Sooo about 10 months ago I started having odd tailbone area pain that was worse upon sitting. After a couple months I went to get an MRI done. It showed 2 tiny "lesions" in the sacral bone region about 6-7mm in size. Doctor sent me for a nuclear bone scan - which showed nothing at all. So nothing sinister right?I then went to get a colonoscopy since that's in that area and it didn't reveal anything. So now what? I haven't gotten any proper advice. My pain has persisted all these months. I just spoke to a guy who tells me he has mestasized prostate cancer (which had no symptoms) and it's spread to his pelvis and femur. Said he had a bone scan which also showed nothing. Then had another bone scan which revealed the bone mets. Now I'm freaking out? Should I be getting my prostate examined? I'm 38 yrs old. My primary didn't even mention this to me and it has me p****d. No, I haven't noticed any urinary issues to speak of. If I have cancer that's spread outside the prostate wouldn't I be having issues with my prostate function? I'm gonna go see a urologist. Any advice here? Thanks.
Hi Diddy, last year I sent my husband to the GP as he kept complaining about low back pain. She examined him and decided on blood tests as well as a PSA test. He had no urinary symptoms. That came back with a raised PSA of 12. He went to fast track cancer clinic. Had an MRI and a biopsy. The biopsy showed low grade PC. One of surgeons upgraded his MRI findings and ordered a targeted biopsy. That showed more cancer in same side. Once prostate was removed the cancer turned out to be in the whole prostate. He has now had two negative blood tests. He was 62 at time of diagnosis. You are young but I would ask for blood tests. It will hopefully be nothing but at least your mind will be at rest. All I will say is my husband is 10months post op. Erections are a problem still and now looking at injections but he has his life to which I am thankful but I would be lying if I said it wasn't an issue.
Good luck.
Extremely unlikely given your age and the symptoms but why not put your mind at rest and have a PSA test? If you had PCa and it had spread to your bones, your PSA would be very high indeed.
Hi Diddy
Yes, you need to ask for a blood test form to get your PSA (Prostate Specific Antigen) level checked. The normal range goes up to 4, but I have read so much documentation on people with values of 3.5 or less having prostate cancer that 4 seems ridiculously high. Mine flagged up at 4.08 and after a torturous 8 month process, I had a prostatectomy for prostate cancer last October. At your young age, 'normal' would be much less. It should be in the region 0 - 2.5 (40 -49 age group - I haven't found a lower age group) I recently spoke with a young man exactly your age who's PSA was less than 1 and was told to come back if and when it exceeded 1. If your turns out to be above 2, I would definately see a urologist - and if above 1 - I would still see a urologist! The most important starting place in my experience is to ask for anMRI (a multiparamagnetic MRI to be precise - this will show up clinically significant cancer.
In my experience it always pays to be proactive. If you leave it up to the medics you will die early! My GP and a retired urologist, both thought I should wait three months and check my level again. I took their advice and it was then 5.2. The GP gave me a prodabout check (DRE) and said all seemed fine and put me on another 3 month wait. After a week or so I thought this was ridiculous, but as I was on holiday abroad it was two months before I told him this and asked for a referral to a urologist. He agreed but put me on a non urgent list - a 7 week wait. So, all in all, I had almost a 7 month wait to see a urologist since first discovering my abnormal PSA - ridiculous!
You can short-circuit all this rubbish Diddy by making a private appointment with the urologist of your choice and asking him/her to refer you for the MRI. All done and dusted in a matter of days! Best of luck.
Hallo Miklemas
Wie sind Ihre Untersuchungen ausgegangen?
Mein Mann hat einen PSA-Wert von 11 plus und wartet auf eine weitere MRT, da die erste "equivocal" zeigte, aber wir mussten seinen Biopsie-Termin verschieben, da er dazwischen eine Notoperation wegen akuter Appendizitis hatte. Wir gehen nächsten Monat zur nächsten MRT, da sein PSA-Wert gesunken war, dann aber wieder gestiegen ist.
Ich hoffe, bei Ihnen ist alles gut ausgegangen. Beste Wünsche. Anne.
