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Looking for advice about an elevated PSA

Preacher49
Posts: 3
Joined: Jan 2017

New guy here and really lost and concerned. I'm 44 and I have been having problems with my prostate for over a year now. Frequent urination, up 2-3 times a night, some pain when urinating but not every time, dribbling, pain when I ejaculate, etc... Finally pushed past my hard head and myself saying; it will pass, and went to my PCP. Explained everything and he suggested a PSA test. Now no one that I know off except one uncle has had prostate cancer; which he passed from, but all types of other cancers in my family line. So PSA came back at 5.1. Did some research and from what I can tell for my age this is high. So he suggested that it may be prostatitis and gave me Cipro and told me to come back for PSA recheck. I have that scheduled for the 24th but I also believe I will request PSA, free PSA, and PHI this time. Should I stop fooling around with my PCP and go straight to a urologist? I'm lost but this is something I don't want to fool around with. So any advice will be greatly appreciated!

A88M
Posts: 15
Joined: Oct 2016

Could very well be prostatitis?  wear protection.  If symptoms dont improve with abx go to urologist.  Younger and younger patients are being diagnosed with PCA.

Old Salt
Posts: 720
Joined: Aug 2014

What your doctor has recommended appears to be standard protocol. I would definitely wait for the result from the next PSA test and then decide whether a biopsy is advisable. The symptoms you have described are typical of prostatitis.

PS: Also ask for a Digitial Rectal Exam at your next visit and be sure to refrain (for two days or so) from activities that might raise your PSA prior to the test.

 

Wishing you the best outcome!

VascodaGama's picture
VascodaGama
Posts: 3013
Joined: Nov 2010

P49

Prostate cancer do not express pain. The symptoms you have listed are typical of inflammation that could be a cause of infection, prostatitis (involving pain) and hyperplasia. These all cause the PSA to increase. Apart from the above, riding a bike, a horse, sex or masturbation or stressful exercice of abdomen muscles the day before drawing blood for the tests can increase its value.

I do understand your concern in regards to your uncle's PCa case. That puts you at double risk for contracting the disease. My son of your age is 3 times at risk so that he started to check the PSA annualy since he became 40 years old.
In any case, the first step is what your doctor recommended; Cipro for about 3 to 4 weeks is the way to start with. This is not fooling around. From there, if the PSA shows constant increases and you continue to feel pain when urinating, then you should consult an urologist.

Best,

VG

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3295
Joined: May 2012

Preacher, I agree with the others that you are doing enough for the moment. Give the antibiotic a chance first, before assuming bad things.

I was in ICU for weeks years ago (accident-related), and after getting out got horrible prostatitis.  It is profoundly painful, as are most UTIs. Urologist's DRE caused blood to fly out...not meaning TMI ("too much information"), but that is how bad it was.  UTIs (urinary trac infections) can be very hard to treat or cure; relapse with the infectiion is common, and more antibiotics required.  I was going back-and-forth for at least  six months, as best I can recall.

As Vasco noted, PCa (prostate cancer) almost never causes pain, and also almost never caused blood discharge, such as I had.  Until the infection is well cleared, I would not trust PSA results very much.  Your symptoms sound more infection-related, at least for now, but DO follow-up. Also, PCa, unlike most other cancers, is virtually never a "rush" situation, since it is 95% of the time an indolent/slow-moving disease.

max

Grinder
Posts: 440
Joined: Mar 2017

Don't know if you still are seeking comments, but here's my experience. I had a recurring prostate infection over a ten year period. Each flare-up knocked me down. Trips to the ER to have Foley catheter inserted (I hate them). Cipro finally failed to work too. Biopsy showed a staph infection either recurring or brought on by the catheters. (Self cathetering is absolutely the worst). Then BPH symptoms started up as well. This was threatening to disrupt whole life style. I was finally to the point of taking Flomax daily just to be able to avoid the ER and another Foley catheter. Finally, two things happened, a friend had a prostatectomy and my neighbor died of prostate cancer. I took the advice of both and had my doctor look into scheduling robotic surgery. Also had biopsy for PC (I hate the PC biopsies too) that showed typically dormant inactive PC cells. But on the post mortem warnings of my neighbor and reassurances from friend, scheduled the Davinci prostatectomy. BEST DECISION EVER. The actual operation was the easiest experience of the past ten years. Had incontinence for a while but that cleared up. 

I would say to you, if the infection reoccurs, it may well continue to reoccur several times, and eventually BPH as well. If it gets to the point where it is ruining your life, you don't have go panic and think this is your life from now on... You have the option to schedule DaVinci robotic surgery with an EXPERT surgeon at a hospital with an excellent track record. This will solve your infection problem, your BPH, and most important, any possible PC metastasis which will be fatal.

Then again, nothing may happen. That would be great. But you can rest assured that surgery is available if it ever comes to that. 

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