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Posted 8/9/2017 10:22 PM (GMT 0)
Hi everyone

I want to start out by saying Your support group is nothing less than outstanding. I have been reading for a while now. I have had prostate troubles for years. I have a history of issues since I was in my twenties. I am now 59. I take flowmax .4 x 2 at dinner. about a year ago I had slow urine stream, stop and start issues and of course referred pain into penis. Urologist put me on oxybutin and increased my flowmax to two a day. This went on for about six months and then suddenly cleared up. One year ago my psa was 1.7, now its 4.7.

Needless to say today I called and scheduled an appointment for next Friday at urologist. I am so happy to have this forum and all of you to rely on. Please let me say now I appreciate any and all help that anyone is willing to give. I have learned a lot just by reading but I would love your opinion on what you think of my newfound increase in psa. Every time I have a urine test it always comes back clear, no infection or problems. If anyone has any special instructions I would love to hear them for my appointment such as tests or biopsy or anything that would help. I live in the Hampton Roads area of Virginia. I go to urology of Virginia.

Thanks for all your help
Posted 8/10/2017 1:13 AM (GMT 0)
Oceanfisher ......welcome to our club that no one wants to join ....but now that your here , stick around .....join the brotherhood !.....as far as your situation , it looks like you are in store for all the basic exams to see where the PSA increase is coming from....DRE....family history ....antibiotics ....biopsy if needed . Lets hope just an infection ........keep us posted on your findings....we`re here for you .........David
Posted 8/10/2017 1:26 AM (GMT 0)
You have all the classic symptoms of chronic prostatitis. Your urologist may feel the inflammation/hardness with a DRE. Antibiotics most often don't work. Sometimes just waiting for a remission is the best course. If PSA doesn't come back down after awhile, you may need a biopsy.
Posted 8/10/2017 2:41 AM (GMT 0)
Fisher,

Like Tall said, your symptoms sound a lot like prostatitis and not so much like prostate cancer. That's the good news. The bad news is that prostatitis is an annoying and hard-to-treat disease in its own right. It won't kill you but its pretty annoying.

The classic presentation of early stage prostate cancer is a man who feels fine -- no symptoms at all -- whose PSA creeps up gradually over time. All of your urinary and prostate symptoms that come and go, and your roller-coaster PSA, are classic indications for non-bacteriologic prostatitis.

Of course, having prostatitis doesn't mean you can't have prostate cancer, too. It could be that a small part of that 4.7 PSA is caused by a bit of prostate cancer, growing slowly and quietly among the inflamed tissue and calcifications from your prostatitis.

I assume that, since you've been treating your prostatitis for a long time, your urologist has tried a round of antibiotics. They will seldom cure persistent prostatitis but sometimes antibiotics will make the PSA reading go down far enough to get below the levels that trigger biopsies and further tests.

You might ask your urologist about doing a test called a Prostate Health Inventory (PHI) next time instead of just a PSA check. It's a new test that is a bit more specific for prostate cancer. It might tell you something.
Posted 8/10/2017 1:48 PM (GMT 0)
A PHI blood test should be demanded. Lots of old school or non up to date urologists don't have a clue about how valuable it can be.

I believe Flomax can artificially suppress PSA readings so keep that in mind.

Good luck!
Posted 8/10/2017 4:09 PM (GMT 0)
You got something, but like others said, PC is likely low on the list.

Do let us know what the URO says.

Andrew
Posted 8/10/2017 5:01 PM (GMT 0)
Hi Everyone,

Thank you to everyone who has answered my post. I really appreciate the support. The thought of having cancer is just horrible. I catch myself even now thinking about it every minute. My wife googled psa 4.7 and is crying and upset saying I must have cancer.

After reading all the posts I will ask urologist for a PHI. Should I also ask for another round of antibiotics? I have been off antibiotics for a year now. I will be urine tested when I walk through the door which is what they do at every appointment. My urologist is not a big fan of giving antibiotics if urine test is clear. I will push for antibiotics if you all think I should. At my last appointment my urologist also mentioned having a cystoscopy test done. Is this a good idea to look at my prostate and bladder? Should I jump right to biopsy if dr wants to before even trying anything else or do you all think it is premature to do so?

