Information on the 'gentlemens gland'

[dannyboy]

I realise that this has got nothing to do with n gauge, or even trains but I believe it is an important message. As some of you are aware, I have had problems in the past, but I am living proof that a sky high PSA count is not necessarily a sign of cancer.  . Below is a link to an article from 'Prostate Cancer UK' which explains some of the myths behind, (sorry  ), the subject. I urge every man on, (and off), the forum, who is of a 'certain age', to ask for a PSA test. You have nowt to lose and maybe a lot to gain.

https://prostatecanceruk.org/about-us/news-and-views/2019/7/prostate-cancer-mythbusting?

[port perran]

I've had the PSA blood test and the physical examination (which wasn't the most pleasant thing I've ever had done) because I was peeing rather a lot, especially in the mornings.
The PSA test was all clear and tge physical check revealed no enlargement of the prostate.
But, of course, you never know so I can only echo what Dannyboy says that it is well worth having a check.

[Paul-H]

Hi have almost all the symptoms but my PSA is 0.8 and digital test said its small and benign.

Apparently I am just getting old

[daffy]

Following on from a urinary tract infection just before Christmas (detailed in the Unhappy Thread of late), I have been welcomed, once again, into the wonderful world of the medical acronym.

As those who have looked at @dannyboy 's link above will have discovered, the nether regions are a veritable goldmine of these little gems, many of which have just three capital letters. And as my own experience can show, getting to grips with these takes a bit of concentration to avoid misunderstandings and to keep up with the various members of the medical profession you are going to encounter on a journey into the realm of the bladder and the prostate gland.

To date I have only met a few of the many shorthand forms in common usage by medics, but my own journey is just beginning. Hopefully it will not be a long one and will have a happy ending, but here's a rundown of those I'm already more than familiar with, and how they come to be dominating my waking thoughts.

It all started with that infection, a UTI, which for unknown reasons, I initially kept referring to as an STI, which is something quite different!

Initial investigation included what some men find particularly unpleasant and/or embarrassing, but which doesn't bother me as I view it as a necessary part of the process. This is the DRE, administered by a Dr, but which has absolutely nothing to do with Dr Dre, the acronym standing for 'digital rectal examination'. I won't elaborate on the process, only to say it was thorough, essentially painless, and led to a conclusion that my prostate was slightly enlarged, though not unusually so for someone of my age (67).

With a practical inability to urinate the next step was catheterisation, something I found far less daunting and uncomfortable than my imagination was suggesting. With a Foley, or indwelling catheter fitted, I was spared a further acronym, CISC (clean intermittent self-catheterisation). For this I was thankful as repeatedly pushing a tube through my manhood each time my bladder signalled a need for emptying, was something I would not wish to do, and can be its own source of bacterial infection if done with any lack in hygiene. Such an infection has its own acronym of course, which is CAUTI (Catheter Associated Urinary Tract Infection).

I departed the hospital with a 7 day course of antibiotics, which I am happy to say, did the trick.

A week or so later the catheter was removed by a nurse whose eyes glinted with a certain amount of mischievous pleasure as she rapidly withdrew the tubing. No pain, no problems, and no acronyms here.

Two weeks later and another acronym is introduced to this tale by my G.P., the PSA Test. Prior reading on t'Internet meant I already knew this one: the Prostate Specific Antigen Test, a measure of the presence of this antigen in the blood, recorded in nano-grams per millilitre. (Antigen: a toxin or other foreign substance which induces an immune response in the body, especially the production of antibodies.)
An average, or median level in men is less than 1, but by the time we are in our late sixties it is commonly about 4. My PSA score was 10.3, and two weeks later it was retested and found to be 9.7.

A careful and thorough reading of quality data on the subject, along with comments from my G.P., informed me that a PSA Test is not, of itself, a reliable measure of any specific inherent problem with my prostate, but merely an indicator that would suggest further investigation. Suffice here to say that Prostatic Cancer, Prostatitis (of which there are 4 types), and benign prostatic hyperplasia, are the usual suspects. The latter is the one with an acronym, BPH, and simply refers to an enlarged prostate that is non-cancerous and not bacterially infected.

