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BarclayB
New Member


Date Joined Apr 2011
Total Posts : 5
   Posted 4/18/2011 1:55 PM (GMT -6)   
I recently completed chemo for testicular cancer (age 43) and my last CT Scan showed prostate enlargement.  MY GP did a DRE and said it felt basically normal but ordered a PSA.  I am now scared of having prostate cancer and have noticed a weaker urine stream especially when first starting to urinate.  I've read that actual symptoms usually don't occur until it is advanced.  Can anyone shed some light on this?  I am hoping it is only BPH and not cancer. Thank you

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 4/18/2011 1:58 PM (GMT -6)   
Welcome to the site...
 
Your guess is as good as anyones... Odds are and my guess would be that its BPH....
 
Have fingers crossed for you cool

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 4/18/2011 2:02 PM (GMT -6)   
BarclayB, I join Steve in welcoming you. I too vote for BPH, but it is what it is, regardless of how hard I hope. So, the sooner you have the PSA done, and whatever other tests might be indicated, the better.

And, please do let us know. After just completing your testicular cancer chemo it must be a huge stress having this pop up.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

BarclayB
New Member


Date Joined Apr 2011
Total Posts : 5
   Posted 4/18/2011 2:10 PM (GMT -6)   
What am I looking for with the PSA?  And can't both BPH and PCa have high PSA?

BarclayB
New Member


Date Joined Apr 2011
Total Posts : 5
   Posted 4/18/2011 2:33 PM (GMT -6)   
And also (then I'll shut up), how accurate is the DRE as a predictor? My GP said he felt nothing abnormal.

reachout
Veteran Member


Date Joined May 2009
Total Posts : 739
   Posted 4/18/2011 2:54 PM (GMT -6)   
Barclay, welcome to the board, and sorry that you've had to go through treatment for testicular cancer.

As my doctor told me once, TC and PC are independent of one another, so having one does not increase the odds of the other one. And as you probably know, PC is like a turtle compared with TC being a hare, it tends to grow much slower. Since you're taking care of the TC, try to calm down and take your time about the prostate.

I'm not a doctor, but enlargement and a weak stream are very common symptoms of BPH and, even though no one can tell you for sure unless you have a biopsy, the odds of your having PC from just a weak stream and enlargement are small. Also, be aware that the PSA being high, in itself, is not an indication of cancer, just a warning to look further. BPH raises PSA as do a number of infections. Also, the DRE being negative is not a definitive test, but another indication that it probably isn't cancer, at least not an advanced version.
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 month detectable .05

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 4/18/2011 3:18 PM (GMT -6)   
Barclay,
There are some ways to distinguish BHP from PC. Have the urologist estimate the size of your prostate or an ultrasound will give the exact size. PSA should be equal to your prostate size in cc times .066. If your prostate is the normal 30cc then psa should be around 2. It could be as high as .1 times or 3 and still be BPH. If you had a CT scan then they should be able to accurately measure your prostate size by looking at the scan.
Prostate cancer is most always indicated by a steady rise in psa over time. BPH will always reflect the size of the prostate, and any infection or prostititis will show a psa trend that bounces up and down with no pattern.
JohnT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/18/2011 3:22 PM (GMT -6)   
Believe it or not the DRE thing is another skill set that one supposedly acquires and gets better at, not something all of us would be qualified or want to be qualified to do.  Docs say it takes practice....surely alot different than golfing practice.

Check this out for Yourine-analysis (-: urology web info www.marinurology.com
covers bph, prostatitis, PCa, bladder issues and more.  Stream on over you feel warm about this information site.

reachout
Veteran Member


Date Joined May 2009
Total Posts : 739
   Posted 4/18/2011 3:24 PM (GMT -6)   
John, I agree with what you said and, to add, an infection can raise PSA much higher than BPH by itself. A family member had a 10.6 PSA that came down to 1.4 after antibiotics.
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 month detectable .05

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 4/18/2011 3:29 PM (GMT -6)   
BarclayB said...
I recently completed chemo for testicular cancer (age 43) and my last CT Scan showed prostate enlargement. MY GP did a DRE and said it felt basically normal but ordered a PSA. I am now scared of having prostate cancer and have noticed a weaker urine stream especially when first starting to urinate. I've read that actual symptoms usually don't occur until it is advanced. Can anyone shed some light on this? I am hoping it is only BPH and not cancer. Thank you


I had same urinary symptoms and mine was caught very early, so don't stress about that too much.

Nothing was abnormal with my DRE and I had cancer.

Newporter
Regular Member


Date Joined Sep 2010
Total Posts : 225
   Posted 4/18/2011 3:29 PM (GMT -6)   
Welcome and hope you are not one of us.

As John T was saying, your symptom could be BPH if you have an enlarged prostate. We encourage you to see your doctor and find out.

A final note: Most of us who crossed over to the other side (treated for PC) can tell you that it is not as bad as we original feared and we intend to (and can) hang around for a long long time. :)

Cheers.
65 Dx June-2010 PSA: 10.7, biopsy: Adenocarcinoma, 1 core Gleason 6, 3 cores atypia; Clinical stage T2; CT, Bone Scan, MRI all negative

8-23-10 Robotic RP; Pathology: Organ confined, negative margins, Lymph nodes, Seminal Vesicle clear; PNI present; multiple Adenocarcinoma sites Gleason 3+3 with tertiary Gleason 4+. Stage: pT2,N0,Mx,R0

Catheter out 8-30-10 no incontinence, no ED. 3/2011 PSA: <.1

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 4/18/2011 3:51 PM (GMT -6)   
My first DRE was positive for nodules.... Second opinion was done by my GP who is from Asia and is a small guy. He couldn't/didn't find the nodules. Third doc (a URO) did also feel the nodules...

BarclayB
New Member


Date Joined Apr 2011
Total Posts : 5
   Posted 4/19/2011 10:43 AM (GMT -6)   
PSA was .07 (0.7?)  I was told that it was normal regardless.  I appreciate everyone's help here.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 4/19/2011 11:21 AM (GMT -6)   
If you still have a prostate, a PSA of either 0.7 or 0.07 seems a very reasonable result.

BarclayB
New Member


Date Joined Apr 2011
Total Posts : 5
   Posted 4/19/2011 1:58 PM (GMT -6)   
Not sure what you mean 142?
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