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PSA Velocity over 4 months since UTI

Posted , 10 users are following.

geoff90305
geoff90305

I am 67, and been having PSA tests for the last 12 years. I have no symptoms what so ever with water works, other than a slow stream from birth defect with a uretra stricture. My PSA has always been averaging 2.4.

This year, before my annual blood test due, I got a bad UTI, shakes, shivers, temp 103, pain passing urine, vomiting, dull ache behind pubic bone...overal, not too pleasant. Went on antibiotics for two weeks, and most symptoms went, other than the dull ache behine pubic bone some times.. When all appeared to settle down, had my annual blood test. Ummm, PSA now 7.4. Antibiotics for another 2 weeks, retested 1 month later. PSA was 8.2. Doctor thought such a quick rising PSA was usually Prostatitus, so wait a few months and retest. New PSA last week(some 4 months after first high reading) was now 12.

So, some thing not too right. I arranged for a T3 mpMRI last night and see my general doctor next week. Can't get to a Urologist for 2 months, so I had a look my self at the hundreds of MRI pics after the scan, but no idea what is good or bad, so will have to wait unti I can see my general doctor. He said he can't read the pics either, but the radioligist is the bees knees at reading them, so, have to rely on his notes with the doctors set of pics. When I eventually see the Urologist in October, hopefully, we can sort out what is wrong.

Geoff

0 likes, 115 replies

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  • george28545
    george28545 geoff90305

    Posted

    WOW Geoff what a story.   In short I suggest you see a Consultant privately it may cost you £ 130 but well worth it as PC waits for no man.

  • Pepasan
    Pepasan geoff90305

    Posted

    I don't blame you if you are somewhat panicked by these test results. You are doing the right thing by getting attended to by the doctors. By being so active you are giving yourself the best chance of early diagnosis and treatment, if necessary. Hope you find there is a benign explanation, but if not remember cancer treatments are very effective these days.

    • geoff90305
      geoff90305 Pepasan

      Posted

      Yeah, Pepasan, at 67, most PC seems to take many years to become an issue. Hopfully, mine, if it is PC, is early days yet. I guess the MRI will give me some answers next week when I can read the radioligists report 
  • geoff90305
    geoff90305

    Posted

    Hi George, In Australia, to see a specialist doctor always requires you to wait months. I guess I can shop around to find one, but then we have to pay to see a general doctor to get a written referal to pay to see a specialist. The way it is here. I could visit a public hospital, but then would not see a specialist there either for a few months. Glad PC is a slow cancer....mostly
  • barry65984
    barry65984 geoff90305

    Posted

    It seems to me that this is taking an inordinate amount of time. Two months to see a urologist is in my opinion excessive. My doctor found a minute trace of blood in my urine in mid-December last year and by the end of January this year I had had a bladder exam, a biopsy of the prostrate, an MRI scan and a diagnosis and was on hormone treatment. My PSA at the time was 6.2 and is now 0.2. I think that if there is a prospect of cancer, which in your case I believe is the case, you are entitled to see a specialist within two weeks. I will check this when I next see my daughter (who works for MacMillan) and let you know. You have to insist with some doctors - after all it is you who have the problem, not them. Prostrate cancer is curable if it is treated early, I have friends who have been cured.
    • geoff90305
      geoff90305 barry65984

      Posted

      Probably, getting to see a "good" specialist takes time. They only have so many hours in a day, and are spread pretty thin visiting several hospitals / clinics and their rooms, as well as their traveling. I possibly could ring about and find "any" specialist who could see me sooner, but maybe not as good as the one recommended.

      Anyway, first things first; the diagnosis. MRI scans will be emailed to both doctors Friday afternoon(today)The specalist said if the results indicate urgent action is required, then he would see me next week. If I do not hear from the specalist, I will be seeing my usual doctor Wednesday, who will have the same results of my MRI. We can go through the results and work out a strategy.

      Ironic, my sister has no health insurance, so went the public way. She had a breast screen xray on a Friday. Result was positive for breast lump. Went to a Public Hospital on the Monday with result. They arranged for a biopsy Tuesday. Result on Wenesday said agressive cancer. She had mastomectomy Friday and was back home Monday. 

      I guess health issues never come at the right time. My wife and I are supposed to be traveling to Canada and Seattle in September for 3 weeks.

    • alfred5
      alfred5 geoff90305

      Posted

      My other half has no symptoms either psa 3.9. Age 57 at diagnosis. He just had general blood tests and it was picked up. He had a biopsy with 2 weeks of high psa reading, then MRI very soon after. I think an mri can't detect if you have a small, slow growing cancer. Only a biopsy can do that. The MRI will pick up other problems or if it has spread outside the prostate. So you will probably need a biopsy. Good luck.

    • barney34567
      barney34567 geoff90305

      Posted

      If the radiological report is available soon, and is not good, then I suggest you cancel the holiday and somehow get the report under your urologist's nose, with a view to a biopsy in the next few weeks.

    • geoff90305
      geoff90305 alfred5

      Posted

      Thanks Alfred. This road I am on can take many different directions...all depending on the Radiologists report next week, I can plan from there.