To determine which relate to me, my GP refers me for another acronym, an MRI scan, reminding me that the very fact that I had had the UTI would lead to a raised PSA, as also would catheterisation, and that a return to my 'normal' PSA levels (whatever that might be) could take six weeks or longer from the clearing up of the UTI following the course of antibiotics.

The MRI scan, in this case an mp-MRI, or multi-parametric magnetic resonance imaging scan, is to determine what exactly is the state of my prostate, or so the MRI Unit Nurse stated today when she rang to offer me an appointment for tomorrow at 6:15pm. The result will be known within a few days when I'll have an appointment with a Urology Doctor who will be able to let me know what the prognosis is.

Until then I shall retain a PMA, let my wife administer copious doses of TLC, keep my eyes away from anything else to do with the subject on the www, and relax with the BBC.

TTFN.

[Bob G]

Ah, the world is full of TLAs.

[Malc]

Been through prostatitis, very frightening. I was peeing blood and razor blades. Fortunately antibiotics cleared it up. That was the start of a recurring UTI at approximately 3 month intervals. My GP sent me to see a urologist who did the manual exam of the prostate and later on inserted a fibre optic into places I would rather he hadn't. He couldn't find anything wrong, so recommended a prophylactic dose of antibiotics. I am diabetic and they think a small amount of sugar in my urine creates a good place to grow bacteria.  After 3 years, my GP informed me that the antibiotic causes some sort of lung contrition that makes breathing difficult, so I've stopped them. I'm hoping my diabetes is now better controlled and l don't suffer any more UTIs.

[daffy]

Wishing you freedom from any more UTIs  Malc.

I know exactly what you mean about the blood and razor blades!   :'(

[dannyboy]

  @daffy for bringing this subject to the fore again. My initial PSA count was just over 12, which started all the tests etc. At one time the PSA count was 25! I was told that it was 'probably' cancer and, after all the tests, I was told it 'probably was not cancer'. However, after about 5 years, I am now on a 'watching brief' and a daily tablet to keep the prostate in check. As you have alluded to, there is nothing that can be described as really painful with the various tests. But as @Malc said, peeing blood and razor blades is not only extremely painful, it is rather frightening  . One of the tests I had was a 'Template Biopsy' and when I came round from the anets anisth anesth sleeping stuff and allowed home, I was told that should peeing become too painful, I was to ring 999 and give a letter I had been given to the hospital. There were a few times over the next few days when I thought. "what was that number I had to ring?".

Seriously though, thank you daffy and I urge all men to consider having a PSA test and any recommended test - stuff the embarrasment.   

[Chris Morris]

I'm in this club. Not really any symptoms but PSA was 26.  Went through all the tests and it turned out my cancer was found just as it was about to break through the prostate wall.
So it was a good job I had the PSA test when I did.

I have recently completed my 20 radiotherapy sessions and now waiting to hear my current PSA . Got another two and a half years of testosterone inhibiting implants to endure. These have a lot of unwelcome but not desperately bad side effects. For instance I still like to see a pretty lady but I can't remember why.

I do recommend that all us chaps of a certain age should get our PSA checked. If I had left it another year I  would be facing much bigger challenges.

[dannyboy]

I'm in this club. Not really any symptoms but PSA was 26.  Went through all the tests and it turned out my cancer was found just as it was about to break through the prostate wall.
So it was a good job I had the PSA test when I did.

Glad it was found in time. I appear to have been more fortunate than you.

I have recently completed my 20 radiotherapy sessions and now waiting to hear my current PSA .

I hope the count is at an acceptable level

.... For instance I still like to see a pretty lady but I can't remember why.

