2 Biopsies later advice please

Hi Guys, I have posted here before and had some friendly, V informative help/advice, haven't been here for a while as had nothing new to report, awaiting procedure(s) and results.....just hoping for a bit of insight from you guys who may have been in the same or similar boat....Or anyone with an opinion. A bit of boring but necessary history. I live in the UK and am now 58 years of age, pretty fit, not overweight etc. Presented myself to the GP 12 years ago at 46 with increased urination during the day....DRE and PSA test, DRE negative PSA "normal" (Only found out recently that the reading was 1.2....I was so pleased at the time that I was "normal" I wasn't asking questions)....symptoms never really went away but learnt to live with them (after all I was "normal" right?)....fast forward 10 years now 56 and go back to doc with regular nighttime visits....DRE again neg but doc wants to refer me to the hospital as PSA 3.3 (cut off in UK for my age is 3) Stupidly I now realise I played the "bike riding, sex 24 hours ago" card and asked for a retest....this came back at 3.1...Doc could see my reticence about going to the uro so went along with my suggestion of PSA test every 6 months....cause in my warped mind how bad could .1 over the "safe" limit be? (See my schoolboy error there?).....So I go every 6 months for 3 more tests and every one is 3.1....So I get complacent and forget 1 visit so it's now 14 months and I visit the Doc and my 3.1 has miraculously elevated to 7.5 (Crap!). Now decide it's time to call in the experts....Doc does blood tests to rule out urinary infection (it isn't). Do lots of research Whilst waiting for hospital to get in touch and read of the free PSA test....NHS don't do this so find a private clinic for a new PSA test with "Free PSA".....This test came back at 4.3 PSA and a free PSA of 23%.(this is 2 weeks later)....Also had a consultation with private consultant from the clinic who are specialists in prostate health and problems. The consultant is a well known Professor of urology with an international reputation, many books and papers published, over a 1000 rp's under his belt etc....40 minute consultation and DRE and he tells me "No Cancer"....."Great" I thought and skipped off.....I was happy to call it a day and cancel the upcoming hospital appointments My wife, although pleased had other ideas and insisted I stick with the program.
So since then I have been called to hospital, had a cystoscopy (Test clear)...a CT Urogram (also clear) and a 3T MRI (something on the scan...radiologist scores it a PIRADS 4...) The Uro tells me that whatever it is it is small and contained within the prostate....So 2 weeks later a 12 core TRUS biopsy.....1 week later result negative. In light of the PIRADS score they now want to do a 36 needle template biopsy....I have now had this today and will now be waiting over 2 weeks (bummer) for the result..... the last 6 -8 weeks I have had a sore right hip that has been getting progressively worse...I'm a keen walker and around 3 weeks ago went with my wife on a gentle 3 mile stroll and the hip was burning by the time I'd finished...freaked a bit went to GP and he pushed and prodded.....shrugged off my bone spread theory and said more likely bursitis, gave me some strong anti inflammatories which I took for 2 weeks and they've done nothing.....and now to cap it all a bit of grumbling back pain has attacked me over the last couple of weeks and now is very uncomfortable when sitting and laying down and can and does wake me up ....Am I now imagining stuff? The pain feels pretty real and will wake me up....so Hip and back pain....My PSA was taken again last week at a pre op assessment and is now 8.3....I was hoping in light of my lowered second (private clinic) reading of 4.3, it might have been lower not higher than the original 7.5 although the blood was taken only 4 and a half weeks after the TRUS biopsy so this may have a bearing...I should also add that my prostate has been measured on Ultrasound at 56cc or 70cc including seminal vesicles......So this image is small and contained within the gland according to the MRI, and I know that a PSA under 10 isn't terrible, but I also know that a middling PSA does not mean low Gleason and the velocity scares me re bone spread.....Anybody have any insights while I'm waiting these interminable 18 days for the results?..Really sorry for the long winded Bio but just trying to give as much info as possible....Would really appreciate any insights
Thanks
Tony
PS I was diagnosed with an inguinal hernia some 2 months ago and I'm even hoping that that could be contributing to the hip/back pain.....(hernia and hip pain both on right)

You've exhausted all the biopsy and imaging options. If all that didn't find it, it is very likely that there is nothing to be found. Nothing to do but wait now. I would point out that % free PSA of 23% and a PSA of 4.3 aren't particularly worrisome.

