PSA of 6 and abnormal DRE…worried

User

Posted 09 Jan 2025 at 08:36

Hi all,

Just looking for some advice as really worried!

Have had some problems with urination for 7/8 years now. Can be up 2/3 times per night but not every night. Can urgently need (mainly in the morning when I get to work) but again not every day. No problems with flow rate. No pain or burning. Went to doctor a couple of times over the years and got two different tablets for relaxing the muscle but didn’t make any difference. As it wasn’t really impacting my life I just left it at that.

I went to the doctor 6 weeks ago and was told I had a UTI. It was a new doctor so I mentioned the above symptoms and that they were ongoing. He told me to come back in 6 weeks to check my prostate.

I had the DRE on Monday and, whilst certainly not long, it took a bit longer than what he had initially said it would. When finished he said that my prostate was enlarged and that a bit felt abnormal. I think he said something about being able to feel each side or quadrant but I’ll be honest that my mind was racing at this point and I didn’t fully take it in. He also did use the terms “I think it will be ok” and “unlikely” when I asked if it meant cancer. But appreciate he can’t say for definite either way.

I was asked to go downstairs and do a blood test and provide a urine sample.

The doctor phoned me on Tuesday night and told me my PSA was 6. As I’m 42 he has referred me to urologist for an MRI.

Im trying not to worry but keep thinking the worst. I would be worried about the high PSA anyway but with the addition of the abnormal DRE I’m really stressed. I’ve read through a few of the posts on the site and can’t find any that mention high PSA and abnormal DRE.

No family history of cancer and I’m generally healthy. I did do a HIIT workout on the morning of the PSA as didn’t realise you weren’t supposed to exercise.

If anybody has any experience or advice on similar situation it would be really helpful. I’m really worried!

many thanks

Bryan

User

Posted 09 Jan 2025 at 10:33

Hi again

DREs are not very accurate, an enlarged prostate can cause elevated PSA, any other abnormalities lumps, bumps and hard bits, doesn't mean you've got prostate cancer. It just means that it's worthy of further investigation. The MRI will be more accurate.

I know it's not easy, mate, but try not to worry. Just take one step at a time and don't think ahead of yourself.

Please keep us updated. We'll do our best to support you. 👍

User

Posted 28 Mar 2025 at 17:24

Hi again Bryan.

Do you know the pi-rads scores of your MRI. My guess, is it'll be 3 which means they are uncertain whether it's cancer or not. The 'shadow' may not be anything to worry about, it could be infection or a benign lesion. Whatever the result, your biopsy will be more informative. It will tell you IF it's cancer and IF it is, how aggressive it is. I know how worrying it is. Most of us have dealt with diagnosis anxiety but unfortunately you just have to play the waiting game, mate.

Best of luck.

Edited by member 28 Mar 2025 at 17:50 | Reason: Typo

User

Posted 28 Mar 2025 at 19:42

Sorry to hear of the waiting and lack of info. When reading up my post MRI and pre biopsy my PIRADS was 'between 4 and 5' which meant a 70% or 90% chance respectively it was cancer. Later evaluation scored a 4. A biopsy gave Gleason 6 (3+3) and at time PSA 6.6 (I'm 58).

If you are given a MRI indication under that % it could well be PIRADS 3 and the OK chances are well on your side.

Also given they're not rushing the biopsy date would indicate a 'just to be sure' scenario.

The waiting game was the worst for me though, but try not to worry - plus your yoyo PSAs (now heading lower) would indicate more of an infection than PCa? I'd take that in the situation. And good luck with the further tests.

User

Posted 28 Mar 2025 at 19:58

Hi,

Thanks so much for getting back to me. I phoned and spoke with one of the specialist nurses on here and she was amazing!! What a brilliant job they do. She took the time to speak to me and explain.

She has suggested that given my age (42), previous urinary problems and PSA heading lower that it could well be infection. She said it would be very rare for someone my age to get cancer and more often it’s prostatitis which would fit with what I have.

