What should happen?

I would say that PSA's - being as unreliable when you haven't had your prostate removed as we all know THEY ARE - are largely at this juncture a waste of time and money.  Better to get a private MRI with radiologist report near to you - and depending on the findings - go back to you urologist.  I had to fight to get one.  I went to my GP surgery over a year and a half ago with a private mri company's referral form - just to get them to sign it - and was told my a lady doctor 'not to waste my money'.  She still refused to sign.  It was what my mother used to call I remember 'character building'.  I'm so glad in the end I DID get it.   It turned out to be one of the best investments of my life.  I was diagnosed with PCa on 4th December 2023 (Gleason 7 (4+3) T2c N0M0.  Prostatectomy 27th March 2024.  Excellent pathology.  No additional findings in terms of the cancer - so pleased the T2 was maintained - and best of all is the fact that ALL margins were 'completely clear'.  Had catheter out today (three days short of a month it was) and happy to report minimum incontinence - i.e., EXTREMELY LITLE - but a few dripples - and that is just on the first day post release.  

I agree with Adrian - your GP has done the right things and at this stage you do not have prostate cancer - but at 62 you should have a PSA test every year just to keep an eye on it.

There are very few symptoms with PCa - slow flow and difficulty urinating can be an indication but they could also be just an enlarged prostate - so it's a case of keeping up with the PSA tests.

Hi everyone.  My first post and all that.  I'm 62, and after all the recent hype about prostate cancer, I thought it best to contact my GP about getting a PSA test.  He did that and a finger test.  The finger test shows that my prostate is enlarged.  The PSA test was normal.

Reading about the PSA, I believe that it misses 1 in 7 cancers, so that test is by no means conclusive.  My GP's comment then that nothing further was required seemed strange to me.  Is he right or should regular monitoring now be taking place?  

The GP did say that if I had symptoms I should contact him, but the symptoms are so vague it is difficult to know if they are due to the prostate or not.  I mean, yes, I go to the loo more at 62 than I ever did at 25, unless I was on a serious session of course!  I have been in a few motorcycle accidents in my youth, and had asked the doc about my right hip last year.  Recently, I have noticed an occasional sharp pain in my back, (right side a little below waist level) than happens when I am preparing food on our work top.  I put this down to making it to something approaching old age.  Lastly, I pretty much constantly have a feeling around the coccyx, like I have been sitting on a hard seat for too long.  All these seem too little to be worried about.....unless someone out there tells me different?

Edited by member 22 Apr 2024 at 16:54  | Reason: Not specified

Evening John,

Your journey is indeed frightening. I notice on your profile history that you don't mention this GP's visit. Do you now think it is relevant to your subsequent cancer diagnosis? Do now you feel he/she should have done more?

I was also about 54 years old when I was refered by my GP to a urologist. due to urination problems. My PSA was 3. I had a DRE, which showed an enlarged prostate. I was prescribed Tamsulosin.

I had annual PSA checks. No further DREs and no MRIs. It was not until 9 years later that there was a slight PSA rise resulting in a further urology appointment, leading to MRI, biopsy and diagnosis of Gleason 6, low volume prostate cancer.

Even then, I was told "Don't worry. Some don't even call it cancer'  Ironically,  it was whilst allegedly being closely monitored on AS,  that my disease supposedly progressed alarmingly to Gleason 9 and had breached the capsule. 

It now seems more likely the intial biopsy had missed the more dangerous cancer cells, as it is rare for the Gleason score to get higher.  I often think I wonder when I contracted the disease. Was it 2020, when I was first diagnosed or could it have been as much as 10 years earlier.

So going back to your GPs visit and the original posters GPs visit. What do think they should have done? Do you think that everyone with a below normal PSA level but enlarged prostate should automatically have regular follow PSA checks or MRIs to double check that's all in order?

I'm a great believer in all men having prostate cancer screening, but unfortunately even then, some will avoid detection.

Edited by member 22 Apr 2024 at 23:19  | Reason: Additional text

Hi Speccy

I'm fine at the moment, 2 year in to taking apalutamide. Tired, having hot flushes, but alive and working. Dreading each PSA test, every two or three months. Blood taken today, next oncologist call next Monday!😬🫣

I wish I'd contacted this forum 6 years ago, like you have, things might have been a lot different.  Reading your initial post, you're getting pains on your right side just like I did, plus your back.  Perhaps with these extra symptoms you might be able to convince the GP to order a MRI. If nothing else to rule PC out for now. However, definitely demand annual PSA tests.

My prostate cancer was only found after a private medical for the renewal of my 7.5 ton driving licence at 70.The urine test picked up microscopic blood in my urine and the PSA was low at 2.19 but my doctor suggested i had further tests that confirmed cancer.I had no symptoms at the time and i wonder if it had not been a private medical would he have sent me for further tests.

My Gleason score was 3+4=7 t2 no mo and 5 cores out of 20 positive ,I had the choice of Robotic removal or Brachytherapy and i went for Brachytherapy. 7+ years on all good.

I believe that if i had waited for symptoms say know at 77 it could have been all 4s with very few options.

It's you body keep on top of it with yearly tests .

John.