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Medical Forum / Diseases and Disorders / Prostate Cancer / September 2005TRUS on Thursday - worried
Hi, I am sure that I am being premature - I am a hopeless "worst case scenario" person. But here is where I am. I went for my annual physical a couple of weeks ago - and when I mentioned to my primary physician that I had had a short bout of blood in my semen (just a few times - resolved on it's own), he referred me to a urologist. I have had both DRE and PSA screening for the last several years (at least) - never a problem up until now. I had my last PSA in December 2004 and it was 0.5 - which the urologist said was great. He also said that the semen issue was not a concern since it had cleared up. But he did feel an irregularity during the DRE - a small nodule ("peas-sized"). He had a colleague feel it and they both decided that a TRUS was in order. Of course - since that moment I have immersed myself on websites on prostate problems. And I feel like I have to urinate all the time - didn't notice it until now. I suspect that that symptom may be psychosomatic. I have also had lower back and leg pain for a couple of years (during which time I have had at least 2 low PSA's. And I am sedentary and desk-bound at my job. The leg pain is very much related to heavy use - if I walk a lot (say an afternoon shopping trip) it is hard to bend my knee. With rest, it gets much better. My back pain is usualy apparent only when I arch my back significantly. But of course I worry now that those pains are related. I realize that PSA < 10.0 is pretty strongly counterindicative of bone metastasis - so perhaps I am being a bit overreactive there as well. I don't my latest PSA yet - I read that a DRE can cause an artificial rise, so I held off on having it drawn until yesterday (the DRE was last Thursday). My urologist says that he has seen plenty of cases of DRE's like mine with negative TRUS/biopsy results and that what he felt may be a stone or BPH. In fact he said "most cases." But I have these fears nonetheless - of my PSA rocketing up to metastasis levels and so on. I am 52 years old and I realize that any panicing is premature - but that has never stopped me before ;) I'd appreciate any thoughts you might have. Ken If the results come back as cancer, then before any treatment, consider a second opinion. I was diagnosed with prostate cancer and was scheduled for a prostatectomey, but took my sides for a second opinion and was told I did not have cancer, only P.I.N. cells, which used to be considered precancerous, but the latest thinking is they do not know what it means. Prostate cancer is a difficult one for the oncologist to properly identify, just look at the number of web sites by medical schools that try to demonstrate the difference between cancerous and non-cancerous cells. By the way, P.I.N. cells are very common. Really. I have never heard of a false diagnoses after biopsy. That's interesting.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > If the results come back as cancer, then before any treatment, consider > a second opinion. I was diagnosed with prostate cancer and was [quoted text clipped - 5 lines] > schools that try to demonstrate the difference between cancerous and > non-cancerous cells. By the way, P.I.N. cells are very common. Ken, Relax. Even if you do have cancer, it will be curable. jimhoney standard RRP age 52, cured, no significant aftereffects > Hi, > [quoted text clipped - 36 lines] > > Ken Ken: It is extremely unlikely that a 0.5 PSA would "skyrocket" to bone metastasis within the time that you've stated. However, the abnormal DRE should be examined further to rule out PCa. The aches and pains that you feel are probably just that, aches and pains, not bone cancer. Get second and even third opinions before agreeing or proceeding with any treatments other than the TRUS. (This, of course, may be moot). Also, in the event that it is PCa, and hopefully that is not, read, research, and read again before rushing into any treatments. Good luck and keep us posted. You came to the right place for information with all of very knowledgeable people here. B.A. Thanks so much for answering. I've done a lot of reading on this newsgroup and I realize that many people here have far greater things to worry about than I. As I said - I'm a "worst case scenario" person. Maybe that comes from 23 years working in IT. And I'm a natural born worrier - always have been. Thanks Ken Ken, If we had better things to do than worry about those here, we wouldn't be here. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Thanks so much for answering. I've done a lot of reading on this > newsgroup and I realize that many people here have far greater things [quoted text clipped - 4 lines] > Thanks > Ken > Hi, > [quoted text clipped - 24 lines] > read that a DRE can cause an artificial rise, so I held off on having > it drawn until yesterday (the DRE was last Thursday). Most likely there is nothing specially wrong with you. But there is some chance you may have an early prostate cancer, so it is wise to have a biopsy to rule it out. In the unlikely case you do have prostate cancer, there is an excellent chance it can be cured, in a man your age, with minimal side effects. As to the back pain, welcome to the human race! 80 percent of the population has significant back pain some time in life. Back pain does occur as a symptom of late, uncontrolled metastatic prostate cancer, but it is highly unlikely with your history that such is the case. Similarly for urinary problems. There is an old saying in medicine. "When you hear hoof beats, don't think zebras." You are thinking about zebras where the only zebras are in the zoo. You shold seek help about your back pain. It can get a lot worse and cause you a lot of trouble, although it is not fatal. Appropriate stretching and strengthening exercises, together with some minor life style changes, can help you avoid problems down the line. > My urologist says that he has seen plenty of cases of DRE's like mine > with negative TRUS/biopsy results and that what he felt may be a stone [quoted text clipped - 3 lines] > I am 52 years old and I realize that any panicing is premature - but > that has never stopped me before ;) I share your predilictions. Believe me. It doesn't do any good. > I'd appreciate any thoughts you might have. > > Ken If you are panicking, then yes, it is probably premature. If you're worried... well, I guess that's an intelligent response. Do you know what your PSA was before this last one. If it was 2.5 and you have a pea=sized nodule, then I'd be concerned. But, you are correct in your apparently assumption that your aches and pains are hardly related. Continue your intelligent response to questionable data. Check it out and deal with it if it proves to be bad. Until then, you have a visitor's pass to the NG and we hope you never become a member. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Hi, > [quoted text clipped - 36 lines] > > Ken > If you are panicking, then yes, it is probably premature. If you're > worried... well, I guess that's an intelligent response. Do you know what > your PSA was before this last one. If it was 2.5 and you have a pea=sized > nodule, then I'd be concerned. Of course, I meant 0.25. I don't recall the previous value - hopefully the new one will be ready by week's end. Of course, there's a slight problem there as my HMO changed its lab service provider and I've read about the variability factor. But the biopsy should tell the tale either way. The fellow who does my guitar tech work had PCa last winter - I think his PSA doubled (something like 3.5 -> 7.x) in a year. He had RP and was back at work in a couple of weeks. Many years ago, I did hospital lab work (late 70's - very early 80's). I seem to recall then that statistically 1 in 20 tests were wrong. Of course that was chemistry not RIA. When I know one way or the other, things will be much better. Ken Ken S, I'm very sympathetic. I was 50 and feeling well when I went for a checkup. I found out I had lost 15 lbs, was anemic, iron deficient and had an elevated PSA. I was insane with worry. The odds are good you don't have cancer. If you do have it, odds are good you are going to do well with treatment. Waiting and not knowing was the killer for me. Get the biopsy and get it over with. My PCa stuff is: age 50 PSA 4.5 Bx showed High Grade PIN 5 months later PSA 5.6 repeat Bx 1/12 cores <1mm gleason 3+3=6 stage T1c RLRP (DaVinci) 2-11-04 at age 50 Favorable path, 5 small foci of 3+3, organ contained Post op PCAs <0.1 I was able to go home 20 hours later, and back to work day 6. I never leak, and I've gotten most of my erection back. Steve U
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