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Are "rough spots" on the gland always cancerous?

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Posted 2/28/2009 8:17 AM (GMT -5)
A recent prostate exam showed that I had a"rough" spot on the gland. I failed to ask the doc the simplest and most important question: are these rough spots ALWAYS cancerous or are a good percentage of them non cancerous? So many of you have already been through this initial phase of "surprise and shock", that i was hoping someone might have some idea about this. Thanks
Posted 2/28/2009 10:04 AM (GMT -5)
Hello and welcome here wanderer. I am assuming from your post that you had a DRE, digital rectal exam, and the dr. felt these "rough spot" upon his examination. What did he suggest next? Did he sugest a prostate biopsy? Did they do a PSA test before the DRE? Kind of help to know the sequence of events here.

I understand your fear and worry, but without further test(s), be hard to judge your situation. If you want a simple yes or no to your question, yes its possible not to have cancer with a "rough" spot being felt, but often PC will also show up as an enlarged or rough area upon a DRE.

You can always call your dr. back and ask him/her point blank, and see if any other tests are needed at this point. Also, how old are you?

David in SC
Posted 2/28/2009 10:28 AM (GMT -5)
Hi Dave...and thank you so much for the reply to my question. I am new to the site so failed to provide additional information about myself. I am almost 61. I have had symptoms of prostatitis for a number of years but have been able to deal with it with little problem. about a month ago I started to notice that my urine was very dark and smelly, and I was getting up at night to urinate...something I never have to do...so went to the family doc and was put on Cipro for 15 days. That seemed to help a bit and I scheduled a visit to the Urologist. The PSA test showed no problem at all and he found no blood in the urine. He did a DRE and found a small "rough " spot and has scheduled me for a biopsy in a month. I guess I sort of "blanked" out as he talked to me and just didn't bother asking any questions...very unusual for me! I know my question is pretty open-ended and any anwsers i get will be just "guesstimates" ut I do appreciate for response...Thank you!
Posted 2/28/2009 11:03 AM (GMT -5)
Ok wanderer, the additional information helps to understand what is going on. Trust me, you blanking out so to speak is common and expected. The prospect of having cancer, let alone Prostate Cancer, is frightening at best, so don't feel bad about that. Most of us with it, go through a period of shock and awe after we get the dx. Good, your dr. has scheduled a biopsy, hopefully, it will give you a clear up or down answer to it, but to be honest, its not always that cut and dry. It took 3 biopsies spready over 18 months before they found it in me, there is one fellow here, that I believe has had 13 biopsies. Hopefully, yours won't be cancer, and until you are told differently, I would try to put it out of your mind, and do all the things you like to do. The fact that your dr took the rough spot serious enough to order the next step means hes at least on top of the situation. Will be hoping the best for you.

David in SC
Posted 2/28/2009 11:18 AM (GMT -5)
wanderer, Welcome to the Forum. When you say the PSA test showed no problem at all, did the doctor give you a number-what it actually read?
Posted 2/28/2009 11:20 AM (GMT -5)
Hi David...again thanks so much for the second reply! Believe it or not...after reading your post here I actually feel encouraged a bit and feel a bit better mentally!!! I've been doing a lot of reading the past 24 hours and it has become quite freaky to say the least! After reading about PSA's (mine was 1.0) it appears that they really don't give a very good measure of the depth of the problem but i guess it is better than being told it is 6.0 (for now anyway)!! There seems to an argument in the field about how doctors are doing to many biposies and operating on patients who may actually not need them but for now I guess I am still lookng forward to having it done.

I do hope that your experience with this is turning out for the best for you!!! Thanks again...you've been a great help to a frizzled mind here!!
Posted 2/28/2009 11:25 AM (GMT -5)
Hi James...thanks for the reply...Yes the PSA reading was 1.0
Posted 2/28/2009 11:44 AM (GMT -5)
Well, my new friend, the best way to overcome fear, panic, and aniexty about cancer or its possibility is with knowledge. Knowledge of the cancer, knowledge of treatment options if it is indeed cancer, knowledge with your local medical resources. Hopefully, you have good family and friends to support you too. That really helps if you do. We here, at HW, stick together good or bad, and are here to support, teach, and encourage each other. We share both sad news and good news equally, it's a brother hood here, of men and their families with a very evil and common enemy, Prostate Cancer. So hang in there, enjoy yourself while you are waiting. Life is precious, life is wonderful.

David in SC
Posted 2/28/2009 11:51 AM (GMT -5)
Again ...thanks David! Your advice is sound and practical and you are right...time to look at the glass as half full and not half empty! I am thankful that I have found this site. While it is sobering to read of the anguish, problems and difficulties that those on this site are going through, it is also so good to see the willingness of folks like yourself to take the time from your own worries to lend a helping hand to others here. Thanks for the support!
Posted 2/28/2009 11:13 PM (GMT -5)

I don't know if this will help or not, but my local urologist said I had a rough spot, he called it a "phlebus" for the past 10 years. I never heard of this term before, could not fnd it on the internet anywhere. Anyway, he never worried about until last year, when my PSA went from 1.9 to 2.85 in one year. First biopsy "suspicous for cancer for diagnostic" , second biopsy in 08/2008 showed early prostate Ca in 2/12 cores. I had robotic prostatecomy on 09/11/08. If the PSA doesn't change I think you are OK, if and when PSA elevates it's time for the biopsy, just keep on top of this issue, it may save your life someday....................

Posted 3/1/2009 6:28 AM (GMT -5)
I was told that nodules found during a DRE could simply be a calcium build up. And that it'd take a biopsy to tell for sure...I sure had high hope there for a while but lost the coin toss.

Posted 3/1/2009 11:23 PM (GMT -5)
Steve's right. It's common for there to be calcifications present after about 40ish. I don't understand why Doc's don't just tell men this when they do an exam.....grrrr :>l

swim
Posted 3/2/2009 10:35 AM (GMT -5)

Hi Wanderer:

...and welcome.  Hope your stay is brief and that you do NOT have PCa. 

Re the rough spot/nodule, as Steve and swimom indicated, this could very well be a calcification.  With your low PSA and no symptoms of infection, most docs probably would do as your doc has suggested and ask that you get a biopsy.

On the positive front, less than 50% of these nodules turn out to be cancerous, and with your low PSA, I hope you are in the non-cancerous 50%!!!

Good luck and keep us posted.

Tudpock

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