I want to say thanks again for everyone taking the time to help me. I will keep reading and let you all know what happens next Friday after my appointment. If anyone has any other suggestions please let me know so I can try them also.

Thank you all
Posted 8/10/2017 6:04 PM (GMT 0)
I've come to agree with your uro - most prostatitis does not respond to antibiotics, and it only causes more resistant infection. Prostatitis relapses and remits on its own. A cysto looks at the urethra and bladder, not the prostate. It can tell you if the urethra is swelling shut, but you already know that. Just give it time and test again. I know that patience is the last thing you want to hear right now, but keep in mind that even if it is prostate cancer, waiting another 3 months isn't likely to make any difference. PHI is a good idea.
Posted 8/18/2017 8:11 PM (GMT 0)
Hi Everyone,

Today was my appointment with urologist. We talked about my two month flare of prostatitis and associated symptoms. We talked about my last flare only being five months ago. I then unloaded my new psa of 4.7 and how it had jumped from 1.7 about sixteen months ago.

He did not seem concerned and said lets retest in ninety days and go from there. I asked about 3T mri, PHI and free psa tests. He said we could consider them in ninety days. His opinion is lets wait and if psa goes up at next test then do a biopsy if it rises. He will do a biopsy now if I push for it. Does this course of action seem reasonable to everyone?

In the meantime I suffer with running to the bathroom every two hours and feeling like I have to go every minute. I hate prostatitis. I guess I could deal with it better if my psa was not elevated. I have not had a cystoscopy done to even look at anything yet. I drink a ton of water, take advil, take Flomax, take a prostate supplement and I still feel like garbage. Does anyone have any ideas on something I could take to feel more normal? I have also tried Oxybutin for overactive bladder.

I would like to thank any and all for your comments. I like this site as it is very helpful and it does calm my anxiety. I would like to also add my urologist is 48 years old with 21 years experience. My father had prostate cancer and died from it spreading to his bones and other organs. Naturally I am worried the same will happen to me.

Thanks
Posted 8/18/2017 8:20 PM (GMT 0)
Hi Oceanfisher58

There is a very good chance that your PSA is rising from something other than cancer. Waiting the 3 months for the next PSA and then deciding if a biopsy is necessary sounds like a good plan, BUT if its going to play on your mind constantly for the next 3 months and your URO is willing to do it now then that might be an idea. Sorry i dont have any experience to offer when it comes to your other symptoms/questions.

Wishing you the very best!
Posted 8/18/2017 8:32 PM (GMT 0)
Your URO has offered a reasonable plan.

Sorry you're having symptoms. Hopefully they will clear soon.

Andrew
Posted 8/18/2017 10:41 PM (GMT 0)
As you can see Oceanfisher, you have come to the right place for advice and support! Hang in there and good luck with the plan. Sounds like you have a good doc on your team. Wishing you the best going forward.
Posted 8/19/2017 4:24 AM (GMT 0)
Thanks and you are right. Much compassion and understanding here. I will keep everyone updated on my journey and keep reading the posts here also. I am trying to relax and let things settle down. I know the advice here is top notch. Much experience in treating PCa if I need the help is greatly appreciated. The process is so slow, it would probably be easier if I felt better. When I asked urologist for suggestions of relief of prostatitis symptoms he had none to offer. I was unpleasantly surprised.

Thanks to all.
Posted 8/19/2017 1:39 PM (GMT 0)
Pre surgery, when being treated for BPH, Flomax didn't work for me and had it's own set of miserable side effects.

A switch to milder Rapaflo did the trick almost immediately. You might want to try it. Good luck.
Posted 8/19/2017 3:34 PM (GMT 0)
Ocean: I'm going through the same sort of thing. Rising PSA, (tested very three months now) ,"suspicious lesion" on prostate, (found after an MRI on 8/11, not fund during a DRE in late July for some reason), blood in semen. I have a biopsy on 8/25. The unknown is scary. This group has been a great help to me, and they will certainly help you too. Good luck with everything. Jack
Posted 8/19/2017 9:38 PM (GMT 0)
Thanks everyone for the support. I am just at the beginning of my journey. I am getting tired of this prostatitis every six months. I listen to all the symptoms others tell me about and try to relate it to my problems. I had prostatitis once where it felt like I was sitting on a golf ball all day. This time around nothing like the last. Now my bladder area feels really sore. I feel like it is bloated or something like that. Believe it or not if I drink a glass of baking soda water in the morning, one teaspoon full, it makes my burning after urination less painful.

