferer and suggest that you are probably 10 years away from PCa becoming an issue. A PSA of 4 will get you on active surveillance which is a 6 monthly PSA blood test and if it gets above 6 then you will likely be referred to urology for further investigation.

An enlarged prostate does not automatically mean prostate cancer and there are very few (if any) symptoms of PCa until it gets highly advanced - that is one the issues with it - most men don't know they have it until someone suggests that they get a PSA test.

User
Posted 24 Jan 2024 at 21:49

Originally Posted by: Online Community Member
As a non-medical person I can only give you my thoughts as a PCs sufferer and suggest that you are probably 10 years away from PCa becoming an issue. A PSA of 4 will get you on active surveillance which is a 6 monthly PSA blood test and if it gets above 6 then you will likely be referred to urology for further investigation.
An enlarged prostate does not automatically mean prostate cancer and there are very few (if any) symptoms of PCa until it gets highly advanced - that is one the issues with it - most men don't know they have it until someone suggests that they get a PSA test.

 

Thanks, and I appreciate that.  I am aware that large prostates are not necessarily cancer - my grandfather had an op when his was "large", and my father is being watched - although he doesn't get PSA tests and the docs don't want to bother him too much as he has a liver condition.  I think one concern I have is that, apart from a DRE that showed a large, smooth prostate, for my father (and a PSA score of 600), he hasn't had any subsequent PSA tests in over 10 years.  

So, in the various questionaires I have answered that there is no history of cancer with my dad and grand-dad - but in reality, the answer is unknown - but I would suspect that the consultants would have tested my father if they needed to.

I do, really, think a lot of this is the result of an infection.  I've not had any other symptons since Dec 27th.  My other recorded problems peeing are always in the morning when I have a full bladder and I can count those on one hand.

The only, real, issue I have is a sore perineum which could be the effect of Monday's DRE and, of course, the anxiety that an elevated PSA score has given me.

 

User
Posted 24 Jan 2024 at 22:06
The sore perineum has nothing to do with PCa and as you say, probably from the Docs fat fingers (fortunately my urologist is a lady with delicate hands LOL).

A UTI or prostatitus is likely your problem at this stage. I had slow pee for 15 years before my first PSA due to a slightly enlarged prostate and the bladder would never fully empty - always having a short dribbles after the main pee.

Get that sorted and I think you will feel a lot better :)

User
Posted 24 Jan 2024 at 22:14

Originally Posted by: Online Community Member
The sore perineum has nothing to do with PCa and as you say, probably from the Docs fat fingers (fortunately my urologist is a lady with delicate hands LOL).
A UTI or prostatitus is likely your problem at this stage. I had slow pee for 15 years before my first PSA due to a slightly enlarged prostate and the bladder would never fully empty - always having a short dribbles after the main pee.
Get that sorted and I think you will feel a lot better :)

 

The nurse on this site also said it sounded like prostatitis.  I think I am confused, or anxious, because the GPs seem to be aiming to rule out the sinister (which I am fine with), but don't seem to be considering prostatitis.  Maybe this is the question I will ask after my next PSA (regardless of if the PSA is high or low).  I do feel like the infection has come back and I'm concerned this will keep my PSA elevated (assuming it's why it is elevated) at the next test - which will mean a referral which brings more anxiety as I wait for scans etc.

It just seems a shame that I am second guessing the two GPs I have seen so far.  Would be nice to get the same one every time.  

Thanks again for sharing your experiences.  It helps a lot.

User
Posted 24 Jan 2024 at 23:19

Originally Posted by: Online Community Member
Although, I am concerned the doctors seem to be going down a path that does not consider prostatitis

I don't think the two doctors have ruled it out - simply that GPs cannot diagnose prostatitis. So the advice to test again in 4 weeks and then decide whether to refer seems very sensible; the next PSA reading will determine whether you are referred to urology on the cancer pathway (2 weeks) or the chronic care pathway (sometimes very long waiting lists).

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

User
Posted 25 Jan 2024 at 07:30

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
Although, I am concerned the doctors seem to be going down a path that does not consider prostatitis

I don't think the two doctors have ruled it out - simply that GPs cannot diagnose prostatitis. So the advice to test again in 4 weeks and then decide whether to refer seems very sensible; the next PSA reading will determine whether you are referred to urology on the cancer pathway (2 weeks) or the chronic care pathway (sometimes very long waiting lists).

 

Thanks again - I didn't realise GPs cannot diagnose prostatitis so this now makes more sense.  I am just hoping my PSA has dropped, although I do feel like I have a virus or infection.  In an ideal world, it will drop and I will then ask to get checked more regularly considering my dad's vague situation.

Does prostatitis also run in families?

User
Posted 25 Jan 2024 at 08:36

Originally Posted by: Online Community Member
 Does prostatitis also run in families?

It appears there are genetic implications but there have been no studies confirming this.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592774/#:~:text=Genetic%20factors%20have%20been%20implicated,other%20prostatic%20and%20urinary%20co

Adrian

 

Edited by member 25 Jan 2024 at 08:37  | Reason: Not specified

User
Posted 25 Jan 2024 at 09:41

 

Thanks Adrian, 

 

That was a useful read, although maybe inconclusive because of the lack of studies, but it is interesting to see more about possible effects of Prostatitis.