For a very rare number of us relying on PSA tests and digital exams alone can get you in a bit of trouble. Depending on which article you read there can be over 24 different types and subsets of prostate cancer. At least two (small cell and Ductal, both quite rare) do not always raise your PSA or result in a positive digital exam. That was my case where for 18 years I had negative digital exams and for 8 years my PSA was around 3 (with 4 or higher being the threshold for further testing). Even with normal PSA levels and negative digital exams I had urinary issues for years that my primary care doctor thought was just "old man's disease". As a result I never bothered to go to an urologist until it was to late. That all changed last January when I ended up having Stage 4 D1, T3N1Mx Ductal cancer. Oh well...

If possible, even if you are cancer free, it would be great if you could get a CT and bone scan. Hopefully they are both negative. In that case they can be used as a control.

I have your concern about body aches and pains. I have/do live an active outdoor life and I have payed the price. I have rotator cuff tears in both shoulders that require surgery (put on hold for now), arthritis in my hands, knees, feet and neck tail bone, bad knees and hips. I also had major back surgery last year to regain use of my right leg. While I have pains everywhere they have once again fallen into "old mans disease". As nothing new has shown up on CT and bone scans I am hoping this is the case. (Note, while they still track my PSA, I am getting scans every six months in case the cancer spreads without raising PSA.)

Like I said, only a few of us are lucky enough to have cancers that are hard to follow. I hope that you do not join that group.

Sit tight until the results of the saturation biopsy come in...That method will find any cancer if it exists......

I can't even imagine why you would have had a PSA test so soon after any biopsy, let alone a saturation biopsy. Why would your doctor order that?

I agree with your GP about the bone scan. Not only a waste of money -- it is a terrible idea - it is not a test for cancer and it is likely to pick up problems that will only cause more anxiety on your part, and lead you into a nightmare of further diagnostics.

- Allen

Allen I know I come across as a major league worrier...Everybody that knows me Thinks I am one of the most laid back people in the world...And usually I am..But I'm sure that I'm not alone in hearing the "C" word and going into a blind panic....I always read your posts with great interest because you obviously are very learned in the ways of the prostate.....I on the other hand have spent 3 months frantically "cramming" because I want to get as much knowledge as possible......trouble is, as the saying goes "a little knowledge is a dangerous thing"....Yes I am scaring the bejesus out of myself, but it's a form of control over something I have no control of......If it wasn't for the very new aches and pains that I'm having (hell they could even be psychosomatic) I wouldn't be thinking of scintagrams, but the pain is freaking me out and it would be something less to worry about if the scan came back negative.
Just so you are aware it wasn't the doc that ordered the blood test, I had to go to the hospital a week before the biopsy to be assessed (They swab you for MRSA etc plus they want to make sure you're not going to die on the table). and it was the assessing nurse who decided on various blood tests the PSA just happened to be one of them....it was 4 and a half weeks after the TRUS biopsy not the big one....I know that 6 to 8 weeks is the accepted time frame which I suppose has skewed the figures a bit, but it was a real downer even so to go from 4.3 to 8.3 ..can't imagine that 8.3 dropping back to 4.3 in that extra 2 weeks...
As ever thanks for your reply
Tony

A biopsy makes a mess out of your prostate..It takes more than 4 weeks for it to heal completely and PSA to stabilize. So the 8.3 is meaningless....Have you read Dr. Walsh's book, Guide to Surviving Prostate Cancer? It will broaden your viewpoint and greatly increase your knowledge about what you MIGHT be facing..