She said that we won’t know for definite until the biopsy which I totally get. She said the tiny shadow, if it was cancer, would suggest it has been caught early. Again there’s no definite on that which I get.

I still can’t help but worry but I’ll just need to get on with it.

I hope you’re well and thanks again for the post. Have a great weekend!

Bryan

User

Posted 29 Mar 2025 at 20:32

Hi again Bryan.

There are several other complaints that mimic prostate cancer on MRI scans.

https://pmc.ncbi.nlm.nih.gov/articles/PMC5496681/

On top of these, even detected cancerous lesions can be benign.

In my experience nothing, including PSA levels, MRI scans, even biopsies are guaranteed to give a 100% accurate diagnosis. You can 'do your head in' trying to interpret results. 🙂

During my cancer journey I've had numerous, fairly low, fluctuating PSA results. T1c, T2a, T2c and T3a staging. I've had Gleason 6(3+3), 7 (3+4), 7 (4+3), 8 (3+5), and 9 (4+5). I think they tried to cover all bases. 😁

Edited by member 29 Mar 2025 at 21:25 | Reason: Additional text

User

Posted 29 Mar 2025 at 21:24

Hi Adrian,

Thanks once again for getting back to me.

I’m going to have to just try and switch off and let what will be be.

Feeling a bit more confident from what I’ve read and the support and advice on here.

You guys do some great work, it’s so good having this support network here.

Have a great weekend!

Bryan

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User

Posted 09 Jan 2025 at 09:22

Hi Bryan.

Welcome to the forum.

Try not to worry, mate. Your elevated PSA can be caused by other non cancerous prostate conditions. The MRI will shed more light on the situation.

User

Posted 09 Jan 2025 at 10:02

Hi Adrian,

Thanks very much for your quick reply.

I think what is making me even more worried is the abnormal DRE in addition to the elevated PSA. I’m thinking that with both it’s increasing the chances of it being cancer. Or could that still be non cancerous?

Thanks for your help, I really appreciate it.

Bryan

User

Posted 09 Jan 2025 at 10:33

Hi again

I know it's not easy, mate, but try not to worry. Just take one step at a time and don't think ahead of yourself.

Please keep us updated. We'll do our best to support you. 👍

User

Posted 09 Jan 2025 at 10:45

Thanks Adrian, I really appreciate your help and support.

Bryan

User

Posted 12 Jan 2025 at 11:55

Hi Bry09

Were the PSA bloods taken after your DRE? If so that will raise it. If your prostate is enlarged in a benign way that could also raise it. Perhaps not long enough had passed since you'd had a UTI either. Plus you had done a work out on the morning of it. Plus your PSA base line might be higher for your age to start with. But. The GP is going the right thing to refer to you a Urologist for an MRI and so you are in good hands.

User

Posted 12 Jan 2025 at 13:14

Hi,

Thanks very much for the reply. I really appreciate it. Still worrying unfortunately! Hope you are well.

yes, the bloods were taken no more than 20mins after the DRE. The DRE lasted longer than he had suggested it would and he certainly was having a good old feel around (or so it felt).

As I’ve had these same symptoms for 7/8 years I am worried that I have maybe left it too late and it may have spread. I don’t feel any different than when I initially got the symptoms all those years ago other than the occasional ache and pain that comes with getting older.

I tried to call the doctor on Friday just to find out exactly what the abnormality was that he had felt but he was off. Just so I’m clear in my head about it.

Ironically the reason I spoke to him in the first place (being up sometimes 2/3 times per night to pee) seems to have changed. I have not been up during the night for a pee since the DRE last Monday.

Thanks again

Bryan

User

Posted 28 Mar 2025 at 16:45

Hi,

So my PSA went from 6.2 to 4.1 the week after my original test. I waited for my consultant appointment and had a further PSA test done that day after another DRE. Consultant said the DRE was normal.

A couple of days after the consultant appointment he phoned with the PSA result which had only gone down to 3.9.

