HealingWell
Search Close Search
☰

Worried and unable to work - 38 years old

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/25/2018 2:28 PM (GMT 0)
Hi. This is my first post on this forum. I haven't been diagnosed with prostate cancer, although I have a terrible feeling that's what I've got.

I am 38 years old. For the last 5 months I have been experiencing frequent urination, discomfort in the pelvic area, dribbling after urination, the tip of the penis is always wet with what I believe is urine, reduced flow, and a gigantic reduction in the volume and strenght of ejaculation. I have also experienced erectile dysfunction.

My first doctor in London ruled out infection and kidneys stones (with ultrasound and CT) and did a physical exam (including DRE) which was normal. Upon my insistence I did a PSA test which came back elevated at 2.82. My prostate is small (20 cc). Doctor prescribed two rounds of antibiotics to no effect and said he thought it was prostatitis. I did a multi parametric MRI which said "small gland minor BPH. there are changes in the peripheral area that are most likely inflamatory. the lack of any abnormality or diffusion imaging is reassuring that there is no evidence of high-grade tumour". I have read profusely about this and it looks like there are no definitive ways of saying whether changes are down to inflamation or cancer in a multi parametric MRI.

I subsequently moved abroad where a new doctor prescribed a number of anti-inflamatories and BPH medicine and redid the PSA test, which came back at 2.2 and 14% of free PSA (3 months after the first one).

All the symptoms feel worse, except for flow of urine which is slightly bettter. My doctor says he doesn't want to do a biopsy because he thinks it's unwarranted given results of MRI and a clear DRE. Based on what I read here it is far from unwarranted. Many people my age have cancer and their situations are very similar to mine. My PSA cut off point is 1.5 at my age.

It's been 5 months, I am incredibly scared and unable to work.

Could you please help me with your knowledge and experience?
Posted 6/25/2018 2:49 PM (GMT 0)
Its highly unlikely that you have cancer..... Infections and BHP, among others, cause these systems and in some cases much worse. The bad news is these are buggers trying to clear up. Relax and breath... I'm sure others will provide good guidance.
Posted 6/25/2018 2:53 PM (GMT 0)
Sorry about all of what you're going through, which certainly doesn't sound like a lot of fun. Regarding your statement that "many people my age have cancer and their situations are very similar to mine"--I'm not a doctor, but I think I can accurately state that is not true if you're referring to prostate cancer. First off, PCa is extremely rare among people your age--I was diagnosed at 51 and the docs kept telling me that I was one of the "young guys." But maybe even more significant, your symptoms just are not consistent with PCa.

You obviously have something going on and I do think it's important to stay on top of it. Prostatitis can be stubborn and doesn't always react to antibiotics. As to PSA, it's a signal of prostate activity and isn't really the most reliable signal of PCa. You might ask about a PHI test--there are others here that are more familiar with the other types of blood tests in addition to PSA.
Posted 6/25/2018 3:46 PM (GMT 0)
There should be no rush to a biopsy especially at your young age. 50% of biopsies are negative. Your doctor is doing the correct thing in working with other more common and expected conditions at your age. If it is cancer it most always cause your will cause your PSA to go up gradually. That doesn’t appear to be what is going on with you.

Please don’t be scared and how this would make you unable to work is beyond me. And there is no cutoff at any age. PSA is not a cancer marker. It shows prostate activity and is indicative of many conditions other than cancer. Riding a bike can cause it to increase, so can an infection or inflammation.