I've been sat in my office chair about one hour now, and the discomfort has returned.  It's not so bad that I cannot sit, but it feels like I am sat on a small stone or ball - this is as a nurse described it too.  

The tip and underside of my penis feels a bit hot (not to the touch, but in my mind) and I have read that because the brain doesn't recognise the prostate - sometimes prostate "pain" or issues can manifest as feelings like this too.  

I'm taking Ibuprofen to hopefully help what may be an inflammation from an infection that I cannot shake off.  

I'm just concerned a raised PSA may be a false-positive and I'll be facing more tests and anxiety to come.  But, it is what it is - it's all out of my hands.

User
Posted 25 Jan 2024 at 10:34
Based on your father's other medical conditions, I suspect that any PCa went to the end of the list given that it is extremely slow growing and his other conditions far outweigh it.

I would probably answer Yes to the history question as on the evidence given, it is highly likely that he has PCa present - just not formally diagnosed or treated.

User
Posted 26 Jan 2024 at 10:46
OK - just as an update.

I called the GP today, spoke to a different one to the first two, to check all my other test results because they have been bugging me.

He said the only other one that came back as not normal was my inflammation marker. He explained that the inflammation markers can suggest many things, from infection to cancer.

This GP called my 3.2 score "borderline", the other GP called it "above expected" so I am not putting to much hope or despair on either comment.

My calcium tests were fine, and the GP explained an elevated score might suggest spread if there is a cancer, but a normal score is good but not conclusive.

I mentioned to him about the DRE results showing a smooth prostate - which he said was good.

I mentioned to him about prostatitis, and he said the water and kidney tests would have highlighted that. However, he did say chronic prostatitis is a possibility. He did say it was pointless for him to prescribe antibiotics because of all the above - and I've previously refused antibiotics anyway when prescribed by a doctor without proper tests.

Generally, whilst overall I am concerned and nervous - moreso about something that could be "aggressive" - I am glad I made the GP appointment, and I am glad I called them today. The above is a bit of a mixed bag, which is all that can be expected considering how early I am in the diagnosis process.

Apart from the perineum pain and the penis discomfort (which I explained to the doc today) - I've had no recurrences of the symptoms on Dec 26th and Dec 27th (1 month ago).

I've been advised to stay from rigorous exercise, intercourse, and something else for 72 hours before the next PSA test. I am just going to try to take it easy until Feb 12th when I get my PSA test. Hopefully the score has come down - I'm not sure how much these things can fluctuate in a 4 week period - but if not I guess it is onto the Urologist and something more definitive. If my score has come down, I will ask about a regular PSA test, considering all this.

User
Posted 27 Jan 2024 at 21:06
Hi all,

I have been feeling mightily stressed by this the last few days. I have OCD which means I am constantly looking for answers - this has been a lifelong issue for me.

Since my DRE, my bum area has been sore - my office chair is not helping too, even with pillows - so I am buying a padded seat.

Also, since my DRE, I have had problems in getting an erection (2 tries, 2 failures). I know this could be caused by many things - including stress - but also other less pleasant things. I know it sounds daft, but did the DRE cause any damage perhaps - not sure if anyone else has experienced that. I spoke to my wife about this issue, and she said it is simply because I am too anxious and that makes sense.

My peeing has been fine, no issues there except today because I had held it in for too long on a family trip. I still feel, at times, that I have a minor UTI, so when I go for my PSA I will take a urine sample with me. I have read that UTIs can cause a spike, and although my last urine test showed no bugs - it was taken 10 days after I felt run down at Christmas.

The other thing is - my PSA is 3.2. In 18 months time, I turn 50, and a score of 3.2 won't cause alarm. I know they are following protocols, and just being safe - but it doesn't half play havoc with your mind.

Sorry to burden you with my thoughts, I just had to get it off my chest.

User
Posted 27 Jan 2024 at 21:23
I know that it's very hard especially with your OCD and the amount of information that can be gleaned from Google searches. Unless you are careful, every ache and pain (that everyone suffers from in one form or another) can suddenly come Cancer, or a Brain Tumour or any other serious illness. As an example, my wife has claimed she has caught Covid at least a dozen times in the last 3 years despite 7 vaccinations and plenty of negative tests - but every cold or ache suddenly matches what she has read.

I can only suggest to take a break from reading about symptoms and listen to your GP. Changing your office chair may well help your perineum pain or getting up more frequently for a walk around and try and not worry about your erections - a disturbed mental state will certainly stop them in their tracks, but maybe watch a little adult video to see if that helps. DRE will certainly not cause any issues - you would be amazed what some people push up their rectums and still get very strong erections!

I think I said earlier, you are probably 10 years away from prostate cancer becoming an issue and even then it is fully treatable/curable.

User
Posted 13 Feb 2024 at 15:08

OK - I see that there are a few instances of elevated PSAs where posters don't update and presumably for good reasons (i.e. their follow up PSAs are fine).

I am posting this one now so that it may help people in the future.  Of course, I still have questions that I need to ask my doctor.

However, my PSA on second reading.

First reading 3.2 - 15 January

Second reading 2.2 - 12 February

Placing here for the record.

Thanks for the support here.

Edited by member 13 Feb 2024 at 22:54  | Reason: Not specified

 
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