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Blood in Semen - PSA .8

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Posted 10/14/2020 7:30 AM (GMT 0)
Hello All (this is an old thread but hoping we might revive it). Thank you for responding if anyone sees it.

My issue is I have been having blood in my semen. As far as I can recall .4 has been my normal PSA test But now i’m 70.

For 10 months I have had blood in my semen. It’s been peaking out from discoloration to approx 50% volume over 4/5 weeks then disappears (started in Feb).
Now it’s Oct same year and this same cycle
has been happening until recently where the blood has remained the last couple weeks.
I’ve had at least 24 mycin antibiotics due to Covid recently and it didn’t affect the blood appearing.
My Dr. does not seem worried (it’s not his blood smile Everywhere you read not to worry but this is not normal and something is causing it. I have seen two Urologist as a 2nd opinion he wanted to possibly do a prostate sample). My #1 Dr does not think that’s necessary.
It’s like your just waiting for worse symptoms before anything can happen. At the same time I don’t want to disturb my prostate unless it’s for sure we need to do that.
What do you all think?
Get a third opinion? Stay with my main Dr. (he is a well known Dr in a big city and my GP trusts him)?
Thank you
Posted 10/14/2020 1:41 PM (GMT 0)
Tex - Have you had any of the prostate investigations done yet, ultrasound, CT, MRI, biopsy, etc? What schedule do you monitor your PSA and have digital exams, annually?

If you want to really find out what is going on, something more than talking about it will have to be done. It would seem that the variety of scans and procedures available would allow the urologist to offer some choices that you could consider. Your regular doctor is really not the best person to advise you on constant bleeding at this point IMHO.

I don't want to worry you needlessly but PSA is not always a reliable indicator of various cancers that one can get so getting to the bottom of bleeding source would seem to be advisable.
Posted 10/14/2020 10:58 PM (GMT 0)
I had blood in my semen two year before the diagnosis and my johnson was not getting hard. I believe that I had PC then.
Posted 10/14/2020 11:32 PM (GMT 0)
I would first rule out any infection such as prostatitis. Many times blood in semen is caused by an infection. Your doctor should prescribe an antibiotic for a couple of weeks to rule this out. It is the less invasive way.
Posted 10/15/2020 6:50 AM (GMT 0)
Thank you Mumbo, Howard and lapilot.
The 1st Urologist my PC sent me to in Feb20 did a blood work up on me. My PSA was .8 (i’ve always had a low PSA .4 in the past). He did not think it was necessary to do further testing based on the blood tests (he is considered one of the best in San Antonio but the blood still kept coming so eventually I went to Urologist #2 in another group).
#2 was going to put me on antibiotics but I got Covid and was on 24 mycin type antibiotics and it didn’t do anything for the blood. This Dr. (#2) did mention the possibility of doing a Prostate sample.
I already had an appointment with my #1 Urologist so I went back there, all I remember him saying is he would not have put me in that antibiotic. If go back i’m sure he will do something more aggressive after all this time.
Now i’m confused and NO other tests have been scheduled by either Dr at this time (not even a finger prostate test) I’m sure if I went back to my second opinion Dr#2 he would suggest we do the prostate test.
Honestly I didn’t care for the #2 Dr (personality) but with you all’s advice maybe I should go back to him or try to find a totally different Dr but this has been going on since before Feb.
I’d sure like to try NON-Evasive testing Mumbo suggested before we start disturbing tissue (both my parents passed of cancer and when they cut on them their cancer spread fast- Dad was lung / Mom breast cancer both heavy smokers - me a non smoker).
Thanks to all for your answers. If I sound confused (and scared), I am.
Posted 10/15/2020 9:33 PM (GMT 0)
This linked article might help a bit

https://www.medicalnewstoday.com/articles/blood-in-semen

Not sure how you avoid some physical tests with the urologist at some point. Scopes and biopsies are what they do.
Posted 10/15/2020 10:23 PM (GMT 0)
Am I reading correctly that your PSA is 0.8? Your normal range would be up to 4.5 or so and you should have some positive PSA as you have your prostate. Correct? And I understand you have never been treated for prostate cancer. Have you had a recent DRE? What were the findings?

