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. :no:. 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?
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.
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
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 (https://www.ngaugeforum.co.uk/SMFN/index.php?action=profile;u=4209) '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.
Ah, the world is full of TLAs.
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.
Wishing you freedom from any more UTIs Malc. :thumbsup:
I know exactly what you mean about the blood and razor blades! :'(
:thankyousign: @daffy (https://www.ngaugeforum.co.uk/SMFN/index.php?action=profile;u=5634) 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 (https://www.ngaugeforum.co.uk/SMFN/index.php?action=profile;u=497) said, peeing blood and razor blades is not only extremely painful, it is rather frightening :goggleeyes:. 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. :beers:
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.
Quote from: Chris Morris on January 23, 2020, 07:02:26 PM
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. :beers:
I second that. :thumbsup:
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/ (https://www.telegraph.co.uk/news/2020/01/16/prostate-cancer-set-become-common-form-disease-half-cases-diagnosed/)
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" :doh:
Note please I'm not trying to detract from the seriousness of the subject but just attempt a little humour.
Just how small is your little finger Mick? :)
(/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. :beers:
[/quote]
Random / routine screening testing is not recommended:
https://www.cancer.gov/types/prostate/psa-fact-sheet (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://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://www.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/screening)
https://prostatecanceruk.org/prostate-information/prostate-tests/psa-test (https://prostatecanceruk.org/prostate-information/prostate-tests/psa-test)
I think These give reasoned assessments to support my summary.
I agree, in principal, with what you are saying Nick @Railwaygun (https://www.ngaugeforum.co.uk/SMFN/index.php?action=profile;u=941) . 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.
I would not disagree with any of the findings illustrated in your post RG, but I would quote from the link I gave above:
QuoteAngela Culhane, chief executive of Prostate Cancer UK said the latest figures were a "stark reminder" that efforts to tackle the disease needed to be redoubled.
She said: "By 2030, prostate cancer is set to be the most commonly diagnosed of all cancers in the UK. Before we reach this point, we absolutely must ensure that as many of these men as possible have their prostate cancer caught early and successfully treated, so their lives are not cut short by the disease."
Those "latest figures" show that over 12,000 men died of Prostate Cancer in 2017.
At present, poor as it is in giving a good indicator of malignant cancer, the PSA test is the best first line of investigation we currently have. As my visit this evening to the MRI Suite of my local hospital has shown, a next step need not be invasive and has practically no side effects but can detect tumour and help determining further steps, should any be in fact required. After all, this evenings scan may show I have nothing to worry about and be unlikely to join the next annual crop of those who succumb to this killer. But if I am to undergo further treatment I'm certainly happy to have started the process with a simple blood test, and maybe quite thankful for that.
It is of course for all men to decide their own action re their prostate, and in all the links given in this thread so far there is ample factual and learned information from various reputable sources that can help each one in that decision.
Quote from: dannyboy on January 24, 2020, 10:28:40 PM
I agree, in principal, with what you are saying Nick @Railwaygun (https://www.ngaugeforum.co.uk/SMFN/index.php?action=profile;u=941) . 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.
the problem is that False positives lead to over investigation and unnecessary reeatment, associated with morbidity.
I write as a generalist rather than a Specialist.
I can't comment on your case, but the NHS has to work on best evidence, rather than "its a good idea". Even the USA has stopped PSA screening, and they get paid per test!
please let us all encourage symptomatic male friends & those at risk, to discuss testing with their GP/urologist.
The problem is that the symptoms described are not far from what naturally happens as you get older. I didn't have any of the symptoms, just a slight discomfort in my side.
The process seems to be very sensible and logical. For me this was as follows:-
1. PSA test which led to hospital appointment
2. DRE by specialist and further PSA test which gave enough cause for the specialist to require further tests
3. MRI scan. This shows up where the prostate may have a problem and in my case they could see quite a problem but I didn't know at the time.
4. Biopsy. This was the first invasive test and is the one required for medics to know exactly what the situation is. I had mine under full anaesthetic because they wanted to take lots of samples. Because there is so much stuff close together down there there is a risk of infection following a biopsy of this kind. I was fine and all of my friends who have been through the same were also fine.
5. The biopsy showed I had a problem but I was not informed at this point. I did however get cordially invited for more tests which kind of told me they had found a serious problem.
6. CT scan - makes you feel hot and that you have we'd yourself. This is done to look for cancer around the body and see how close it is to any organs.
7. Bone scan - you get an injection of something radioactive and are told to keep away from young children for the rest of the day! This is to check whether cancer has spread to your bones.