As to many people have PCa at age 38, that simply is not the case. Very few have it at that age and the significant risk doesn’t occur until one is in their 50’s. Average age at diagnosis is age 66. While it is possible you have PCa it is very unlikely and should not be driving you anxiety. Keep working with your urologist to mitigate the symptoms and find the cause. Also, I suggest you seek professional assistance to manage your anxiety. It appears to be causing the most stress and needs to be managed to get you back to a healthy normal condition.
Posted 6/25/2018 5:14 PM (GMT 0)
You are stressed out with anxiety and presume that is why you cannot work. See you regular doctor and get some anti anxiety medication like xanax. It will calm you down so you can get back to living.
Posted 6/25/2018 5:21 PM (GMT 0)
Many thanks for listening and for your kind words. What i said wasn't t indeed very accurate. I know pca is rare in men in their 30s, but in absolute terms there are a few men who had it at my age. I came across a few on this forum, and the circumstances they describe, particulalrly their psa levels, were in some cases the same as mine. I am quite scared because the symptoms severely reduce my life quality, and because there's no unequivocal diagnosis. One of my fears is ithat if I have cqncer by waiting so long i could be lowering the chances to cure it. It's the not knowing that's causing me great distress.
Posted 6/25/2018 5:26 PM (GMT 0)
The most likely culprit is prostatitis. The fact that inflammation was noted on the MRI confirms this. Prostatitis seldom responds to antibiotics. Most kinds relapse and remit, so if you just wait it out, it may go away, at least for a while. Some men have found relief by taking tricyclic antidepressants (no one knows exactly why they work for this, but they do). It is highly unlikely to be prostate cancer.
Posted 6/25/2018 6:48 PM (GMT 0)
Lewis, you have gotten very good advice here, from a group of men who have been through this. These men are different than most men who have prostate cancer, because they have taken the time to become experts on the ins and outs of their disease. Tall Allen in particular knows more about the disease than most GP's and probably knows more about it than some, even many, urologists.

So take what they say seriously. You need to figure out, with the help of a GOOD UROLOGIST, NOT A GP, what is going on, you need to get some help with the anxiety, and you need to realize that while there are no guarantees in life, the chances that you have prostate cancer based not only on your age, but your symptoms, are miniscule at best, and probably nil.

I feel for you, anxiety is a difficult thing to deal with, it can overtake your life. Please get som ehelp for it. Thats as important as figuring out what your symptoms are, maybe more. Anxiety will MAKE you sick.
Posted 6/25/2018 9:38 PM (GMT 0)
Thanks. I'm being seen by an urologist, not a GP. He is respected and apparently he's one of the best. I am indeed anxious because the symptoms don't match what i find on the internet about prostatitis. Particularly, the dry orgasm (very little volume) is something I've seen with reference to pca but never prostatitis. And it is very scary - the body behaving entirely different out of a sudden.
Posted 6/25/2018 10:15 PM (GMT 0)
Dry orgasm is not a symptom of prostate cancer, it’s a side effect of prostate cancer SURGERY. Because the prostate is removed.

Clearly, based on the symptoms you describe, something is going on. But it’s highly doubtful that it’s PC
Posted 6/25/2018 11:44 PM (GMT 0)
Ironically, a lot of your symptoms (ED, dribbles,frequent urination) can all be exacerbated by stress and worry. While I certainly don’t want to make light of your condition (I’m glad your dealing with a respected Urologist) it’s possible you are making all the conditions worse with your worry. Plus as everyone else is saying it really doesn’t sound like you have prostate cancer. I hope you can find some peace of mind knowing it’s almost unanimous here.
Posted 6/26/2018 6:14 PM (GMT 0)
Dry orgasm can certainly be caused by prostatitis as the swollen tissues close off the seminal ducts. Also, the drugs given for symptomatic relief - alpha blockers like Flomax - have a known side effect of causing the semen to travel up to the bladder instead of down the urethra at orgasm. This is called "retrograde ejaculation."
Posted 7/12/2018 12:32 PM (GMT 0)
Hi guys. Just to give you an update. I did another PSA test and it came back at 2.58, so higher than my previous measurement (three weeks ago, which was 2.2). My doctor now thinks I should do a biopsy. Which I will do on Monday. I am very very worried and it's hard to think positively.
Posted 7/12/2018 12:44 PM (GMT 0)
I never like to tell somebody "I know how you feel" but in this case - I know what you're going through like all of the other guys here. It is for sure a very stressful situation but stay busy, do fun things and don't focus on the future event. It would be very rare for somebody as young as you to have PCa.
Posted 7/12/2018 1:31 PM (GMT 0)
a biopsy will help determine how extensive the prostatitis is and hopefully will give the doctor better information to develop a treatment plan.

