Prostate is hard

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surbhu
New Member


Date Joined Mar 2015
Total Posts : 4
   Posted 3/23/2015 3:21 AM (GMT -6)   
Hi

My dad who is 64 had a rectal exam and the doctor said that the Prostate is a bit hard, and his PSA score was 8.9 so the doctor has advised that he gets an MRI scan but has not recommended a Biopsy.

Of course we are going to do as the doctor advises us but just wanted to understand if there is any reason other than Cancer that the Prostate is harder than usual or does hardness confirms cancer...

And my understanding was that if the doctor suspects cancer then first test recommended is biopsy... why MRI...

we are all very nervous and very anxious so wanted to seek opinion of people here while we wait...

PSA3DOT7
Veteran Member


Date Joined Dec 2013
Total Posts : 720
   Posted 3/23/2015 4:09 AM (GMT -6)   
Surbhu,

A PSA of 8.9 is a bit high. I was 3.7! But, if the doctor is a urologist one would expect that he knows what he is talking about. I'm one that never truly believes whatever doctors tell me and always seek some sort of convergence of a diagnosis hence I'd seek a second or sometimes even a third opinion.

My second URO, although well credentialed, had one of those two-way mirror windows: you could see the people in the street except they couldn’t see you. It just awkward because the mind reasons that if I can see you (or vise versa) you can see me. It was "hard" to relax under those circumstances whilst being "fingered"; nevertheless, he confirmed a certain hardness and I proceeded with a biopsy. Glad I did!

Why this strange story about second opinions, mirrors and PSA? Because this journey is a strange one that affects many, the sufferer and the family bystanders and lots of "things" will happen along the way. Read as much as you can about prostate issues, there are many, including cancers!

Take care!
Pre-op:DX 9/13 Age 58-- G9(5+4) 1/16cores-- PriorPSA 3.7 08/13;2.4 03/12;1.9 12/10;1.6 12/09;0.8 03/04
Op:RRP 10/13, LNerve spared pT2aN0M0
Post-op:PSA < 0.01 11/13, 01/14, 02/14, 04/14, 05/14, 09/14, 10/14, 03/15-- ED: PDE5i & TRIMIX (0.1cc) 05/14-- Continent: 02/2014
Extra:HRT Nebido-- my story www.healingwell.com/community/default.aspx?f=35&m=3215183

Post Edited (PSA3DOT7) : 3/23/2015 3:12:38 AM (GMT-6)


surbhu
New Member


Date Joined Mar 2015
Total Posts : 4
   Posted 3/23/2015 4:22 AM (GMT -6)   
I am sorry but I think I did not make my self very clear, the doctor has not said that it is cancer he wants my dad to go through MRI before he can diagnose, but I would like to know that is it possible that prostate is "bit hard" without cancer?

Pratoman
Forum Moderator


Date Joined Nov 2012
Total Posts : 6131
   Posted 3/23/2015 6:42 AM (GMT -6)   
Subhuman , biopsy is an invasive procedure and will often miss a tumor, as it takes tiny needle samples from an entire Prostate. So think of it as hit or miss. Often it will miss a Cancer. I had a biopsy 2 1/2 years ago that was negative, and anothe 5 months ago that was positive. I am sure the first biopsy missed it, and it was there.

With today's new technology, MRI can highlight specific areas that might look suspicious, which the Dr can then target on a biopsy, if he feels one is still necessary. You want to have your dad do a 3Tesla or 3t Multiparametric MRI, if possile. which is the most advanced technology. Think Hi Def

If the MRI shows nothing, then it's likely that your dad either doesn't have Cancer, or has a low grade which often doesn't need treatment but just needs to be watched.

Unfortunately, there is very little black or white in this disease, it's all grey. Keep us posted, and good luck.

NE-skier
Regular Member


Date Joined Mar 2015
Total Posts : 52
   Posted 3/23/2015 6:50 AM (GMT -6)   
During my DRE the urologist felt hardness and promptly said based on years of experience he was confident it was cancer. A week later I had a positive biopsy and only then a CT and bone scan. My PSA was 5.7.
7-12 DRE normal? the test was shallow and quick, no PSA
5-13 chg Doctor
5-13 DRE lump left side PSA 5.7
7-13 Biopsy 10 of 12 cores 4/4 = Gleason 8
CT, bone scan negative
11-13 DaVinci surgery, BIDMC Boston, non-nerve sparing - surgeon went wide,
seminal duct, urethra, pos margins, 3 near of 26 lymph nodes pos
PSA 3/14 <.01, 6/14 .01, 9/14 .05, 11/14 .1
11-14 HT - Lupron
salvage RT start 4/1/15

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 3/23/2015 7:41 AM (GMT -6)   
Hardness is very subjective. Feeling a nodule or lump is much more suspicious.
Any thing other than a 3T MRI would be a waste of time and money.
Sounds like your Dr is taking the right steps.
70 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. 6 years of psa's all at <0.1.