I know the myth of baking soda and honey or molasses is frowned upon here as a cure for cancer. Believe me I know nothing about cancer compared to all of you. I am only using it because it helps with burning pain. My urology group is large and I have been going there for twenty years or more. I have had many different drs because some leave the practice or whatever so I get a new urologist every few years. Just recently my dr said he was surprised my urine ph values were changed by 2.5 pts. I told him I was drinking baking soda water as he just laughed. As I cant get any help with my symptoms I just do what I can for relief.

Jack try to hang in there I know its hard for you also. Waiting is such a pain. Being in pain sucks also. Thanks for all your support everyone. I feel bad complaining when others here are going through cancer battles. I might have cancer also but I know I can trust all of you great people to help us new folks out.

Thanks
Posted 8/19/2017 10:26 PM (GMT 0)
Oceanfisher, your PSA of 4 point something is not outrageously high for a man approaching 60. Your immediate family history is probably making you worry more than is warranted. If your PSA continues to rise, and especially if it goes to 10 and stays above that, THEN you can panic.

My PSA went up steadily for a couple years and my Uro was unconcerned. When the first biopsy was negative his response was to wait then repeat the biopsy. I had no idea what was going on. This is like, if you fail a test you just take it again?

Unfortunately there are set rules, primarily insurance rules, about what can be done and when, and in what order. Your Uro is probably more concerned about moving forward when it may not be justified by those "rules". If he says wait, wait the three or six months, whatever he says. If your PSA continues after that, maybe look for another Uro. In the meantime, TRY TO RELAX.
Posted 8/20/2017 3:37 AM (GMT 0)
"My wife googled psa 4.7 and is crying and upset saying I must have cancer. "

Please let your wife know that I have read posts from men who had psa's of 3,000, 5,000, 7,000, and even 8,000.

Why am I mentioning this? Because all of those men were posting TEN YEARS or more after their diagnosis.

Even if you DO have cancer, it may never need treatment, or it can be easily cured. The American Cancer Society states that less than one percent of the men diagnosed today with prostate cancer will die from it in the next ten years. Take a deep breath....
Posted 10/27/2017 3:10 AM (GMT 0)
Hi everyone,

It has been almost three months since I last posted here. I had a psa test then which came back at 4.7. It was 1.7 a year ago. Now almost three months later I had another psa test which came back at 4.8. I would love to know what anyone thinks I should do at this point. I have an urology appointment soon. What do you think would be a good course of action? Should I go ahead and get a prostate biopsy? I know there is an mri that can detect prostate cancer and is less invasive. Should I ask for that?

Thank you all for you support through all this.
Posted 10/27/2017 3:31 AM (GMT 0)
You should ask for a PHI test. That might give more useful info. A MRI won't confirm PC, it can only show possible suspect areas. Not sure that would really be helpful for you right now. One benefit might to find out your prostate size and rule out any obvious other issues like BPH. prostatitis is still a possibility.

I think you should see the URO and get the doc's opinion. I could see a recommendation for one and I could see a recommendation to retest in 1-3 months.

Either would not be bad. There are worse things than a biopsy - not sure I'd ask for one, but if the doc recommends it, I'd be inclined to say yes.

Andrew
Posted 10/27/2017 6:50 AM (GMT 0)
Agree with Andrew that a PHI test is a good idea as it is a simple blood test. PHI is a more accurate test than PSA on its own. Men with PHI score of 27 or less have only about 10% probability of having cancer. I was also told some prefer a cutoff PHI score of 24, that is if higher than 24 then those doctors suggest biopsy. The following article is of interest:
http://www.latimes.com/science/healthy-living/la-he-hl-psa-alternatives-20171012-htmlstory.html
Posted 10/27/2017 8:08 AM (GMT 0)
Hi and sorry you have to deal with this issue. None of us know whether you have PC or not. What we (I) know is how I approached this disease. My PSA history is much like yours. There are statistical tables that show risk for PC based on PSA trends. I had PSA under 4 for years and then it crept to 4.6. My Uro said there was a 30% chance it was PC and ordered a 3tmri which showed a suspicious lesion. We then did the biopsy and found Gleason 6 cancer. I believe we would have found it years earlier if we did the biopsy. Now that may not be your case, prostate size does influence PSA.

