PSA Value 0.6 but with a prostate like a hard lump??

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fred olsen - 07 Jan 2008 18:39 GMT

Hi everybody,
I am from the Netherlands.
Since a few weeks I have problems with urinating (LUTS).
I have seen my doctor and he did a DRE. He said that
my (normal sized) prostate felt like a hard lump with irregular tissue.
I did a PSA bloodtest, but the result was 0,6. So very low.
But I felt uneasy with the result of the DRE and now I am going to
see a urologist for transrectal ultrasound exam at the end of this week.
Despite the fact that I have a very low PSA I am scared to have
some form of prostate cancer.
Should I be scared?
Thanks for your replies.

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Steve Jordan - 07 Jan 2008 20:31 GMT

(snip)

> Since a few weeks I have problems with urinating (LUTS).
> I have seen my doctor and he did a DRE. He said that
> my (normal sized) prostate felt like a hard lump with irregular tissue.
> I did a PSA bloodtest, but the result was 0,6. So very low.

What are the units of measurement? Nanograms per milliliter (ng/mL) or
nanomols per liter (nmol/L)? This is very important. I suspect that the
0.6 is nmol/L.

> But I felt uneasy with the result of the DRE and now I am going to
> see a urologist for transrectal ultrasound exam at the end of this week.

The ultrasound may or may not provide useful information.

> Despite the fact that I have a very low PSA I am scared to have
> some form of prostate cancer.

PSA is *not* cancer-specific. An elevated PSA simply alerts one that
further testing is necessary. For example, an elevated PSA could be
caused by an infection, prostatitis, any activity that stresses the
gland including DRE or ejaculation within 48 hours of the blood draw.

One of the first elements to rule out is infection. A urinalysis will be
informative. Treatment is usually Cipro (ciprofloxacin).

The only known method of reliably diagnosing prostate cancer is a biopsy.

Good luck!

Regards,

Steve J

> Should I be scared?
> Thanks for your replies.

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safire - 07 Jan 2008 20:58 GMT

> Hi everybody,
> I am from the Netherlands.
[quoted text clipped - 8 lines]
> Should I be scared?
> Thanks for your replies.

A low PSA number doesn't mean you don't have PCa, just like a high PSA
value does not mean that you do have PCa.

Your urologist may also do a DRE and, as you do have symptoms, probably
suggest a biopsy with the TRUS, which is somewhat unpleasant but not
that bad. The result of the biopsy may be more certainty about whether
or not you do have PCa. The symptoms could also be the result of benign
prostatic hyperplasia, for which he may prescribe tamsulosin. Even if
you do have cancer, you may, for the time being, want to forego
treatment (generally prostatectomy or radiation) given the unfavorable
side effects. It all depends on your age, the nature and scope of the
cancer (staging and gleason score). Your should not base your choice of
treatment, if any, only on the advice of the urologist.

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Steve Kramer - 07 Jan 2008 23:40 GMT

> Hi everybody,
> I am from the Netherlands.
[quoted text clipped - 8 lines]
> Should I be scared?
> Thanks for your replies.

I believe "scared" is not the correct choice of words. "Concerned" comes to
mind. If you had a 4.0 or 6.0 and a DRE by a urologist, I'd say "scared"
would be a sane emotion. Quite frankly, emotionally, who wouldn't be scared
at any chance of cancer?

PSA and DRE goes hand-in-hand to establish cause for a biopsy. Some people
get diagnosed with cancer with a PSA of 0.6 or less. I have been tracking
PSAs on this NG for several years and have since seen 824 people come
through. Of those who have declared their PSA, only five (5) were diagnosed
with a PSA of 0.6 or less. Of those, to my knowledge, all are alive.

If you are diagnosed with cancer, I'd be happy to give you their emails,
since they no longer frequent the NG, but at 0.6, it almost seems a waste of
time typing them in.

Good luck and keep us apprised.

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