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Cancer: Prostate Message Board


Cancer: Prostate Board Index


Hi Guys,

A bit of boring but necessary history. I live in the UK and am now 58 years of age, pretty fit, not overweight etc. Presented myself to the GP 12 years ago at 46 with increased urination during the day....DRE and PSA test, DRE negative PSA "normal" (Only found out recently that the reading was 1.2....I was so pleased at the time that I was "normal" I wasn't asking questions)....symptoms never really went away but learnt to live with them (after all I was "normal" right?)....fast forward 10 years now 56 and go back to doc with regular nighttime visits....DRE again neg but doc wants to refer me to the hospital as PSA 3.3 (cut off in UK for my age is 3) Stupidly I now realise I played the "bike riding, sex 24 hours ago" card and asked for a retest....this came back at 3.1...Doc could see my reticence about going to the uro so went along with my suggestion of PSA test every 6 months....cause in my warped mind how bad could .1 over the "safe" limit be? (See my schoolboy error there?).....So I go every 6 months for 3 more tests and every one is 3.1....So I get complacent and forget 1 visit so it's now 14 months and I visit the Doc and my 3.1 has miraculously elevated to 7.5 (Crap!).

Now decide it's time to call in the experts....Doc does blood tests to rule out urinary infection (it isn't). Do lots of research Whilst waiting for hospital to get in touch and read of the free PSA test....NHS don't do this so find a private clinic for a new PSA test with "Free PSA".....This test came back at 4.3 PSA and a free PSA of 23%.(this is 2 weeks later)....Also had a consultation with private consultant from the clinic who are specialists in prostate health and problems. 40 minute consultation and DRE and he tells me "No Cancer"....."Great" I thought and skipped off.....I was happy to call it a day and cancel the upcoming hospital appointments My wife, although pleased had other ideas and insisted I stick with the program.

So since then I have been called to hospital, had a cystoscopy (Test clear)...a CT Urogram (also clear) and a 3T MRI (something on the scan...radiologist scores it a PIRADS 4...) The Uro tells me that whatever it is it is small and contained within the prostate....So 2 weeks later a 12 core TRUS biopsy.....1 week later result negative. In light of the PIRADS score they now want to do a 36 needle template biopsy....I have now had this today and will now be waiting over 2 weeks (bummer) for the result....basically I have a few questions for you knowledgeable guys out there who may have already been there or just know "stuff"... the last 6 -8 weeks I have had a sore right hip that has been getting progressively worse...

I'm a keen walker and around 3 weeks ago went with my wife on a gentle 3 mile stroll and the hip was burning by the time I'd finished...freaked a bit went to GP and he pushed and prodded.....shrugged off my bone spread theory and said more likely bursitis, gave me some strong anti inflammatories which I took for 2 weeks and they've done nothing.....and now to cap it all a bit of grumbling back pain has attacked me over the last couple of weeks and now is very uncomfortable when sitting and laying down and can and does wake me up ....Am I now imagining stuff? The pain feels pretty real and will wake me up....so Hip and back pain....

My PSA was taken again last week at a pre op assessment and is now 8.3....I was hoping in light of my lowered second (private clinic) reading of 4.3, it might have been lower not higher than the original 7.5 although the blood was taken only 4 and a half weeks after the TRUS biopsy so this may have a bearing...I should also add that my prostate has been measured on Ultrasound at 56cc or 70cc including seminal vesicles......So this image is small and contained within the gland according to the MRI, and I know that a PSA under 10 isn't terrible, but I also know that a middling PSA does not mean low Gleason and the velocity scares me re bone spread.....Anybody have any insights while I'm waiting these interminable 18 days for the results?..Really sorry for the long winded Bio but just trying to give as much info as possible....Would really appreciate any insights
Thanks
Tony
Hi Tony,

Waiting is hard, and no doubt your days are going by slowly while you wait for results. In the meantime, here are a few things to consider.

Your current PSA of 8.3 is elevated, but not as high as you might think in view of the fact that you have a 56 cc prostate, which indicates benign growth. A rule of thumb for PSA produced by non-cancerous prostate cells is to divide the volume (56 cc) by 10, which yields 5.6 for PSA likely produced by health cells. Another competing rule of thumb is to multiply the volume by 0.067, which would result in 3.8. If your prostate behaves more like the first rule, the "unexplained" PSA would be just 2.7.

Also, infection, which can be quite subtle and hard to identify precisely, can boost PSA quickly, sometimes to high levels, but also up just a little. Often the pattern of PSA is up and down as an infection waxes and wanes.

Neither benign growth nor infection rule out cancer, but, with that earlier negative biopsy, you have odds in your favor. If you do have cancer, it is more likely to have been caught early and/or be a mild case.

About that hip pain, I'll add to what Jack said. I do racewalking for fitness, and for years a muscle in my hip would be sore after an intense workout. Three years ago I was doing some emergency lifting and the next day had difficulty walking because that "muscle" was so sore. It turned out I had strained a ligament; I had probably been nearly straining it for years. I actually needed about seven sessions of physical therapy to get rid of the problem. I suppose it is possible that it could be due to metastatic cancer, but with all you have said and with my own experience plus what I have learned, that possibility seems remote.

Good luck with the wait for the results.





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