If you have normal DRE and amazingly low PSA for your age, then PCa investigation would probably not be Primary in determining the cause of the blood.

I have not searched for what reasons one might have blood in semen. After my brachytherapy I did, which is normal due to the procedure. I imagine that invasive PCa could break through membranes that would allow the blood leakage, but it would be rare at such a low PSS and no other indications.

Keep searching.
Posted 10/21/2020 10:24 AM (GMT 0)
Thanks everyone, here is an update.
My urologist ( #1) has prescribed
me 5mg of Finasteride once a day for the bleeding.
I read that drug is for an enlarged prostate. He or my #2 Urologist have not even tested me to see if I have an enlarged prostate! No physical. only blood test that showed my PSA as 0.8
I don’t have symptoms of an enlarged prostate only the bleeding going for over 8 months now.
It’s a pretty strong med and I can’t give blood while on it and it may conflict with some of my other meds. I’m not anxious to start it or get a biopsy until there is something less invasive showing that’s what needs to be done next.
I’d rather have a physical exam to see if my prorate is actually enlarged and a CT scan and other non invasive tests until something shows up showing i need a biopsy or more.

I’m thinking of getting a 3rd Urologist that will do these and possible other tests that Mumbo suggested at the tip of this string.
I lost a friend today & another a month ago to PC so i’m feeling the pressure
What say y’all! Thanks
Posted 10/21/2020 10:30 AM (GMT 0)

Mumbo said...
Tex - Have you had any of the prostate investigations done yet, ultrasound, CT, MRI, biopsy, etc? What schedule do you monitor your PSA and have digital exams, annually?

If you want to really find out what is going on, something more than talking about it will have to be done. It would seem that the variety of scans and procedures available would allow the urologist to offer some choices that you could consider. Your regular doctor is really not the best person to advise you on constant bleeding at this point IMHO.

I don't want to worry you needlessly but PSA is not always a reliable indicator of various cancers that one can get so getting to the bottom of bleeding source would seem to be advisable.

Hello Mumbo... I added sine more info below since your post. i’d love your feedback plz. I have had no testing dine except a blood test. See below the med my #1 Urologist wants me to take without even looking to see if my prostate is enlarged. it never has been through the years.
I’ve found Drs don’t like probing men even though it’s their job.
Thanks
Posted 10/22/2020 2:03 PM (GMT 0)

Mumbo said...
Tex - Have you had any of the prostate investigations done yet, ultrasound, CT, MRI, biopsy, etc? What schedule do you monitor your PSA and have digital exams, annually?

If you want to really find out what is going on, something more than talking about it will have to be done. It would seem that the variety of scans and procedures available would allow the urologist to offer some choices that you could consider. Your regular doctor is really not the best person to advise you on constant bleeding at this point IMHO.

I don't want to worry you needlessly but PSA is not always a reliable indicator of various cancers that one can get so getting to the bottom of bleeding source would seem to be advisable.

