Prostate is hard

Surbhu,

A PSA of 8.9 is a bit high. I was 3.7! But, if the doctor is a urologist one would expect that he knows what he is talking about. I'm one that never truly believes whatever doctors tell me and always seek some sort of convergence of a diagnosis hence I'd seek a second or sometimes even a third opinion.

My second URO, although well credentialed, had one of those two-way mirror windows: you could see the people in the street except they couldn’t see you. It just awkward because the mind reasons that if I can see you (or vise versa) you can see me. It was "hard" to relax under those circumstances whilst being "fingered"; nevertheless, he confirmed a certain hardness and I proceeded with a biopsy. Glad I did!

Why this strange story about second opinions, mirrors and PSA? Because this journey is a strange one that affects many, the sufferer and the family bystanders and lots of "things" will happen along the way. Read as much as you can about prostate issues, there are many, including cancers!

Take care!

Subhuman , biopsy is an invasive procedure and will often miss a tumor, as it takes tiny needle samples from an entire Prostate. So think of it as hit or miss. Often it will miss a Cancer. I had a biopsy 2 1/2 years ago that was negative, and anothe 5 months ago that was positive. I am sure the first biopsy missed it, and it was there.

With today's new technology, MRI can highlight specific areas that might look suspicious, which the Dr can then target on a biopsy, if he feels one is still necessary. You want to have your dad do a 3Tesla or 3t Multiparametric MRI, if possile. which is the most advanced technology. Think Hi Def

If the MRI shows nothing, then it's likely that your dad either doesn't have Cancer, or has a low grade which often doesn't need treatment but just needs to be watched.

Unfortunately, there is very little black or white in this disease, it's all grey. Keep us posted, and good luck.

Hardness is very subjective. Feeling a nodule or lump is much more suspicious.
Any thing other than a 3T MRI would be a waste of time and money.
Sounds like your Dr is taking the right steps.

Welcome to HW, sorry you need to be talking to us.

Short answer: Yes there are a number of things that make the prostate feel 'hard' other than PC. Your father's doctor is following a good path. Of all the things that can go wrong with a prostate - infection, enlargement, etc - cancer is very low on the list. Before a biopsy recommendation is made, a good doctor will rule out all other possibilities before doing that procedure.

Andrew

also, your father's PSA history plays a lot into it. A single reading isn't all that meaningful (except in extreme cases). The doctor will look at his PSA numbers over a series of tests. Don't be surprised that even after the scan the doctor says something like, "We'll retest in three months and see where we are."

That would be normal too.

Andrew

Do keep us updated on progress. And ask any other questions you have.

We're here most days,
Andrew

A hard prostate is a typical finding for prostatitis, and a rare finding for PC. As John T said, lumps are more likely to signify cancer, but are often cysts or calcifications. Most prostate cancer presents with a negative DRE.

A doctor usually wants to eliminate the more common reasons for the elevated PSA and the hard prostate, before exploring less common reasons. I'm surprised he jumped to an MRI before trying a course of antibiotics, but some doctors seem to be scan-happy.

- Allen