Partner has high PSA and burning, booked for biopsy.
Posted , 10 users are following.
My partner (50) has never had any major health issues. Four months ago he began needing to pee frequently and went to gp with a sample expecting antibiotics for UTI. His sample was clear of infection but he was put on antibiotic while it was sent to lab. Symptoms didn't ease and he had burning sensation at tip of penis most of the time. No stds detected. A blood test was taken to check PSA and it came back raised at 7.2. He then went private to a leading urologist who said it could be either enlarged prostate or prostatitis and gave him a different antibiotic. Meanwhile he had a very painful urinary retention and had a catheter for a few days. Four weeks later he had another PSA test and it had gone up to 9.5! Naturally we are worried. The urologist consultant took another test(2 weeks after the 9.5 one). We have not found out the result of that yet but have been told that biopsy is recommended. The burning eased off for weeks but in the past couple of days has increased to a stage now where it has taken over daily life. A urine sample tested at home with professional testing strips showed high levels of white blood cells which I took to mean an infection was present in urinary tract somewhere. However his gp says it is clear, only 2 days later!! I am concerned that if he is biopsied with an infection present it will let the infection into the blood stream and he will end up really ill. I just wondered if anyone here could shed some light on any of this, doesnt sound like Pc me, more like BPH or prostatitis. Think the consultant opted for biopsy route when level rose by 2 points in space of 4/5 weeks. I thought catheter would have been cause of raised levels, he had retained an enormous amount of urine and prostate was bound to have been swollen. He now has a pain inside which he never had before retention. Any help or advice greatly welcomed thanks.
0 likes, 24 replies
caz11527
Posted
Thank you all so much for your help. I want to locate a private clinic in our area where he can have the PCA3 test and depending what the result of this is, have a 3TMRI scan. It may mean transferring to another consultant but if I were him I'd be going to one anyway for a second opinion. He has been scared into accepting that biopsy is only way to tell what is going on inside the prostate. To me it seems important middle steps are being missed. He can't see this because he has put all his faith in the expert consultant, whom he had never heard of before August. I will let him read all of your posts and hopefully he will then see that more needs to be done.
Howard31850 caz11527
Posted
Neil
craig84609 caz11527
Posted
Before jumping into a biopsy. Read some health journals on it. Biopsy itself isn't very accurate. It misses cancer because they blindly shoot needles into the Prostate and can miss it. If nothing turns up you can bet on more Biopsies in the near future. A 3T MRI will show if cancer is present and will give them a target for the biopsy and a PCA3 test will tell if a biopsy or MRI is even needed. Believe me, this was me a few months ago. My Uro started talking about a biopsy even though I had not had a PSA test yet, due to my symptoms. I am now much improved. I mentioned the PCA3 test to her and she said well there are some new tests out there, but she wasn't willing to give me one, but she was willing to schedule a biopsy if my PSA was high. At least get a second opinion. A biopsy can be really dangerous with an infected organ.
BobbyT caz11527
Posted
Also, there are different PSA tests by different manufacturers and they can not be equated. You need ot be sure that the exact same test was administered from the same test provider.
They need to test for bound vs. free PSA and determine the ratio. Then look up that ratio on an age chart.
Keep asking questions. Best of luck.
geoff90305 caz11527
Posted
I would discuss with your urologist about a 3T MRI to confirm if there is anything serious going on before a biopsy. At 67, I have been having PSA done for many years, so had good graph points to measure recent UTI effect on my prostate PSA. My PSA went from 2.4 average to 13 in 4 months after the UTI. My urologist said we should get a biopsy asap...But, upon further discussions and looking at my PSA graph, he thought the spike was too high too quick for PCa, and put me on 6 weeks of cipro. ( I had no side effects at all) Now, 2 weeks after the cipro antibiotic, my PSA has returned to 12. Urologist said it may take 12-18 months to return to previous levels because my prostate has prostatitus, BPH and is enlarged. A recent 3TmpMRI said nothing serious was found (PIRAD score 2) which again supports the no biopsy. However, if the PSA was to start to rise again with no UTI, then a biopsy would be on the agenda.
caz11527 geoff90305
Posted
Hi Geoff,
Goodness, that sort of reinforces what I have been thinking regarding him having a UTI. Why oh why won';t the doctor send the sample off to lab to double check?? As was previously mentioned it's most likely all about the cost. His urologist surprisingly has not yet mentioned the existence of the 3T MRI, it was only on this brilliant forum I learnt of it. My partner would be paying for this himself so no idea why he wouldn';t be informed of the option. I have located three different clinics/hospitals where the scan could be carried out. It means a flight to the mainland but that's not an issue. His PSA was 7.2 in late August and 9.5 two months later. It seems this quick change has warranted a biopsy even though after a bladder scan in a local hospital he was left in agony with acute retention and had to have a catheter in. I'm no expert but I do maintain that this should be taken into account. His PSA on the day of retention could have been sky high and the 9.5 reading could have been it on it's way down. All I know is that they want to do another PSA in January and then proceed to biopsy depending on whether it has came down or increased. They seem focused only on biopsy.
derek76 caz11527
Posted
A flght to the mainland amused me and reminded me of my second urology appointment in 1995 when I was told that I needed a TURP as a matter of some urgency ( I actually waited about nine years for PVP to get here)
He said that I could go into retention at any time and not to be too far from an A&E and not to visit any islands. He rolled his eyes when I said that we were planning a trip to Zambia. I never did have retention and we visited a lot of island and remote places before my PVP though I avoided long bus journeys. As soon a I had my PVP we went to NZ and travelled around by bus for a month on busses without toilets.
geoff90305 caz11527
Posted
Hi Caz,
Where do you guys live?
I guess you do not have any PSA history to look back on, mostly, because your partner is so young to have many. Well, at least his PSA journey has begun.
Interesting you talk about bladder issues. I just read a medical paper talking about higher than normal PSA readings when there has been any bladder retention, and a catheter being involved just made it worse. They were talking about at least a 8-12 week wait before a PSA test due to the irritation of the prostate.
A cancer can only grow so quick to change the PSA level. We talk about 'doubling', which is the PSA going from say 2.5 to 5.0 in 12-18 months is not a good thing. As you do not have any idea of the 'normal' starting PSA, you do not know when the PSA rise commenced and for how long it has taken.
I live in Australia, and the 3T mpMRI cost AUD500, with no insurance or gov't monies forthcoming. But, the MRI, in my case, said nothing serious going on...My urologist did warn me though, 20% of people with meaningful cancer do not register on the MRI due to their tissue not being MRI receptive.
What sort of biopsy are they planning? If he decides to get a biopsy, request the perineal version, as less chance of infection that you get with the rectal version.
If your partner has had a serious UTI, and it certainly sounds like it, it is debatable if the UTI damage to his prostate has cleared yet. meaning the PSA may still rise because the prostate is still very unhappy and not from cancer, but infection, which can be non bacterial, making it harder to diagnose.
If you get the MRI, the radiologist will advise the size of the prostate, what the condition of the prostate is, and the likelihood of any PCa(cancer), if any found, they will talk about its staging and if still contained. They will also give a PIRAD score 1-5. 1= a teenager, 5= you got problems.
You are doing the right thing...research....when it comes to decision time, you have to make one that appears right for you. Do not let the 'professionals' bully you. Time is on your side until proven otherwise.
I would get the MRI before any biopsy and give it time to settle down before any thought about sticking a dozen needles in it. Then, "if" the MRI did show a lesion that looked dodgy, the biopsy would target the lesion. If the MRI showed nothing, you need to make a decision.
david41064 caz11527
Posted