Question, age 47, PSA 3.9, DRE a little firm on one side...?

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New Member

Date Joined Dec 2008
Total Posts : 6
   Posted 12/15/2008 7:45 PM (GMT -6)   
Folks, I have a question for you all.  I went for a regular physical checkup and my Dr. felt a little something (firmness) on my left side of the prostate.  I also had a PSA of 3.9. I also had a little testicle pain on one side and he gave me antibiotics for "epidimiytis".  I went to a Urologist upon my Docs refferal and he said he felt a little firmness too.  He gave me two options, watch and wait or do a ultrasound and a biopsy.  I chose the ultrasound and a biopsy.  I can't get back in to have this done until the end of December and I am very worried and not sleeping well at night.....!  This is all I can think about for the last two weeks and I am having trouble focusing at work.  Is a "firmness"  always pretty much cancer or could it be scar tissue or something else?  I am getting concerned by seeing a lot of folks here with PSA's from 2-8 and normal DRE's ending up with positive PCa biopsys.  The more research I do the more I am getting scared...!   Lately I have been having lower back pain too as my back went out but it is getting better (cold weather and stress have caused my back to go out in the past).  I have read that lower back pain can be a symptom of "prostitus".  My brother is age 52 and has a slightly enlarged prostate (BPH?) and was told by his Doctor he has the prosate of a 60 year old.  No male in my family history has ever had PCa.  What do you think my odds are here for PCa...?
Regards, Chris

Regular Member

Date Joined Jun 2008
Total Posts : 440
   Posted 12/15/2008 8:18 PM (GMT -6)   
how old are you ??  I would think it could be anything not nessesarly Pc. probably prostitius of BPH just get it checked. Try not to worry too much worse case you are seeing it sooner rather than later, keep us posted

Ralph Alfalfa
Regular Member

Date Joined Nov 2008
Total Posts : 469
   Posted 12/15/2008 9:12 PM (GMT -6)   
I can understand your worry since you came to this site. My uro. didn't feell anything but the Psa came back high, thus the ultrasound and the biopsy. I certainly hope it's nothing but some sort of infection that can be treated. And I hope you never have to come back here except to tell us that it was nothing. Let us know.
That would be great news.

 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci scheduled for Jan. 19, 2009.Dr. Scott Montgomery, KC Urology,
Shawnee Mission Med. Center. Kansas

Veteran Member

Date Joined Nov 2008
Total Posts : 697
   Posted 12/15/2008 10:11 PM (GMT -6)   
It's impossible to predict, of course. A biopsy is the only way to definitively diagnose prostate cancer. I'm probably telling you something you already knew, but I'm just trying to emphasize the point.

3.9 is high for someone your age. In fact, it would be high for someone in their 50's. (I'm looking at a table on p. 155 in "Patrick Walsh's Guide to Surviving Prostate Cancer").

Looking at a table on p. 156, I see that based on PSA alone, not taking age or anything else into account, that when men with PSA between 3.1 and 4.0 are biopsied, cancer is found 30% of the time.

Was this your first PSA and DRE? A trend over time is more important than a single score.

The abnormal DRE adds to your doctor's concern.

It's good that you are getting a biopsy and ultrasound. If the results are negative, you might want to ask for a "free PSA" test. (the name refers to free vs. bound PSA, not the cost) Free PSA, or fPSA, can help determine whether elevated PSA is coming from a benign or cancerous source.

Hopefully, you've just got prostatitis or BPH. That's still very likely.

Don't panic. I know the anxiety is hard. But if it IS cancer, chances are good that you've caught it early, when it's very curable.

Information is now your best ally. I highly recommend Walsh's book, and websites like Prostate Cancer Infolink, and the Prostate Cancer Foundation. I think all men should read Walsh's book, even those who don't have prostate cancer. It's like an owner's manual.

Standard disclaimer applies: I'm not a doctor, please don't take any of this as a substitute for advice for one.

Best wishes.

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1

Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 12/16/2008 5:37 AM (GMT -6)   

Hi Chris, if you look at my signature, I was also "firm on one side"...glad you are getting biopsy, hope it all works out ok, if not you have got it early.

regards Mal.

age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7  right side tumour adenocarcinoma stage T2a
RP on 30th July,
Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck, free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.
Post op PSA 0.5 26th Sept.
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)

Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 12/16/2008 8:21 AM (GMT -6)   

Just a note - your concerns are something that everyone here has experienced and are unfortunately normal.  Several years ago my father-in-law was going through the same thing this time of year and it ruined his Christmas.  As it turned out he was cancer free, but he sat in misery the whole Christmas.

I would say this - if it is cancer you are very likely catching it early, and you will have several good options for a cure.  If it turns out to be cancer, you are still blessed that you caught it now - and in this worse case (that it is cancer), the treatments etc. are not that bad and life will go on!  Hang in there!

Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

Veteran Member

Date Joined Jul 2008
Total Posts : 981
   Posted 12/16/2008 11:18 AM (GMT -6)   
Hey Chris the waiting is the worst part I know. My PCa was detected by a DRE. My PSA scores were always low but the main thing about PSA is not so much the score it's the rise of the score from a previous reading. Thus I was a T-2-A. which initially sounds worse than all those with T-1 scores but may not be much in reality. My PCa was after all that considered low risk and I was eligible for a clinical research study. That said I know this screws up ones holiday season. I was there last year I was diagnosed in November and all through the holidays I didn't know what was going to happen. Take care my friend and I'll tell you what I tell everyone IF you are diagnosed with PCa take your time to learn all your options before deciding on a treatment. Recently we seem to have some new guys here who have to decide asap. Something that major should be considered and evaluated, you have plenty of time usually. If diagnosed empower yourself with fully learning all the options and all the possible effects after. Good luck and do the best you can enjoying the holidays.
Diagnosed 10/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
Size: 34g
3D Mapping Saturation Biopsy
1 of 45 @2%
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
Psa: .32
April, 2009
Final Biopsy scheduled to
complete clinical research study 

Regular Member

Date Joined May 2008
Total Posts : 29
   Posted 12/16/2008 11:42 AM (GMT -6)   

I was on virtually the same schedule as you last this time, waiting to do a biopsy after an increase in PSA, nothing on DRE. Hopefully (and probably) yours is nothing more than prostatitis, but the biopsy is the only way to sleep soundly again. Even if the worst happens, is nothing more (or less, for that matter) than another one of life's issues- you deal with the best way you can and go forward. In my case, an early diagnosis and a good surgeon have me nearly back to pre-cancer days a year from where you are today. Best wishes on the Biopsy.
58-year old attorney, no family history of PCa
Biopsy 12/29/2007 with 1 of thirteen samples positive; estimated 5% involvement
3+3=6 Gleason
TR2C Stage
RRLP on 2/21/2008 with excellent prognosis (no evidence;margins and other tissue clear) on cancer clearance and sparing of both nerve bundles
Post-OP:Actual involvement 15%, one lobe only; PCa fully contained in prostate-no involvement with other tissues and margins clear
Catheter out on 3/2/2008; fully continent by 3/31/2008
Undetectable PSA on 3/31/2008
Working on ED: 20MG Levitra every other day; Vacuum pump almost daily; some improvement, but not there yet. Started using MUSE with some success, 11/1/2008
2d undectable PSA on 7/21/2008
3d undectable PSA on 10/30/2008

Regular Member

Date Joined Jul 2006
Total Posts : 202
   Posted 12/16/2008 1:22 PM (GMT -6)   

Prostate cancer is a slow growth cancer.  I wouldn't worry about waiting a few weeks for the biopsy.  If you have cancer, you caught it early and have many options available to you.

Use the time to research treatment options.  It took me a while to get comfortable with the option I ultimately chose.  It was about 4 months from the time I was referred to a urologist to get a biopsy until I had surgery.

I'm not a doctor or medical person, but I think it is extremely unlikely that your back pain is related to prostate cancer with a PSA of 3.9.  I would expect a much higher PSA for there to be a connection there.

I know how you feel though.  I had similar concerns.  It wasn't until I actually had surgery that I had a comfort level that it wasn't in my bones or otherwise spread.  Patrick Walshs book has a lot of information and may help to put your mind at ease.

Good luck.


PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.

Forum Moderator

Date Joined Sep 2008
Total Posts : 4274
   Posted 12/16/2008 2:31 PM (GMT -6)   

Hello Chris:

There is no way any of us here - or your doctor for that matter - can really answer your question about your "odds" for PCa, other than just quoting broad statistics.  And those odds would predict that you do NOT have it!

Having said, that I still think your choice to have a biopsy is a good one.  Please ask ahead of time if yours will be done under anesthesia or not...that makes a real difference in your comfort during the procedure...not so much re after affects (which are generally mild). 

I'm sure all of us worried between the time we made the biopsy decision and the time it was done, so I would be less than candid to advise you not to worry.  However, as other have posted, even if you get bad news the cancer is generally slow growing and you shouldn't worry about harm from the dealy.  And, if the news is bad, you probably caught it very early so you have lots of treatment options.

I'm hoping you get good news, however, so please come back and let us know.  And, try to enjoy the holidays!

Age 62
Gleason 4 +3 = 7
PSA 4.2
Brachytheraply volume study done on 11/14/08
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort. 

Regular Member

Date Joined Jun 2008
Total Posts : 440
   Posted 12/16/2008 2:50 PM (GMT -6)   
How old are you ?? Galielo said for someone your age its high but I dint see an age rolleyes

New Member

Date Joined Dec 2008
Total Posts : 6
   Posted 12/16/2008 3:46 PM (GMT -6)   
Hey CVC, I'm 47.   To the rest of you thanks for your responses as you have given me some hope....   I'm trying to keep my spirits up but it is really hard.  Hopefully it is just prostitis.......   I'll keep you all informed.  Regards, Chris

Veteran Member

Date Joined Nov 2006
Total Posts : 883
   Posted 12/16/2008 10:02 PM (GMT -6)   
CVC, I would not worry too much. Even if it is PCa it will have been caught eary and should be easily curable.
wish you well,
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey

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