50years old PSA 4.7 Enlarged Prostate

[Gasit]

Hi. New to the forum and doing my research as I feel a diagnosis of PC might be coming?

I have had a raised psa for a couple of years. MRI and biopsy 2 years ago showed no PC but prostate abnormal- size. Toilet habits more frequent and urgent etc.

Recently experienced bladder pain so had another MRI followed by a colposcopy to inspect my bladder yesterday. Prostate confirmed as enlarged so I have now got to wait for a further biopsy. I was advised this will be under a general? Why would this be under general?

Also is BPE common at 50?

[ceejayblue]

At 53 (in 2004) my OH had an op on his enlarged prostate after all the symptoms that you have and so was told he would need regular PSA tests. In themselves they don't prove cancer can be present but in 2014 his PSA was raised and he had a biopsy under local anaesthetic that showed about 3% cancer present. Again, this doesn't mean that it aggressive or anything so his consultant at the local hospital (who was less than supportive) sent him to Guys for a template biopsy, this is done under a general anaesthetic because it is a lot more invasive than the first one he had. It can cause problems and he now has some erectile disfunction but it showed the cancer was slightly more than previously thought but not aggressive or invasive.

He is on active surveillance and has regular PSA tests and has been told if it goes up over 8 then he must contact Guys immediately but it is still only around 6.4 at the moment.

It is scary getting the diagnosis but it can be treated if it does become aggressive but for my OH the active surveillance is proving a good thing as he is feeling well and although he is due another MRI this year and possibly another template biopsy but currently this is on hold as they don't think it is needed.

I hope that your results are good but there is a lot of help and support on this forum and you must make sure that you ask your consultant lots of questions and don't let them fob you off (some do ) with things that you aren't happy with.

[Gasit in reply to ceejayblue]

Thanks for your reply. As I haven't been told PC is present I am wondering why the recommended general anaesthetic route. I shall ask very careful questions before going under for a further exploration.

Glad your OH is keeping well.

[Hidden in reply to Gasit]

Hi Gasit. I note you said you had a colposcopy, I imagine you mean "cystoscopy". Colposcopy is only possible for women!

I also imagine you had a cystoscopy because they wanted to examine your bladder, not just your prostate. I also imagine it was a flexible endoscope and they used a local anaesthetic.

However, a flexible cystoscopy has it limits and now they would like to extend their investigations of your bladder and prostate. To do that they need to use a rigid (metal) cystocope. They're big! They wouldn't be able to use that with a local aneasthetic, I imagine the pain would be impossible to bear. Hence the general aneasthetic, and nothing sinister to be read into it.

I had one in 2004, they were able to have a good look while I was under. When I woke up after they would only let mego home after I'd managed to pee. I managed,but it feklt luke peeing broken glass and there was blood for a couple of days. That gives you an indication of how painful it might be if you were awake.

I had it done because they wanted to confirm a diagnosis of chronic prostatitis. It did. Subsequently for years I had medication to relieve the prostatitis. Prostatitis is quite common, but not often recognised. Prostatitis can cause symptoms such as pain, frequency etc and can raise your PSA. I note yours is only 4.7, only just above normal.

Perhaps you should research chronic prostatitis and ask your urologist if you might be suffering from that.

It took nearly a year for me to get the correct diagnosis, they insisted I had an STI.

I believe you can have Benign Prostatic Hyperplasia at your age, if it's prostatitis, the gland may be enlarged because it's inflamed.

Prostatitis does not increase the chances of having cancer, I was told. I managed it by taking alpha-blockers and saw palmetto.

I was diagnosed with PC in 2011, it took a couple of months because first they had to eliminate the prostatitis as the cause of my raised PSA, it was 6.2.

It might just be wishful thinking, but it's possible you have chronic prostatitis.

[Gasit in reply to Hidden]

Hi Timz. You are correct. I did have a cystoscopy. iPhone must have changed it when typing lol.

Yes my bladder was examined and that was clear but did show evidence of prostate enlargement. That's why further tests are required.

I shall update further when I have seen the consultant.

Thx for taking the time to write your experience as knowledge is key at this stage.

[ceejayblue in reply to Gasit]

He had a visit to GP today and his PSA has gone up to 8.1 from 6.4, not good but as always we are optimistic and he is going to call the clinic on Tuesday to make an appointment for chat with the consultant. I've been out all day and as he'd not got a call about his results (done 2 weeks ago) he rang and got a quick appointment this afternoon. Its knocked us a bit because its so unexpected but he was due for another template biopsy this year that he wasn't looking forward to and was trying to put it off and have an MRI instead.

Still, he's in good hands and so we're not panicking.

[Gasit]

Now confirmed as PC after template biopsy. 3+3 so good news in one way as it's early diagnosis . I am now On active surveillance with options of a way forward to discuss etc.

I am glad I now know for sure it's PC but now unsure of the best treatment options available. Any advice welcome.

[kevinf]

Hi, I'm exactly the same. Perhaps we can swap notes as time goes on? I have my first psa check due in March 2018 followed by telephone appointment with nurse to discuss results. What's your next move?

[Gasit in reply to kevinf]

Sorry to hear your also diagnosed with PC. Is your Gleason 3+3? PSA? What symptoms did you have prior to template biopsy being offered?

I have an appointment in December to chat with consultant again. I have been with a catheter since august as I had blood clotting in my bladder a couple of days after the template biopsy. It's being taken out in October thank goodness.

So it's PSA check 2 weeks before December appointment. A bladder /urine flow test after October catheter removal in November.

So hopefully in December I will be able to discuss options.

Doing research is tricky as everyone has different experiences. That's why I started on this forum. It's uk based and very good but varied advice.

I expect I will just have to be guided by the consultant and their recommendations.

Surgery is a possiblity but that's got its negatives. I.e. ED, and possible complications.

It's a bit of a minefield knowing what's best.

Happy to swap notes buddy. The more we talk the more people we can help as I am sure we are not the only 2 looking at our discussion. 👍🏻

[kevinf]

Hi, thanks for the reply.

My symptoms were the usual problems with urinating but nothing much else. So I had a PSA blood test, DRE, MRI and trans rectal biopsy in rapid succession.

My Gleason was 3+ 3 but I'm having an issue with the PSA. I was told by both my GP and consultant I was 4.4 but my correspondence from the hospital says 6.6. I did have a second test so maybe I have a revised level but haven't been told. I suppose I should find out. I may phone next week to clarify.

I am really sorry to hear about your problem after the biopsy, it sounds awful! My own biopsy was the usual exercise in discomfort but the surgeons and nurses were first class and minimized the misery as much as they could and I only suffered minor side effects.

My next move is to get a further PSA reading next March followed by a telephone chat with my nurse to discuss the results. What comes next is in the lap of the gods, like you I fear surgery to some extent but, on the other hand, without it we can never again hope to be declared cancer free.

Do let us know how you get on in December.

You have my best wishes for a good result!