Got referred for an MRI which was done on 16 March.

I phoned yesterday for the results of the MRI. The consultant phoned me back today to say that there was a “tiny shadow” on my prostate and so now being referred for a biopsy.

I was feeling a bit more positive given the drop in PSA from 6.2 to 4.1 in a week and then the normal DRE. But now with PSA only dropping to 3.9 and this shadow I’m back to worrying quite a bit.

Has anyone experienced anything similar?

Many thanks in advance

Bryan

User

Posted 28 Mar 2025 at 17:24

Hi again Bryan.

Best of luck.

Edited by member 28 Mar 2025 at 17:50 | Reason: Typo

User

Posted 28 Mar 2025 at 18:19

Hi Adrian,

Thanks for getting back to me so quickly. He didn’t give me a score. He’s quite cold and doesn’t really entertain questions (turned and said to me at previous consultation when I was in the middle of asking a question “thanks for coming”).

When I asked him what the chances were that it was cancer he said 50/50.

Im not getting biopsy until May which seems quite a wait. Guess I’ll just have to wait it out.

Hope you’re doing ok and thanks again

Bryan

User

Posted 28 Mar 2025 at 19:42

If you are given a MRI indication under that % it could well be PIRADS 3 and the OK chances are well on your side.

Also given they're not rushing the biopsy date would indicate a 'just to be sure' scenario.

User

Posted 28 Mar 2025 at 19:58

Hi,

Thanks so much for getting back to me. I phoned and spoke with one of the specialist nurses on here and she was amazing!! What a brilliant job they do. She took the time to speak to me and explain.

I still can’t help but worry but I’ll just need to get on with it.

I hope you’re well and thanks again for the post. Have a great weekend!

Bryan

User

Posted 29 Mar 2025 at 18:37

Hi all,

I’ve been doing a bit of reading on MRI results to try and get a bit of knowledge and also trying to get myself into a more positive frame of mind.

Although the consultant didn’t give me a PIRAD score I’m assuming from his “50/50 chance” comment that I will be a 3, given that a 3 means they can’t say one way or the other. Would that be accurate?

So a lot of the stuff I have read suggests a 3 is not quite 50/50 but I can see why a doctor wouldn’t commit beyond the definition. Some of the studies I have read say 25-40% chance and some less.

I guess I’m trying to take some comfort from that but also want to be realistic. I’ve also read a PIRAD of 3 is quite commonly found to be prostatitis at biopsy. Again, want to take some comfort from that but want to be realistic.

I know ultimately I’m not going to know until the biopsy. But I’m just trying to be more positive but realistic at the same time if that makes sense. I have a 3 year old at home so apologies for another post here but I’m trying to stay positive for her but crumbling a bit inside.

I appreciate others are/have been in a worse position than me and don’t want to come across as a pain but the support on here really has made a massive difference to me from my original post until now.

I was put on Tamsulosin back in January by my GP due to the peeing a lot. I’m definitely not peeing as much anymore and am not up during the night anymore where previously I was up every night, sometimes 2/3 times.

Im trying to frame my mind to this being infection but again want to remain realistic.

Hope this all makes sense.

Bryan

User

Posted 29 Mar 2025 at 20:32

Hi again Bryan.

There are several other complaints that mimic prostate cancer on MRI scans.

https://pmc.ncbi.nlm.nih.gov/articles/PMC5496681/

On top of these, even detected cancerous lesions can be benign.

In my experience nothing, including PSA levels, MRI scans, even biopsies are guaranteed to give a 100% accurate diagnosis. You can 'do your head in' trying to interpret results. 🙂

Edited by member 29 Mar 2025 at 21:25 | Reason: Additional text

User

Posted 29 Mar 2025 at 21:24

Hi Adrian,

Thanks once again for getting back to me.

I’m going to have to just try and switch off and let what will be be.

Feeling a bit more confident from what I’ve read and the support and advice on here.

You guys do some great work, it’s so good having this support network here.

Have a great weekend!

Bryan

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