I have seen 2 urologists. #1. Did A PSA.
Through the years I’ve always had low PSA #s. 0.4 in the past to 0.8 now.
Years past when they did the finger test Ive been told by my family Drs that I had no enlargement 10-15 years ago to a slight enlargement 2-3 years ago by another family type doc. .
FYI- I’ve taken a daily saw palmetto for at least 25 years.
Now I have gone to 2 Urologists since the bleeding started
All #1 Urologist did was do blood work.
When he saw my low PSA he kind of brushed me off. No physical exam or Cat scans nothing. Months went by more bleeding so I got a second Urologist. Again no tests of any kind but he wanted to put me on Antibiotics. I got the Covid and had to take a 24 days of a Mycin antibiotic so he didn’t prescribe another antibiotic thinking the one i was taking should have done it - still no change though. He did mention doing a biopsy.
This is where I balked- “I would like to have non - evasive tests run before we start disturbing tissue”. I lost both my parents to cancer and when they operated both their cancers went into high gear.
Neither Urologist have even felt up in there to see if I have an enlarged prostate yet BUT #1 Urologist did prescribe me Finasteride 5mgs last time I saw him. I have not started it as I am about to give blood so they can use my Covid antibodies for Covid patients.
I do have a question about the Finasteride...Why would a Dr start you on Finasteride when he hasn’t even checked you physically to see if you have a swollen prostate? I know they are busy but seems like they are not thorough. And they have done none of the tests you suggested above and don’t seem interested in doing any except for Urologist #2 suggesting he might do a biopsy (again i’d prefer non-invasive tests prior to a biopsy).
We are at a stalemate... I think I need to do a telemed call appt with my Urologist #1 and ask him about doing the tests you suggested. That’s the route I would prefer.
Is that reasonable?
Thank you for your time.
Posted 10/22/2020 2:06 PM (GMT 0)

lapilot said...
I would first rule out any infection such as prostatitis. Many times blood in semen is caused by an infection. Your doctor should prescribe an antibiotic for a couple of weeks to rule this out. It is the less invasive way.

Lapilot... Thank you... I’ve added more info at the bottom.
Posted 10/22/2020 2:14 PM (GMT 0)

Mumbo said...
This linked article might help a bit

https://www.medicalnewstoday.com/articles/blood-in-semen

Not sure how you avoid some physical tests with the urologist at some point. Scopes and biopsies are what they do.

Thank you Mumbo...
At 70 my sex life is really boring so nothing there, I’ve had 24 mycin antibiotics, did not stop it).
At this point I’d like for them to at least stick their finger in there and see if i have an enlarged prostate and some of the other tests you suggested before a biopsy.
Posted 10/22/2020 2:23 PM (GMT 0)

JNF said...
Am I reading correctly that your PSA is 0.8? Your normal range would be up to 4.5 or so and you should have some positive PSA as you have your prostate. Correct? And I understand you have never been treated for prostate cancer. Have you had a recent DRE? What were the findings?

If you have normal DRE and amazingly low PSA for your age, then PCa investigation would probably not be Primary in determining the cause of the blood.

I have not searched for what reasons one might have blood in semen. After my brachytherapy I did, which is normal due to the procedure. I imagine that invasive PCa could break through membranes that would allow the blood leakage, but it would be rare at such a low PSS and no other indications.

Keep searching.

Thank you but yes i’ve always had a very low PSA.
I think that is why my Drs aren’t doing tests. not even a finger to see if my prostate is enlarged but they did prescribe me Finasteride not even knowing if I have an enlarged prostate.
No digital anything. No physical just one blood test. That’s what scares me.
Somethings causing the bleeding all these months. I researched all I can find on the net and nothing there do i do are gsve done that would cause this.
Thank you for your reply
I have more info detailed on Mumbo post
Posted 10/22/2020 3:13 PM (GMT 0)
Tex - Doctors can be frustrating at times. The pandemic has changed the way many of the practices and doctors act now so it probably is not fair to be too critical during these times. That being said, many could be doing a better job now that we are over 6 months into this mess.

Many many years ago as a young man, I had some sort of odd urinary issue where the urologist did a digital exam and pressed on my prostate to get a sample to look at under a microscope. Not saying that would help the diagnosis at all and does not feel good, but it was at least something tangible.

Usually if you complain enough, the doctors will explain more clearly why they are not doing anything. The link I previously listed shows that there are a lot of possible causes. I might suggest contacting the urologist you like best and politely ask if there are other tests or procedures that can be employed to give you peace of mind due to the long period of bleeding episodes without medical resolution.

Wish I could offer a better response but your situation is difficult and you will just have to stay after the doctors without causing them to dismiss your questioning.
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