John_TX
Veteran Member


Date Joined Jan 2015
Total Posts : 1245
   Posted 3/23/2015 8:29 AM (GMT -6)   
One side of my prostate felt hard when my primary care doc did a DRE, then a follow up with a urologist and he came to the same conclusion. The urologist recommended a biopsy and you can see the results of that in my signature, the hardness was a tumor. I didn't have a pelvic MRI until I went through pre-operation tests, the surgeon used the MRI to guide him in surgery.
DX - 1-13-2015 (age 66) -- PSA 4.02 (9-16-2014) to 4.38 (12-5-2014)
da Vinci RP on March 2, 2015 @ MD Anderson
---------------------
Stage T2c
right apex: benign
right mid: benign
right base: Gleason score 6 (3+3) -20%
left apex: Gleason score 6 (3+3) -40%
left mid: Gleason score 6 (3+3) -70%
left base: Gleason score 7 (3+4) -100% with perineural invasion

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 9369
   Posted 3/23/2015 8:36 AM (GMT -6)   
Welcome to HW, sorry you need to be talking to us.

Short answer: Yes there are a number of things that make the prostate feel 'hard' other than PC. Your father's doctor is following a good path. Of all the things that can go wrong with a prostate - infection, enlargement, etc - cancer is very low on the list. Before a biopsy recommendation is made, a good doctor will rule out all other possibilities before doing that procedure.

Andrew
I'll be in the shop.
Age 55, 52 at DX
PSA 4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13, .7 5/14, .5 10/14
GS 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

surbhu
New Member


Date Joined Mar 2015
Total Posts : 4
   Posted 3/23/2015 9:42 AM (GMT -6)   
Thanks for your considerate reply...

That's is so good to know. Just waiting for a good news from the scan!!

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 9369
   Posted 3/23/2015 10:14 AM (GMT -6)   
also, your father's PSA history plays a lot into it. A single reading isn't all that meaningful (except in extreme cases). The doctor will look at his PSA numbers over a series of tests. Don't be surprised that even after the scan the doctor says something like, "We'll retest in three months and see where we are."

That would be normal too.

Andrew
I'll be in the shop.
Age 55, 52 at DX
PSA 4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13, .7 5/14, .5 10/14
GS 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

surbhu
New Member


Date Joined Mar 2015
Total Posts : 4
   Posted 3/23/2015 10:38 AM (GMT -6)   
ok got it...

Thanks a lot Andrew...

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 9369
   Posted 3/23/2015 1:15 PM (GMT -6)   
Do keep us updated on progress. And ask any other questions you have.

We're here most days,
Andrew
I'll be in the shop.
Age 55, 52 at DX
PSA 4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13, .7 5/14, .5 10/14
GS 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

Aussie Amnesia
Regular Member


Date Joined May 2014
Total Posts : 87
   Posted 3/23/2015 2:57 PM (GMT -6)   
I'm all for the 3t mri before biopsy too! Significant nodules can be identified.
Biopsies, as we know can indeed miss due to its very random targeting.
My experience of a mri guided biopsy hit the G4 tumour, yet a 12 core random biopsy resulted in totally negative findings.
PSA @ diagnosis 6.2 nil symptoms.@ age 65
Robotic Prostacectomy & Pelvic Lymphnode dissection 07/13 Surgeon: Geoff Coughlin, Brisbane
Gleeson 7 (4+3)
Surgical margins negative, LV: present
PV: present
Tumour stage: pT2pNO Lymph node: 29 negative nodes
PSA Post Op:.02 @3mths:.01 @6mths:.02 @9mths:.05 @10mths .06 @12mths:.08 @15mths .14 retest @16mths .12 No ED

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 3/24/2015 12:15 AM (GMT -6)   
A hard prostate is a typical finding for prostatitis, and a rare finding for PC. As John T said, lumps are more likely to signify cancer, but are often cysts or calcifications. Most prostate cancer presents with a negative DRE.

A doctor usually wants to eliminate the more common reasons for the elevated PSA and the hard prostate, before exploring less common reasons. I'm surprised he jumped to an MRI before trying a course of antibiotics, but some doctors seem to be scan-happy.

- Allen

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 3/24/2015 4:31 AM (GMT -6)   
surbhu

I had my first PSA test as part of a routine screening when I was 56. The result was 17.8. Yikes! My GP immediately called me into his office and did a DRE. He said my prostate was "a little firm on one side."
We started a course of Cipro (antibiotic) and tested again in 3 weeks. My PSA was 22.
He referred me to a Uro who did another DRE, and scheduled a 12 core biopsy. 7 were positive - 6 on one side and 1 on the other. The "firm" side was the side with 6 positive cores.

Jeff
Age: 62, Mar 39 yrs, 56 dx, PSA: 4/09 17.8, 6/09 23.2
Biopsy: 6/09 Pos 7/12, 20-70%, G 4+3, Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: G 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE pres., PNI exten., Sem Ves, Vas def clear, Lymph 0/13
Incont.: AdV Sling 1/11
ED: Quadmix
PSA: 10/09 .04, 7/10 <0.01, 7/11 <0.01, 1/12 <0.02, 9/12 <0.02, 4/13 <0.02, 3/14 <0.02!
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