There are plenty of treatments available in the unlikely event of another DX.

Andrew
Posted 7/12/2018 2:50 PM (GMT 0)
Thank you smile But would the PSA level go up with prostatitis, after six months of medication? This is what is troubling me. From what I read PSA levels going up is a bad sign.
Posted 7/12/2018 3:09 PM (GMT 0)
yes psa levels can and do go up with prostatitis...yes psa levels going up is a bad sign...and if "they" ever develop a test that tracks levels of anxiety...that going up is also a bad sign...the only good sign im aware of is life...'' choose life" anything else is an imposter....im poster...now there is something...to meditate on.... devil scoolgood luck...live long and blah blah...
Posted 7/12/2018 3:20 PM (GMT 0)
Sometime using a visual aid helps to make a point.

The link below is to a page containing a series of statistically based graphs that plot and display various facts about prostate cancer, arranged by age and age groups. (The page can also be displayed by googling "prostate cancer age graphs" and clicking on the relevant line).

I invite you to click on the link. If you do, you will see a series of graphs, and for every one of them, you will also see that the number of men aged 38 "at first diagnosis" is virtually off each graph, it is such a small number!

It even looks to me, with my poor graph reading skills, that these graphs are saying that a 38-year-old man probably has a about a 99 % change of not having PCa!

A picture is worth a thousand words?

Take a look and see for yourself!

/www.google.com/search?q=prostate+cancer+age+graph&tbm=isch&tbo=u&source=univ&sa=X&ved=0ahUKEwiEyOri6JncAhVLZKwKHS6lAY8QsAQIdQ&biw=1024&bih=635
Posted 7/12/2018 3:29 PM (GMT 0)

Lewis Michael said...
Thank you smile But would the PSA level go up with prostatitis, after six months of medication? This is what is troubling me. From what I read PSA levels going up is a bad sign.

Prostatitis doesn't respond well to medication (especially antibiotics), so this wouldn't be unexpected.

If you've decided on a biopsy, that's your next step. Speculation and worry aren't going to help. Get the testing and then you'll know.

Andrew
Posted 7/12/2018 7:13 PM (GMT 0)
You can ask for a Prostate Health Index (PHI) - it is less subject to errors due to prostatitis and BPH than the PSA test (which is included with it). It might help you avoid an unnecessary biopsy (which might aggravate your prostatitis).

A PSA of 2.58 is not measurably different from 2.2. There are normal day-to-day variations. Antibiotics seldom control prostatitis.
Posted 7/12/2018 8:49 PM (GMT 0)
In my forties...I was convinced I had pancreatic cancer. I had an MRI. The radiologist said there was no evidence of pancreatic cancer.

I then went back to my GP and asked him "What now?" He told me...."Exploratory surgery." That's all I needed to hear to stop worrying about it.

Hopefully Lewis...that's all that will happen here. Good luck man.
Posted 7/12/2018 9:16 PM (GMT 0)
I know it's wrong to ask for advice on what i should so. So let me ask the question differently. If you were in the same circumstances i find myself in, would you do the biopsy?
Posted 7/12/2018 9:20 PM (GMT 0)
I can only repeat the advice i've already given - get the PHI test.
Posted 7/12/2018 9:24 PM (GMT 0)
I'm no doctor, but a biopsy is an invasive procedure and you have the symptoms of prostatitis, not PCa. Personally, I'd try the other diagnostic tools (like PHI) before playing the biopsy card.
Posted 7/12/2018 9:25 PM (GMT 0)
Lewis - where are you located? You mentioned a doctor in London. Are you in the UK?

I know the NHS might limit some of your choices.
✚ New Topic ✚ Reply
12