      Geoff 

    • geoff90305
      geoff90305 barney34567

      Posted

      Agree Barney. All depends on the report. My local doctor said , no worries, go on vacation and when you come back get the MRI etc as PC is slow..Umm, maybe correct for most, but some aint...Hence why I got the MRI carried out straight away. 
    • barney34567
      barney34567 geoff90305

      Posted

      It is true that PC is generally slow, but that depends on its Gleason score. A 3+3 is slow and a 3+4 a bit quicker.

      If the MRI report indicates the possibility of anything more aggressive then, it is safe to say it is quick and unpredictable.

  • barney34567
    barney34567 geoff90305

    Posted

    Why did you chose the imaging facility you chose for the MRI?

    Did an experienced  urologist recommend it?

    I ask because there are few radiologists who specialise in reading and reporting on prostate images. And that is what you want.

    An experienced radiologist will be sure to grade any carcinoma on a PI RADS scale. If it is suspicious for cancer, then you can go ahead with the biopsy. 

    The fact that antibiotics did not help, indicates the problem is not an infection and that  investigations that include cancer are reasonable.

    • aksns61
      aksns61 barney34567

      Posted

      (From the US)  Acording to the  American Cancer Society, the ONLY way to identify the type and scope or any cancer in your prostate is with a biopsy. "Procedures like MRI, PET/CT scans and ultrasounds can be used to aid the detection of prostate cancer. " " Cancer can only be diagnosed by a tissue sample." The sooner you get a biopsy, the sooner you will really know about any possible cancer.

    • geoff90305
      geoff90305 barney34567

      Posted

      Hi Barney,

      I chose this imaging facility because they have the best 3T machine here, use coils, and are the imaging facility for a local private hospital specialising in prostate. When I had the test done, had to get the enama to make sure pics clear as possible, and had the contrast towards the end of 35 minute session. Technician said my specialist(who only does Prostate issues) insists only two of their 20+ Radilogists in the practise are allowed to report of his patients studies, as their speciality is the prostate and their results are always spot on. Depending on the results, a MRI guided biopsy will then be undertaken, if the images suggest some abnormality.

      Apparently, many men have a non bacterial version of prostatitus, which do not respond to antibiotics and also have high PSA readings.

      Anyway, next week, I shall know more and will report back.

    • barney34567
      barney34567 aksns61

      Posted

      I agree that a biopsy is the only definitive pre-op means to cinfirm PCa.

      But my point is that a pre biopsy MRI can immeasurably assist the urologist when conducting the Biopsy to target the region that is said, by the MRI, to be 'clinically suspicious' for cancer.

      This involves, ideally, a biopsy that is guided by ultrasound which is fused with the MRI images.

    • barney34567
      barney34567 geoff90305

      Posted

      i understand that some radiologist that specialise in prostate do not require the use of cool. Or an endorectal coil to use its formal name.

      I chose NOT to have the coil.

      If possible I suggest you see if you can forget using the coil.

      the coil is very uncomfortable and adds little to the interpretation of images by a very good radiologist.

      As mentioned earlier, I had a 1.5T scan because I can not handle a 3T given my history. And I chose not to have the coil.

    • geoff90305
      geoff90305 barney34567

      Posted

      Barney, why couldn't you use the 3T machine? I specifically went looking for the 3T, thinking it is "the best". As for the coil cage the technician placed on my lower chest/stomach area, was not really uncomfortable for me..never really thought too much about it. He said the coil made a slight difference to the prostate outline, making it easier to see. The imaging practise had both the 1.5 and the 3.0 machines, as well as the wider tunnel version 

      I did find it very cold in the MRI room and technician placed a blanket over me, otherwise I would have been shaking though the whole scan...not to good for the pics.

      Geoff

    • barney34567
      barney34567 geoff90305

      Posted

      Hi

      When I mentioned the coil I referred to a coil placed in the rectum. This is called an endo rectal coil. And I understand it is uncomfortable.

      I was not referring to a coil placed on top of the body.

      As for me, I had a brain operation a few years ago and have an implant in the brain. Only highly experienced radiographers can scan such patients with a 3T safely.

      Most radiographers I met are not confident that they can scan me safely with a 3T.

      This is not to say that I cannot be scanned safely. Only they say they cannot do so.

      as as for your comment on blankets, note most patients feel better with a blanket while having the MRI.

    • geoff90305
      geoff90305 barney34567

      Posted

      Hi Barney,

      The specialist said if he had a choice of machines, the images with 1.5 and endorectal coil and 3.0 images without endorectal coil, but with pelvic coil, in the right technician's hands can be similar, though, the 3.0 machine had the edge, especially if there is a tumour, and it's evaluation. The procedure is also quicker. Which is also good for the imaging people, as more through put.

      I guess in your case, there would be some worries about your implants with the more powerful 3.0 machine and can understand the technicians being more than a little worried.

    • barney34567
      barney34567 geoff90305

      Posted

      I agree that the 3T scan is, all things considered, better than a 1.5T

      But the #1 priority is a radiologist with particular expertise in prostate imaging.

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