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Posted 4/6/2015 3:20 PM (GMT 0)
I might be a little presumptive but can use some advice. I am a little concerned about my urology care last femonths. I am a prior bodybuilder and used testosterone therapy for five yrs. I always checked my PSA and below is my time graph.
2008-1.6
2009-2.0
2012- 2.5
june 2014-2.4
oct/2014-3.0
i was told by uro that i have enlarged prostate (dad had radical at age 72-lived to 93 NO CA) AND FOLLOWING ME.
Last 2 mos i have frequent urination 2x night and every 2-3 hrs day. My stream is very weak and bi streams often. I feel tired but no weight loss. Am i freaking out for no reason and have appt for new psa/exam april 21. Just concerned TIA
Posted 4/6/2015 4:10 PM (GMT 0)
Welcome to HW.

May I ask how old are you?

Remember that PSA is not a test for cancer. It just measures prostate activity and may indicate that something could be wrong and may warrant further testing. PSA can be elevated for a number of reasons, infection, BPH - enlarged prostate, recent sex, bike riding, bad day at the lab and cancer. PC is very low on the list.

If your URO has already found an enlarged prostate that could and likely is the source of your problems and PSA. In fact everything you mention is typical of an enlarged prostate.

Good to here you've got a follow up scheduled. Has the doc prescribed anything yet for your symptoms?

and even if the worst is eventually found, it would be early stage and a little treatment and you'll be just like your father living to well into your 90s. Treatment for PC or BPH isn't fun and normal changes, but it's just a bump in the road you'll have to deal with.

Ask any other questions you have, we're here most days.

Hang in there and let us know the results of the next test,
Andrew
Posted 4/6/2015 4:14 PM (GMT 0)
How old are you, Dr. Bill? Your PSA is within the "normal" range for a man of 60-ish and it's not particularly high for anybody. Which is not to say you shouldn't get yourself checked out.

The frequent urination and the weak stream sound a lot like the symptoms of an enlarged prostate (which your uro mentioned) and that could easily explain your PSA creeping up, too.

Has your urologist talked to you about any meds for your enlarged prostate? There are generally two kinds. One kind (Flomax, etc.) relaxes the smooth muscles in the narrow part where your prostate presses in on the urethra (the pressure makes it hard to pee) and the other kind (Avodart and competitors) actually shrinks your prostate, again relieving the pressure, this time more permanently.

You should get that sorted out first and if your PSA still keeps going up then you can talk to your doctor about other concerns you might have. Chances are, treating your BPH (Benign Prostate Hypertrophy) will be all you need.
Posted 4/6/2015 4:50 PM (GMT 0)
Thank you Peter and Andrew for your quick and informative replies. I know my concerns are low on the severity list compared to many of the forum members but i appreciate your attention to my concerns. I am 55 and my Uro rx'ed me Many of the BPH meds in the past incl flomax and uroxatral but because they are smooth muscle agonists my increase heart rate was an issue. I had little better success with rapaflow but didnt like the retrograde ejaculation. i guess i have to stay on it:( do my symptoms seem definitive for BPH and do these symptoms not usually present with early CA? wouldnt a CA also cause constricture of passage thru the urethra therefore leading to urinary retention, freq urination similar to BPH?
Posted 4/6/2015 5:35 PM (GMT 0)
First, I am not a doctor, just a random guy on the internet.

Second, early stage PC rarely produces symptoms. You'd have to have a tumor large enough to press on the urethra. That is somewhat rare and I'd think produce far more PSA than you have. BPH is much, much more likely (definitive is a difficult word to use with medical issues). In your place I'd keep going down the BPH treatment path until you rule that out completely.

So far it sounds like your URO is following a good plan. Keep monitoring the PSA.

Andrew
Posted 4/6/2015 6:57 PM (GMT 0)
DrBill, if you are concerned, request a 3T MRI test. It will visualize your prostate pretty well.

I hope the guys above me are correct. It is good that you are paying attention because of family history.
Posted 4/6/2015 10:13 PM (GMT 0)
Hey man.

I had the same symptoms as you're having. (Started last October)

Scared me to death. I figured my tiredness was due to my being "eat up with the big C".

Turns out it was due to the fact that it's hard not to be tired getting up all night instead of sleeping...that...and the stress of worrying about it.

Bph and a slightly elevated psa is enough to work on a man's head.

Turns out the BPH is what's causing my symptoms. Retrograde ejaculations aren't harmful....and gets in one's brain...but, once used to them, you begin to realize their not as bad as NO ejaculations!!

Like has already been said....your symptoms are almost certainly related to bph and even if there's some cancer in their...it's almost certainly the low grade stuff.

Good luck with it. Uro said I'd have to probably have to have something done for my BPH in the next couple of years....The jury's still out on my cancer as far as whether it'll need treatment or not.


Fiwi...Most urologists will go with a blind biopsy if they suspect cancer. That's beginning to (very) slowly change. As Jane said...a 3t mri would be alot less invasive and should show anything big enough to be biopsied.
Posted 4/6/2015 10:15 PM (GMT 0)
ditto to mostl the above posts.drbillr. You may eventually need a Turp. Please google that. It will answer it much better than I could. Read Patrick walshes book on Pca, It will answer most of your questions on any prostate issues. noncancer and cancer issues. I do not agree with mri or any major search for hidden minuscular cancer in your prostate. That road will lead to a labyrinth you may get lost in for no reason at all. Its a fine line but medicos have a tendency to lead you that way, when faced with patients who unknowingly push them there themselves. Fine line...
Posted 4/6/2015 11:31 PM (GMT 0)
I will take a middle position on the question of an MRI. Certainly the 3T MRI is a very powerful tool for finding areas of the prostate that are probably cancerous. And, it would make a lot of sense to have one before any biopsy, as it will provide targets for the sampling. But, I believe that it shouldn't be called for in a case like yours, where a need for a biopsy has not yet been established. You are being monitored, and there is no need to jump ahead with testing until that need has been justified.
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