So do I and I can remember why - I just can't do a lot about it 



I do recommend that all us chaps of a certain age should get our PSA checked. If I had left it another year I  would be facing much bigger challenges.

Every male over 40 should get their PSA checked. (It is not something that affects only pensioners!)

I hope things go well for you in the future Chris. 

[daffy]

I second that.

The odd thing for me is that I was, prior to my recent UTI, on the verge of asking my G.P. for a PSA test anyway. This was due to the fact that my best friend from childhood was raising money for Prostate Cancer research, having had hs prostate removed as it proved cancerous.

So as already stated, get tested guys! The facts are plain, and the initial test is simple and could save your life.

And those facts are simple too:

https://www.telegraph.co.uk/news/2020/01/16/prostate-cancer-set-become-common-form-disease-half-cases-diagnosed/

[Newportnobby]

Further to Daffy's reply #3 and all the 3 letter acronyms, my last marriage was to a nurse and she said I had IVS. It was only when we broke up I found it meant "It's Very Small"

Note please I'm not trying to detract from the seriousness of the subject but just attempt a little humour.

[dannyboy]

Just how small is your little finger Mick? 

[Railwaygun]

(/quote}

I do recommend that all us chaps of a certain age should get our PSA checked. If I had left it another year I  would be facing much bigger challenges.

Every male over 40 should get their PSA checked. (It is not something that affects only pensioners!)
[/quote]

I hope things go well for you in the future Chris. 
[/quote]

Random / routine screening  testing is not recommended:

https://www.cancer.gov/types/prostate/psa-fact-sheet

The problem is that all (genetic) men have a prostate, and the PSA level may vary from individual to individual. Infection, and other factors, as well as Ca (cancer) may raise levels.

What to do with a raised PSA? 1) repeat after a few weeks ( DRE may increase PSA levels)

This may show a continuing raised PSA - then MSU (Urine test), DRE, MRI, and cystoscopy are options.

They may reveal nothing, so patients are then monitored regularly.

2. A mass may be found - Prostatic biopsy indicated ( ever seen a cork-borer/spud gun?) - it may/may not get a sample.
If it shows CA - it is sometimes difficult to say if it is an indolent ( incidental/slow) growth, which will not affect normal lifespan, or an aggressive tumour.

Indolent =watch & wait.

It may show frank Ca - =operation (prostatectomy, heat therapy, freezing, microwave treatment, partial/complete prostatectomy, +/- DXT(radiotherapy, Chemo(therapy)).

so overtreatment is no picnic.

So the jury is out on every man over 40 being screened, UNLESS you are BLACK or have a FMH (Family Medical History) in which case, due to increased risk, you should seek advice.

https://about-cancer.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/tests/prostate-specific-antigen-psa-test

https://www.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/screening

https://prostatecanceruk.org/prostate-information/prostate-tests/psa-test

I think These give reasoned assessments to support my summary.

[dannyboy]

I agree, in principal, with what you are saying Nick @Railwaygun . The PSA test is only an indicator - it can give false positives, it can miss something. A 'normal' biopsy does not necessarily find anything. It is only, certainly in my case, a needle taking 12 tissue samples. As it was explained to me, the gland is divided into 4 imaginary quarters and three samples taken from each quarter. I had two of those and nothing untoward was found. The specialist was not satisfied, so I had a MRI scan, This showed a small 'dark' area so I had the Template Biopsy, which targets the 'dark' area. Still nothing was found and all the specialist could say, (and having researched him on line, he is a Professor who was renowned in the UK for his ability in the mens health field, (don't know why he came to Ireland  ), it 'probably' was not cancer.

It could be said that I had five years of not knowing what was wrong for nothing, but I still say that it is better to get ones PSA checked even if it does lead to a false positive. At least that way, your GP can keep an eye on things. Since the specialist put me on my daily tablet, my PSA has been near 'normal' levels for a couple of years now.

Cancer can be found with a biopsy, but without the initial test, it might not be ever found.