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Posted 4/18/2018 2:12 PM (GMT -5)
Hello all,

Been lurking a bit and reading but it’s time to introduce myself.

I’m 49 with symptoms of BPH for a few years now (slow stream, frequency, and nocturia but no start-stop and only rare dribbling).

My father was diagnosed with BPH at late-50’s but no family history of prostate cancer.

Had a recent DRE with my family doc and he noticed significant enlargement with no nodules but definite asymmetry to the right lobe.

A few days ago I got a call from my family doc and my PSA is 19.5. No recent sexual activity, no bike riding, no infection (as far as I know), etc.

I am aware PSA is not a cancer test but rather a “prostate activity” test but my family doc did express concern about a number that high in someone my age with no good explanation.

I am currently waiting for an appointment with a urologist and I’m a little concerned. I am thinking he may want to repeat the PSA and then maybe head to biopsy but time will tell.

Thanks for letting me share.

Marc

Post Edited (Thomarann) : 4/18/2018 8:16:20 PM (GMT-6)

Posted 4/18/2018 2:32 PM (GMT -5)
Welcome to HW,

are you taking any meds for BPH? Best to get the URO to do an evaluation. It's possible that your PSA is due to BPH. There are other tests that the URO can do like PHI (prostate health index) that might give you better data. A PSA retest in a few weeks/months is a good idea to confirm and rule out any testing issues.

You might needs some meds for the BPH which could change the whole PSA picture.

I know it's hard not to be concerned, but what you have is a mystery without many answers. What you need is more data and that visit to the URO.

Hang in there and let us know what the doc says.
Andrew
Posted 4/18/2018 3:16 PM (GMT -5)
Andrew, don't you think his URO will want to get a biopsy? Based on his urinary issues and high PSA?
Posted 4/18/2018 3:30 PM (GMT -5)
I think that it's good that you have a uro on the case. But there's so many things it could be besides PCa, so to the extent that you can put that out of your mind, I would certainly try. (I know, easier said than done.)

Do keep us posted...
Posted 4/18/2018 3:47 PM (GMT -5)

dbell said...
Andrew, don't you think his URO will want to get a biopsy? Based on his urinary issues and high PSA?

No, first step is to rule out all other causes. BPH, could account for all the symptoms and PSA. I would expect the URO to repeat the DRE, order a new PSA test in a few weeks, maybe recommend an ultra sound to determine prostate size, and likely recommend some meds to reduce the prostate size.

Biopsy shouldn't be on the radar at this time.

Of all the things Marc needs to be concerned about, a biopsy isn't one. The BPH meds alone should give relief for the symptoms and even reduce PSA.
Posted 4/18/2018 5:41 PM (GMT -5)
Thanks for the reassurance.

No, no BPH meds yet so hopefully that’s all it is.

The studies I read saying PSA > 10 but < 20 and abnormal DRE are associated with PC 40-65% of the time do give me concern tho.

I will keep you posted but that Urologist can’t call me soon enough.

Marc
Posted 4/18/2018 6:25 PM (GMT -5)
DREs are a bit subjective and family doctors aren't exactly the experts in that so you'll want the URO's input on that. Frankly, I'd get on the meds first and then see what happens in a few months.

PC is a slow grower so even if (big if) you have it, you've got plenty of time for tests and treatments.

Andrew
Posted 4/18/2018 7:36 PM (GMT -5)
Prostatitis would be my first guess based on the symptoms. Unfortunately, it seldom responds to antibiotics and is hard to diagnose. The best way is to just wait - if the PSA goes down, prostatitis is probably going on. Try to put a number on "significant enlargement" too. The Uro can do an ultrasound from the front and get a pretty good estimate.

I agree that PHI would be a better test than just PSA.
Posted 4/19/2018 8:29 AM (GMT -5)
You could also start a round of Avodart. This will shrink your prostate and lower the PSA. If it is BPH this will help. If it is cancer, then the PSA will continue to rise and may be easier to detect a trend. Then it would be time for a biopsy.
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