What symptoms do people have of PCa

I (56 year old) recently had a high PSA of 6.5 (also after a DRE from my PCP) and saw an urologist. I have had a past history (maybe 20 years) of prostatitis problems. My last PSA about 1.5 years ago was 3.5. The uro suggested getting a confirmatory PSA, however after my appointment apparently the DRE aggravated my prostatitis (My DRE was OK). This Uro does not believe in treating with antibiotics and when I called to talk with him about this problem he didn't bother to call me back. Of course if the PSA value remains high the Uro would want to do a biopsy. I'm still waiting for the putative prostatitis to ease up befor getting another PSA. I have also made an appointment with a new urologist who I hope will do a better job of working with me.

My question: I am wondering if my symptoms are from cancer as opposed to prostatitis?. I am having some uriniation urgency/frequency/slight burning, and a newer symtom for me some perineal/anal discomfort. What do people with documented cancer have in terms of symptoms -if any??

Thanks

I too didn't have any symptoms. I just happened to go to a free men's health screening one Saturday morning. DRE found some nodules and the rest is history. The best doctors in the world can hard to get a hold of...I try to get in good with their assistants who are much easier to talk too and will generally call you back after talking to the docs..

Mine started with the frequent and urgent urination problems and needing to get up several times at night. When I went in for my annual physical I told my doctor about the symptoms thinking it was an infection. The testing didn't indicate an enlarged prostate and the culture of urine didn't show any signs of infection either. So I guess in my case the symptoms I had was related to the cancer...but very unusual from what I read.

I had absolutely no symptons ahead of time. Just a stedily rising PSA from age 50. Didn't make me feel one way or the other ahead of time.

David in SC

Just a quick thanks for all your responses. I think this is an excellent group.

Hi Rocket,

I had no symptoms either other than the urgency and frequency of urination.  I suspected swollen prostate and went to a uro I had seen a couple of years earlier.  Dre showed no nodules, but Psa was 13.5, follow up Psa 14.5.  Went with a biopsy, which he performed with local anesthetic and lo and behold, 4 of 12 cancerous.  Biopsy was not uncomfortable and took only about 15 minutes total.  He sat my wife and I down and explained our options but pretty much told me that surgery would be what he recommended.  He doesn't do DaVinci because he said he was too old to be trained and do enough procedures to be proficient.  I went to one of six Drs. in Kansas that does the procedure and we consulted for nearly an hour.  Decided on DaVinci, if possible(due to some scar tissue from gut surgery 12 years ago) in January.  I think it was a good move to dump the first Dr. and go with another.  Good luck and let us know what you find out.

Bob

Similar to you, I had problems with prostatitis for over 20 years prior to PC diagnosis at age 59. My docs did believe in antibiotics for control of prostatitis, which alleviated some symptoms (mostly difficulty in urinating), but never really eliminated the problems. However, the prostatitis did get me to a good urologist regularly, who noticed a slight elevation in PSA about a year before diagnosis of PC; we watched the PSA and it continued slightly upward, so he recommended a biopsy "as a precaution", which found the very early stage PC. In my case what worked was to watch the PSA for a consistent climb, and if you have it get the biopsy. It's not much fun, but it beats the alternatives by a long way!
Never noticed any physical symptoms from the PC other than a feeling that the antibiotics weren't working quite as well as they used to. Incidentally the biopsy also showed the prostatitis was caused by a persistent e.coli bug, and since removal of the prostate in RP surgery, living without the prostatitis (or for that matter, the prostate) has been a blessing.

Thats exactly how I felt too, Dave7. Made me wonder if I should have just taken my chances and did nothing, ,its a tough choice when you feel well.

David in SC

Initially the doctor thought I had an infection due to elevated PSA. the doctor gave me antibiotics for 30 days and the PSA went down. 3.5 months later and I got another PSA test and it was back close to 4. I had the biopsy and was told I had cancer. As for symptoms, looking back I peed a lot more in the mornings than I do now but there was no pain or other indications (may have had premature ejaculation too).

As the others have said, don't wait too long. I ended up with a Gleason 8 and am a very lucky person. Let us know what happenss. this is a great site for information.

I had an enlarged prostate for 15 years prior. I had two biopsies during the last four years. The first came back negative, the second came back cancer.

A biopsy is the way to go, in my opinion. You certainly don't want to put it off and find out you've had cancer developing for a number of years. That makes the treatment and recovery that much more difficult. This is your life we're talking about.

I'd also get another doctor, based on the apparent lack of communication.

Thanks for the information. It seems like most people don't have prostatitis-like symptoms from their cancers. This is no proof that I don't have to deal with prostate cancer or tests such as a biopsy. Also some of you note that PCa may co-exist with prostatitis. My appointment with the new uro is in 1 1/2 weeks. I will be asking for an antibiotics trial and a PSA restest and see what he thinks. I am also having some anxiety issues dealing with this.

Thanks
Rich

I thought I should update things.----- As noted, I have a PSA of 6.5 taken about 2 1/2 months ago and I'm 56 years old. My DRE was negative. I also have had a history of prostatitis. 18 months ago my reading was 3.5. For my new test, I waited for my prostatitis-like symptoms to lessen and did not have a DRE (like before my 6.5 reading) and no sex for several days. My new reading is 3.6. I tend to think that my 6.5 reading was a fluctuation. My thinking now is that prostatitis is much more likely than PCa. For now I won't be getting a biopsy, I still intend to keep my appointment with the second urologist since I have some rear-end pain which can be fairly bad and may be related to prostatitis. Also I want to keep monitoring my PSA to establish a trend. My anxiety level has now decreased , but first-hand I know PSA can do a nasty job on you when it rises.

Thanks for all your comments
I will still stay in touch with this great board

Post Edited (rocket1952) : 12/16/2008 10:49:11 AM (GMT-7)

Hi Rocket:

Glad to get your update and that you are still going to see a new urologist...that sounds smart.  And, not to be a downer, but PSA fluctuations may also indicate PCa presence.  I went thru a couple of urologists and PSA tests before finally admitting that having a biopsy was the right thing.  So, if your new uro recommends a biopsy, it's probably a good idea.  At least then you are armed with the knowledge, one way or another, to deal with your prostate issues.

But, I surely hope you get good news one way or another and PCa is not the issue with which you have to deal..

Keep us up to date and we'll hope for the best for you!