For me, the idea that there was a possibility of PC made it easy for me to agree to MRI and biopsy. And I was out for the biopsy, many guys had local anesthesia. I like not having any memory of the procedure!

I wish you well in your journey and keep asking questions. Also be your own health advocate! Denis
Posted 10/27/2017 10:40 AM (GMT 0)
Here's a few things to add to the other thoughts:

First, PSA is NOT a cancer test. PSA is a test of "prostate activity", and lots of things can cause it to rise. You're of an age that you probably DO have diagnosable prostate cancer, but also probably at a low level that won't cause you harm for a long, long time.

Second, PHI, MRI's, etc are predictors, not diagnostic at this point. They can say "maybe" but not for sure. Whether we like it or not, a biopsy is the only way to actually say "yes". Unfortunately, a negative biopsy does not mean a sure "no".

The good news is, that PC is such a slow grower that most researchers thing that PC is floating around in there for several years before it triggers enough PSA to raise concern. PSA is also multi-focal, which means that most men don't have single lesions, they have multiple small ones, which is why the biopsy is so hit or miss: hit a lesion dead center, get a diagnosis. Miss one by a millimeter, get a 'no'.

Keep us posted, and tell your wife that PSA is not a cancer test. Oh, and make sure to empty that prostate gland of yours as often as possible. (even though one thing that cause a PSA spike is sexual activity)
Posted 10/27/2017 5:37 PM (GMT 0)

oceanfisher58 said...
I may have cancer


Actually, you probably do have prostate cancer...based purely on your age (59).

Close to 60% of 60-year olds DO have somewhere between (i) an aggressive case which they probably do know about and will probably kill them (rare case) and (ii) a tiny, but measurable, trace of PC that the man is completely unaware of. In fact, the vast majority DO NOT know that they have PC...and more importantly, it will NEVER bother them.

So your statement "I may have [prostate] cancer" is going to get pretty much a shrug from people who know much about prostate cancer. You're 60...of course you probably have PC.



How do I know this fact about 60% of 60-year olds, you might ask? It's interesting; let me tell you:

Autopsy studies have been conducted on men of all ages who died an accidental death, and their prostates were examined. Starting at about age 40, about 40% of men had detectable PC, 50% of 50-year olds, and so on up to 80% of 80-year olds, etc.

But the reported incidence rates of PC are far lower at all those same age ranges. So, we know that most men never know they have it...or more specifically, they never encounter the set of circumstances which ends-up with them getting a biopsy (which is the only way PC is diagnosed).

And the death rates of PC are far, far lower, which helps us to understand the important adage:
    Prostate Cancer is among the most common and least lethal of all cancers.

So, now that you've learned that, you'll understand that the important point for men our age who have a biopsy is NOT about whether they have PC or not (they probably do); rather, it is whether they are one of the uncommon cases that actually needs treatment. The most common PC cases needs no immediate treatment whatsoever...and is some cases no treatment ever.

Hope this information helps...

Post Edited (NKinney) : 10/27/2017 11:48:14 AM (GMT-6)

Posted 10/27/2017 7:14 PM (GMT 0)
You asked about what other medications may be of help. In my case, my urologist put me on Avoderm which helped for about two years (between 2010 and 2012), and is a one-a-day pill that helps greatly with symptoms, especially with the pain and frequency of urination from a growing prostate.

I should point out that I eventually progressed to first stage 2, then stage 3, and finally stage 4 during these next 7 years, but I have a genetic mutation (PTEN L247) that makes my cancer grow at about 12 times the normal rate, and my doctors tell me I still have another minimum 5-8 years to live, so have faith and keep tracking your progress and get great ideas from this site (I know I have) .
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