Over-concerned wife or Not?

rinbea
rinbea Member Posts: 3 Member
edited November 25 in Prostate Cancer #1

I hope someone can help me clarify my concerns. Husband is 54yrs old with high blood pressure (medicated) & on testosterone for (Low T.). He is not a smoker, but drinks alcohol nightly. Because of his testosterone injections, he regularly has bloodwork done. 

12 days ago he had a bloody ejaculation and it has been bloody every time he has sex (8 times). Not a little drop of blood, but red bloody.  No other symptoms, no pain, no urine hesitancy and no problems with flow output or frequency.

During this time he had his regularly scheduled blood draw and his PSA came back high 4.4.

2010-2017 -PSA ranged from 1.1-1.2

2018 -PSA 1.7

2019 -PSA 1.9

2020 -PSA 1.9

2021 -PSA  2.2

May 2022 - PSA 2.6

Nov 2022 - PSA 4.4

Today we went in to his Urologist. He is a young guy with great credentials, and has written papers on Prostate Cancers. They had him do a urine test (there was a trace amount of WBCs). And the doc said he wanted him to do a month of antibiotics and retest PSA in a month. If it’s high again, then he would do a MRI / 3D Fusion Prostate Biopsy.

I told the doc my concerns: Hubby’s PSA has increased by almost 2 in just 6 months and isn’t that a indicator of possible cancer? The doc said he wasn’t worried about that since he had bloody semen and there was WBC in his urine. He felt sure it was Prostatitis.

I also said Are you going to do a DRE? He said no we don’t do those anymore.  I said, then how can you be so sure. He said the only sure way was to do a biopsy and he said it would be premature to put him through that when he felt sure it was inflammation. He said your husband is the third man I’ve seen today with blood in their urine.

I mentioned that his father had Testicular Cancer, it metastasized and he died at age 54. The doc said there is absolutely no correlation to that and Prostate Cancer so it was not a factor.   

In the end he was put on 28 days of antibiotics and made an appointment for a PSA in 30 days.

Hubby is a Reactive type of person (he waits for the fire and then puts it out.) I am a Pro-active person, (I anticipate the fire and try to mitigate the risks before it happens.) I’m afraid that it could be cancer and we are wasting valuable time allowing it to possibly grow. Am I being overly negative and overly worried?  Do I need to chill?

Comments

  • eonore
    eonore Member Posts: 135 Member

    Hi,

    I understand your concern about delay, but be advised that prostate cancer is typically a slow moving disease and your Doctor is following a prudent course of action. An infection can cause the bloody ejaculate and the rise in Psa. In fact, sex within twenty four hours of a Psa test can cause an elevated reading. A 4.4 Psa is a cause for further investigation, but is not so high as to form any immediate conclusions. Your husband’s Doctor seems to be on top of things, so stay patient and stay the course.

    Eric

  • Old Salt
    Old Salt Member Posts: 984 Member

    Agreed with eonore; no reason to worry right now.

    Note that sometimes prostatitis is caused by a virus; if so, an antibiotic won't help.

  • fallonboy
    fallonboy Member Posts: 27 Member

    I think your doctor is on the ride path.

  • VascodaGama
    VascodaGama Member Posts: 3,549 Member
    edited November 25 #5

    Hi, Pro-active lady.

    I concur with the opinions of above survivors . Your husband's doctor is following the recommended procedure and by waiting one month in the diagnosis he is not losing time for a needed treatment, if any. Prostate cancer does not spread overnight.

    Surely the doctor could have done the DRE but such wouldn't alter the course in the diagnosis steps. DRE doesn't diagnose cancer.

    WBC in urine identifies inflammation and the blood in ejaculation should be checked firstly.

    It could be a cause of testicular inflammation (epididymitis, orchitis) or inflammations at any organ of the urinary system (the kidneys, bladder, ureters, urethra).

    Infection caused by a sexually transmitted bacterium (Prostatitis, Cystitis) or excessive sexual activity or masturbation also can lead to bloody semen.

    The constant increase of the PSA since 2017 is worrisome and could provide possibilities to prostate cancer but it also doesn't identify cancer. The biopsy is the ultimate means to diagnose it.

    Testicular cancer usually is considered when it is found a lump or swelling in either testicle. However it usually causes pain or discomfort at the lower belly or groin.

    The course of diagnosis is set. It starts by obtaining a "clean" PSA followed by image studies (MRI) and a biopsy.

    Meanwhile I would recommend your man for abstaining from the testosterone intake until the just cause is found.

    Best

    VG

  • rinbea
    rinbea Member Posts: 3 Member

    Thank you for the response. Your experience is much appreciated.

  • rinbea
    rinbea Member Posts: 3 Member

    Thank you for going over each of my concerns. Your response has allowed me to stop and take a deep breath. I'm just so scared. His next PSA /Consult is scheduled for Dec 29th. I'll post an update when we have the results. Thank you