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Do I need to be concerned for prostate cancer?

sealion
Posts: 2
Joined: Jul 2021

PIRADS 5 lesion 4.1 x 3.1 cm, one side of prostate only.  PSA 0.9. Age 40. Several suspicious rectal lymph nodes lit up on the MRI. Leg has pitted edema on the side with the lesion.

In very poor health, breathless and tired all the time. Having urinary and prostate symptoms. Family history of early onset cancer in both parents and sibling.

They are scheduling biopsy for a month out.

Do I need to be concerned for cancer and go for second opinon to get the biopsy done sooner or is the long wait for biopsy standard practice? Was told after the biopsy it takes 2 weeks for results. So I am looking at about 6 weeks to knowing what this lesion is. I was told lesion is suspicious for cancer but probably slow growing so there is no rush.

hopeful and opt...
Posts: 2335
Joined: Apr 2009

Prostate cancer is very slow growing, so you simply need to purposefully test to determine where you stand, as your medical as indicated. You can use this time to educate and learn about prostate cancer and treatments, just in case. 

I wonder did you have a digital rectal exam, were the result normal or abnormal.  What were your psa numbers? 

sealion
Posts: 2
Joined: Jul 2021

Digital rectal exam is extremely painful and caused profuse bleeding. They haven't done one in a while (couple months) but it was abnormal. There is some suspicion it might be cancer in the rectum but I haven't had a biopsy yet. PSA was 0.9. I had a pelvic MRI a about a year ago and no prostate lesion, so this must be recent.

hopeful and opt...
Posts: 2335
Joined: Apr 2009

Not an expert, but aside from the suspicious lesion in the prostate, these symptoms can be attributable to something else rather than prostate cancer

Georges Calvez
Posts: 542
Joined: Sep 2018

Hi there,

I would not rule out prostate cancer, but it is possible that you do not have it.
An MRI is indicative rather than conclusive, and your PSA is very low for a case of prostate cancer.
Prostate cancer is normally not invasive at the beginning, it sits in the prostate and grows slowly, often for many years if it is not detected.
Symptoms are minimal at first and may be mistaken for ageing, etc.
A month or two waiting for a biopsy is usually of no significance in prostate cancer, as it grows so slowly.
I would ask your doctor if you have something else, as some of your symptoms are very unlikely to be or never associated with prostate cancer.

Best wishes,

Georges

larra
Posts: 2
Joined: Jul 2021

Get the biopsy and if still concerned get another one

as my first biopsy came back low grade cancer and my second higher

grade.

Max Former Hodg...
Posts: 3690
Joined: May 2012

As someone above mentioned, the specifics of your case sound more like perhaps a colo-rectal cancer than prostate.  This is based upon profoundly low PSA; it is very close to impossible for a prostate cancer with a PSA of .9 to nonetheless be so aggressive as to cause bleeding and lymph node involvement.   NOT impossible, but damn-nigh close. 

Nonetheless, the bleeding and amount of pain warrants fast diagnosis.

Max Former Hodg...
Posts: 3690
Joined: May 2012

sealion,

When I was 30, I developed a severe UTI and prostatitis about a month after hospital discharge. Apparantly the infection developed from having a cath in for 25 days in ICU, after a severe auto crash.  I went to a urologist with unbearable pain and fever.  He did a DRE, said it was very swollen, but felt nothng solid; he said it had to be from infection, which a culture had already confirmed.  He 'expressed' the gland, and there was a lot of bright red blood.  A lot.

Guys with PCa seldom present with urinary bleeding, especially in early stages.  My point is that other things do cause UT bleeding.  It does not sound like you have infection, or your temp and cultures would indicate it.   I am of the layman's opinion that your issue may lie elsewhere, however.   Be aware that cancers other than PCa can enter the prostate (or anywhere else in the body), but such a cancer is NOT PCa, but a cancer from the source-organ.   You just need biopsy information to get a solution rolling.  Scans cannot definitively provide diagnosis of any cancer, but are often highly vauable as regards staging and probable source.

lighterwood67's picture
lighterwood67
Posts: 298
Joined: Feb 2018

If I were you, I would be going to see a gastroenterologist.  Maybe a colonoscopy and endoscopy may be in order to see what is going on.  Good luck on your journey.

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