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'Ridge' on prostate with very low PSA

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Posted 3/5/2018 12:38 AM (GMT 0)
My PSA has never been above 1.3 (and was only 1.3 because of some time on an exercise bike). The latest one, on 30 Aug 17, was 1.1. So I was shocked when a urologist found a 'ridge' on my prostate last week. He didn't commit to a diagnosis, and I was too upset to ask the questions I should have, e.g., is it cancer, do I need additional tests, should I just get it removed now, etc.
Since I'm by nature an anxious worrier (sigh), I want to go to a different urologist and ask those questions. But I'm curious as to whether others have had something similar happen. By that I mean a very low PSA and an abnormal digital exam.
Oh BTW I went to the first urologist just to talk about my prostatitis (an unrelated issue). I'm 69 and a 'gym rat': 5-6 days a week in the gym, strenuous exercise of various types. Have been doing that for over 40 years.

Edit: Forgot to say that the urologist said that if my PSA were higher, he would recommend something additional, but that he didn't need to see me for a year: getting a PSA next January (therefore 16 months since my most recent one) 'wouldn't make any difference.' Bottom line: he didn't seem concerned about the 'ridge.'

Post Edited (NavyCT) : 3/4/2018 6:08:14 PM (GMT-7)

Posted 3/5/2018 1:07 AM (GMT 0)
hey there ...been watching this web site for over a year now and never heard of a " ridge" on the prostate, but heck with your super low PSA #`s I would just forget about it all and go work off the anxiety at the gym. Just my opinion and that does`nt weigh in much .....really though your doctor knows best ....sometimes.................some more folks will be along to add more educated opinions ......do try and relax ....you have GREAT #`s.......David
Posted 3/5/2018 1:10 AM (GMT 0)
NavyCT....forgot to welcome you to the forum......WELCOME!! please stick around and let us know how this pans out ....~D
Posted 3/5/2018 1:39 AM (GMT 0)
NavyCT, well, an abnormal DRE is something--but what it is cannot be sure of. That being said, with your very low PSA, it probably doesn't mean anything. Asking for another opinion from an expert is always a good thing to do.

Beyond that...you are a number of steps away from anything resembling a treatment. Get that second opinion (and yes, it will involve another DRE), and after that....well....get back in the gym.

Welcome, and I hope your stay with us is brief.
Posted 3/5/2018 3:24 AM (GMT 0)
Welcome to HW.

A second opinion is always in order. It would be interesting to see if another URO feels the ridge. A DRE is somewhat subjective. You can't know if it's cancer without a biopsy, so he wouldn't be able to give that kind of DX with just a PSA and DRE. It would be very rare to have PC with a PSA that low. Also PSA is not a test for cancer - it just measures prostate activity.

The only real thing you should do is get a second opinion on the DRE and take it from there. It's just possible that the ridge is nothing to worry about.

Andrew
Posted 3/5/2018 9:36 AM (GMT 0)
Welcome, and the answer is to continue to investigate and to try to not to jump to conclusions. Go Navy!
Posted 3/5/2018 2:20 PM (GMT 0)
I would equate the "ridge" term to a hard place on the prostate. Definitely get another DRE and opinion. My PCP felt a hard place on my prostate, urologist confirmed that. My PSA was slowly climbing so the next step was a biopsy. With your low PSA, I'm guessing you are okay but another opinion is certainly warranted.
Posted 3/5/2018 6:03 PM (GMT 0)
My PCP found a ridge on my prostate. My PSA was not as low as yours but it was only 3.4. He referred me to a urologist who also felt the ridge and told me if I wanted a biopsy he would recommend it but that my PSA was pretty low. He gave me the option of waiting and check again later.
I was in basically the same spot that you are in. Should I have a biopsy or not? I had other symptoms that were concerning to me ,such as frequent trips to the bathroom ,difficulty starting, weak stream, decrease in seaman ,etc.
I'm not trying to add more anxiety to what you already have, but I would definitely get a 2nd opinion. . As others have said it probably isn't PC but I would not just let it go.
I had a biopsy and I ended up having PC G9. There are some prostate cancer that gives off little PSA but that is very rare. Keep us updated and best of luck to you.

Mark
Posted 3/5/2018 7:17 PM (GMT 0)
I agree with the other post see a Uro. There is a form of PaC that has a low PSA. Look at the profile on Clearwater Cowboy as an example.

Cajun Jeff
Posted 3/5/2018 8:28 PM (GMT 0)
The ridge may be related to the prostatitis, or it may just be a benign cyst or other benign stuff. Our bodies are full of such stuff. I'm surprised you have prostatitis with such low PSA. A simple ultrasound may be able to provide more detail on the "ridge."
Posted 8/6/2018 12:49 PM (GMT 0)
I went to a second urologist who pronounced my prostate 'perfectly normal' when he examined it digitally! This of course was wonderful news. I did ask him how someone else could feel a 'ridge' and determine it to be problematical. He explained that my very small prostate makes the natural anatomical bifurcation of the prostate more feelable (my word). He added that it's just like a balloon. When minimally inflated, you can feel ridges; when completely inflated you can't.
So, I am left with the opinion that the first urologist, board-certified, in his 50's and therefore having lots of experience, is incompetent. The first guy also makes the list of 'best urologists' in both of the local magazines. That's disturbing: how many other people has he misdiagnosed? But for fear of legal action, I'm not going to post any reviews of the first guy. Always get a second opinion!
Posted 8/6/2018 12:57 PM (GMT 0)
A second opinion is better than an unnecessary biopsy.
Posted 8/6/2018 2:06 PM (GMT 0)
Always good to get another opinion on the big stuff.

DREs can be subjective.

Andrew
Posted 8/6/2018 2:55 PM (GMT 0)
A negative DRE is not a good indicator that you don't have PC. In almost all men, even with large amounts of high grade disease, the DRE is negative.

It's not like a balloon (like the bladder) - it's an organ full of dense tissue. It doesn't get "wrinkly" when empty, if that is what he's suggesting.
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