ABSOLUTELY get to a urologist. A good one if you can find one. My husband had a PSA reading of 49 5 years ago and our primary didn't make that sound urgent (which he should have). He didn't start feeling "pain" until about a year ago and that pain was when he urinated. We were hoping it was just a bladder infection but finally got him to go to the urologist and indeed it was prostate cancer. They were going to remove the prostate but when they went in they noticed it had spread to the "neck of the bladder." He is now receiving treatment at the Cancer Center in Phoenix. 9.5 weeks of radiation. They re-did bone scans, etc. but THANK GOD it has not spread any further. He also received hormone therapy shots and after just 1 shot his PSA went from 49 down to 6.4 and after his 2nd shot, it went down to 1.7. And now with the upcoming radiation the plan of attack is to kill off the cancer cells currently in the prostate and stop it from growing which the doctors in Phoenix have full confidence this will work. He is 61 and just retired from the RR. I'd like to have him around so we can enjoy the retirement as I am also retired at 58. GET TO A UROLOGIST ASAP! Please don't do what we did...sit around and say, "I don't show any symptoms!" Cancer is not your friend so it's not going to tell you anything. GOOD LUCK and keep us posted. Take care. Also, if your primary did a blood test WHY didn't he/she do a PSA? That should be part of it. WOW!
A 7 month wait to see a urologist? What the? I have insurance that doesn't require referrals so I'm just going go to sched an appt to see a urologist straightaway as my GP seems to have his thumb up his a$$. If it takes too long to get a urologist appt i guess I can just go to my primary first. All this info seems very odd. Even if your PSA is very low you can still have cancer? I guess my thing is if the primary concern is mets to the bone and the PSA is low then that's probably not very likely? To spread to bone the PSA would have to high right?
Not necessarily true about high PSA same for low. But again, cancer is not your friend. A 7 mos. wait is out of the question. You truly have concerns and my suggestion would be to see a urologist ASAP like yesterday. Also, cancer doesn't discriminate against age. Express your concerns when you call around looking for a urologist too. As for your primary, yes, we've been through the "thumb up their butt" too. We just went on our own. Our insurance doesn't require referrals either. Take advantage of that fact.
So low PSA can still mean cancer and high PSA can mean not? So confusing. Earliest appt I could get with a urologist was Sept 1 as a first time patient. I can get my PSA checked at my primary this Friday so I guess I'll just do that first? What makes my blood boil is when I went to see my primary months ago after a colonoscopy i ASKED him is there anything else down there I need to get checked that could be leading to this MRI popping hot in a couple spots? I even asked should I have my prostate or anything else checked. He said no. Or the bone scan coming up negative made him think it can't be anything sinister. I guess he's so stuck on my 30s age that he's not thinking outside the box.
Hi Diddy
Normally metastatic cancer yields an extremely high PSA but I have read that in certain rare exceptions, the PSA stays low. These are only around 1% of cases and are a certain type whose name I forget. Definately get your PSA checked before seeing the urologist as he/she will be in the dark and you will no doubt need to see him again when he has the result - a waste of time and money.
Hi Anne
Make sure your husband has a multiparamagnetic MRI as a normal one will not be up to the job.
I've been referred to an oncologist who thinks my PSA values post prostatectomy are too high to suggest the op was a total success. She thinks I still have some cancer active, local or metastatic. At present just getting monitored 3-monthly. If I get three consecutive rises they will want to zap me.
Vielen Dank, Miklemas. Soweit ich verstanden habe, wird es sich um eine multiparametrische MRT handeln, da dies das war, was wir selbst bezahlen wollten, als sie zustimmten, meinen Mann in die Studie aufzunehmen.
Es tut mir sehr leid zu hören, dass Sie noch nicht am Ende dieses Prozesses sind, aber ich wünsche Ihnen alles Gute und eine gute Genesung und hoffe, dass Sie keine drei aufeinanderfolgenden Anstiege erhalten und Sie gute Nachrichten bekommen.
Alles Gute, Anne.
Ok so the PSA # will probably tell the tale here. Fingers crossed. Ill tell you what, if that number IS really high I will legit flip out at my primary for not testing me for this sooner. Absolutely ridiculous. Any reason why he wouldn't?? Because I'm not 40 or 50 and aren't p*****g blood? Good lord.
