Best way to diagnose prostate cancer?
I'm new to the forum. Basically I have one question, which is what is the best way to diagnose PC? Over the past year I have seen a number of different urologists (nearly all quite young) and always been told my prostate feels fine when getting the DRE, however my symptoms have gone from bearable to nearly unbearable. My PSA is low (0.40 - I'm 38 years old), however I get strong pain in my lower pelvis after urinating, my urine stream has gone from being normal to coming out flat and then splitting into several streams. I had a cystoscopy some months back and was told that I have an "anatomical narrowing" between my prostate and bladder, which I found surprising as I'd never had any issues like this before. I've also had several ultrasounds & a CT scan, which indicate my prostate is slightly enlarged. I was told that the CT scan is not of much use in picking up prostate cancer and also been told that both the DRE & also the PSA tests don't always pick up cancer (depending on where it is etc).
My current symptoms (apart from the pelvic pain) are pain in my upper legs, hips and thighs, pain up my anal passage and pain going up my penis from the pelvis. I've also had spasms in my lower back and also spasms roughly where my prostate is.
My question is, what is the best way to check whether I do indeed have prostate cancer? What are the latest ways of detecing it (I read somewhere that they're developing a urine test for it). I'm happy to travel if need be (preferably to Europe as I have family there) I can't put up with the pain much longer. Thanks for any help. Norb.
Forgot to add: was given Flowmaxtra for the urine stream issue but this had no effect
Forgot to add: lower back pain which started nearly a year ago
Forgot to add: erectile dysfunction (not total, but impaired) as another factor
There are a couple of other PSA tests including free PSA and PCA3 test. You might try a course of antibiotic to see if symptoms decrease with an antibiotic (in case an infection is the problem.)
I think biopsy is the most common tool. The device shoots needles through the rectum into the prostate (one at a time). It stings a bit. An ultrasound is usually done at same appointment.
I would try an antibiotic first. I that didn't help, then I would have a biopsy done.
DOB Sept. 1947. Prostate cancer Gleason 7 (3+4), PSA 5 in Oct 2010. Cryoablation Jan. 2011. Had some complications.
Experienced nocturia, irritable bladder summer 2011. "Agent Orange"compensation from VA Oct 2011.
PSA: .05 01/26/2012, .06 6/26/2012, .04 12/24/2012, .04 6/26/13, .05 1/27/14, .05 10/21/14, .04 10/15
I am eating vegan mostly plus a little fish. Take some supplements.
(Any advice given is the personal opinion of a layman and is not intended to replace the advice of a health professional.)
Sounds like you need a TURP.... a.k.a. roto-rooter. Look it up...
PSA 6.48, biopsy Gleason 3+4, robotic prostatectomy 9/17/08, pathology Gleason 4+5, pathologic stage T2c, positive margins, SRT completed May 22, 2009. 1st post-radiation PSA, 8-4-09, <0.06. 2nd post-radiation PSA 12-22-09 <0.06. PSA, July 23, 2010: <0.06. PSA, January 10, 2012: 13.90. Re-test, February 6, 2012: 16.47. April 6, 2012: 25.6. PSA, May 2, 2012: 37.74. PSA, May 27, 2012: 37.4. PSA, June 17, 2012: 51. PSA, Sept 27, 2012: 110.24. PSA, January 28, 155. May, 2013, Well, you get the idea...
But is it usual for benign enlargement to cause this sort of pain??
Originally Posted by mkane09
Hi Norb, - There is only ONE widely accepted method of accurately diagnosing Prostate Cancer (PCa) and that is by a Pathologist observing malignant cells when examining Prostate tissue samples, under the microscope. These samples are most often obtained by Biopsy. PSA (blood), Free PSA (blood), PCA3 (urine) and ALL imaging results are only aids to determining whether a Biopsy is advisable to confirm PCa suspicians.
I would suggest that you take your numerous symptoms to one of the University Medical Centers or one of the major Cancer Centers, where all medical specialties are readily available, to pursue a satisfactory answer to your problems. The kind of symptoms that you describe could be from skeletal and/or neurological origins, as well as several internal organs. A complete work-up may be the place to start, with a Specialist in Internal Medicine, who can then refer you to other specialties within the same institution, as is deemed advisable, with the Internist serving as the coordinator of care. Good luck. - John@newPCa.org (aka) az4peaks
At some point, we will need to talk about your medical insurance....