I understand how you feel believe me. They don't make doctors like they used to. CARING, what's that? Pay your bill. That's how it is now. SAD! But you have to do what you have to do. Again, best wishes to you and keep us posted. Take care.
anthony70342:
Möglicherweise werden Hormontherapie und Strahlentherapie als empfohlene Behandlung in Betracht gezogen. Ich habe einen erneuten PSA-Test in zwei Wochen und werde nach Erhalt der Ergebnisse mehr wissen. Meine Frage an Sie lautet: Welche Nebenwirkungen haben Sie seit der Verabreichung Ihrer Hormonspritzen erfahren? Hat Ihnen jemand die Möglichkeit von kurzfristigen oder langfristigen Nebenwirkungen erläutert? Hat Ihnen jemand Ressourcen empfohlen, um die Nebenwirkungen der Hormontherapie zu untersuchen?
Danke
Ich befinde mich in einer ähnlichen Situation. Mein erster PSA-Wert nach der Operation betrug 0,15. In zwei Wochen gehe ich zur Nachuntersuchung. Mein Arzt war besorgt und sehr überrascht. Wir sind nicht sehr ins Gespräch darüber gekommen, was los sein könnte, und er hat weitere Behandlungen mit den Worten abgetan: „Lassen Sie uns nicht das Pferd vor den Wagen spannen.“ Ich habe viel recherchiert und wenn sich meine Werte nicht verbessern, ist es sehr wahrscheinlich, dass weitere Tests, Scans usw. nötig sein werden und wahrscheinlich auch weitere Behandlungen.
Meine Fragen an Sie sind: Wie hoch war Ihr PSA-Wert? Wenn er schlechter ist, welche Tests und Scans werden sie empfehlen? Und wurde neben der Strahlentherapie auch eine Hormonbehandlung erwähnt?
Danke. Halten Sie durch. Ich kenne die Angst, nicht zu wissen, was passiert. Ich hatte gehofft und gedacht, dass ich nach der Prostatektomie krebsfrei sein würde.
Richard
Hi Richard
I'm really sorry to hear your news. PSA values are supposed to nadir (reach minimum) around the 3 month mark, so when was yours done? Mine is lower than yours averaging around 0.02 so far. There were two consecutive rises and then a drop. They want me to do two more over the next six months.
Regarding my value, my oncologist thinks it too high and infers I still have active cancer.
Regarding your value, she would therefore think that was too high but would no doubt wish to check the value with one or two further PSA tests before suggesting treatment.
PSA values are subject to error - they are actually centre dependent as the result depends in part on the assay used, the accuracy of the techniques used and also the accuracy achieved by the operators.
However, I am sure you have read that various sources do not consider it to be a biochemical relapse (failure) until the PSA value reaches 0.1, 0.2 or 0.4, depending on the source AND associated with a rising PSA. If your's is constant at around 0.15, I would expect some urologists/oncologists to wish to just monitor you indefinitely - if no further rising trend then nothing much is happening out there. Some, like mine, would no doubt suggest the same if no rise but suggest radiotherapy for three consecutive rises above my current level of 0.02 - X-rays to the prostate bed, daily for around 7 weeks. I read that radiotherapy should begin before a rising PSA reaches 1.0 for a RISING PSA for the best chance of a total cure.
So I guess the question for us both is - is our PSA continuing to rise?
All the best Richard. Keep in touch.
My husband has only said he feels tired from the hormone therapy shots. He just got his 2nd shot and supposedly 1 more in 3 months. But everyone is different. As for radiation, we don't know yet but doctors have said "tiredness". Again, everyone is different. We're just hoping for the best and that's all we can do. As for his PSA starting at 49 then down to 6.4 then now down to 1 is a good sign that something's working.
Thank you Anne for your concern and I hope all works out well for your husband.
Best wishes
Mike
Meine erste Operation nach der Prostataentfernung war 10 Wochen danach, also hoffe ich, dass es daran lag, dass es weniger als 3 Monate her war. Bei meiner Recherche scheint es, dass der ANSTEIGENDE PSA am meisten besorgniserregend ist, aber wenn er 0,2 erreicht, ist es Zeit zum Handeln.
Ich werde dich auf dem Laufenden halten.