8. Meeting with consultant to discuss findings and further treatment.
The reason for not saying anything to me before meeting the consultant was so that they he could give me a full picture of where I was and what he recommended next. The point is that it is a logical sequence of events. The PSA test being just a start point to kick off further investigations and these investigations only continue if the previous one gives cause to continue. So far as I am concerned I am very pleased that my GP decided that a PSA test was worth doing even though my one slight problem (and it was very slight) was not a symptom of prostate cancer. I'm also pleased with myself for going to my GP because the normal bloke reaction would be to just ignore such a small problem.
The PSA test did good for me.
One message that I hope others take from this thread is the importance of being aware of men's health issues and being forthright and courageous enough to discuss these with your family doctor. I state this from experience being almost five years post-surgery and (multiple rounds of) chemotherapy for testicular cancer.
My experience stated with a simple observation that one testicle didn't feel the same as the other - At the earliest opportunity (as I was travelling overseas for business when I first noticed this in the shower one day), I visited my local doctor. My doctor assured me that it was probably nothing, but gave me a referral for an ultrasound - I arranged this for during my lunch break on the same day and afterwards continued on with my day, unperturbed and reassured by my doctors' calming words. As such, I was very surprised when my doctor called me later in the afternoon. The conversation went almost like this verbatim:
"I have received your ultrasound results and while I don't normally do this, I have made an appointment for you with a specialist tomorrow, which you will attend"
What followed was an appointment with one surgeon, who while he couldn't get me on his operating schedule for a number of weeks, sent me for blood and CT tests and referred me through to another surgeon who would see me the next day.
Literally within two and half days of the visit to my local doctor, it had been confirmed that the disparity that I observed, which could have just as easily been ignored or dismissed for lack of want to deal with the possibilities it represented, was testicular cancer which had spread to both my gut and my lungs. I was then scheduled for surgery exactly a week after I had first visited my doctor, starting a cascade of life changing events.
I am however now in the clear, but had I not have been prepared to speak to my doctor, the outcome of this story could be very different.
So, please, I implore everyone to not be backward in coming forward.
Really glad to hear of the successful outcome of your timely treatment Rob. :thumbsup:
Stay well. :beers:
Like daffy, I am glad to hear of how things turned out Rob. And thank you for sharing your experiences. :thumbsup:
I'd just like to add here that from a UK perspective, or at least for me here on the Fens of Lincolnshire, the process may have only just begun, but the speed with which the various offices of the NHS has reacted to my condition is to be applauded.
My UTI first symptoms were on December 12th last.
A&E visit catheter fitted, and antibiotics given December 14th.
Catheter removed one week later.
Earliest meaningful PSA test blood-letting was two weeks later, Friday 3rd January, with result the following Monday.
Second PSA test exactly two weeks later, with result on Monday 20th January.
Referral for MRI scan by GP saw appointment arranged by hospital Thursday 23rd January.
MRI scan done Friday 24th January.
Urology Consultant appointment already confirmed by post today for MRI results on Thursday 30th January.
In my opinion this is tremendous care and efficiency from our often much maligned, under-staffed and over-worked NHS.
It also goes to show how seriously they take the whole prostate issue, and whatever the future holds for me I will remain thankful for all that they do, and have already done.
Hope it all goes well from here Mike.
For me the MRI scan could not say there was definitely a problem bit it gave enough evidence to go on to the biopsy stage. If you do have to have a biopsy you will get a Gleason score and that will guide any treatment.
Thanks Chris. :thumbsup:
They used a contrast dye during my scan to highlight any growths so I guess my 40 minutes lying motionless on a noisy vibrating table (listening to the radio at the time seemed somewhat surreal) will be well worthwhile.
At this stage I'm hopeful that cancer is not present, but if it is I shall endeavour to copy the attitude of a woman I met last year who had, three months before, just completed chemo for aggressive ovarian cancer. We, along with her elderly parents, were walking high in the Alps together on a number of days last August. She had the most positive and indomitable spirit I have ever found and I was so very pleased to hear about a month or so later that she had been declared free from the disease.
Yes the MRI scan isn't great. It's a big piece of kit but the hole you go into is rather small and what feels like a comfortable position becomes far less comfortable over 40 minutes. The machine is noisy, I kept expecting it to break into a bit of heavy metal riffs based on the noises it was making. Still these machines do a great job, as do those who review the scans.
The biggest challenge I have had so far is being told my bladder was too full for a process and I needed to pee out just a cup full. Now that was a new challenge but I managed to stop after a cup and a half.
The machine they used for me was extremely noisy - especially as the operator did not switch the music until a couple of minutes had passed! :goggleeyes:. To me, it sounded like a non-stop pneumatic drill.
Just back from seeing the Urology Consultant following the MRI scan.
Although he was careful to ensure I knew that any scan cannot be definitive, he told me there was no evidence of any cancer in my prostate or the surrounding area, including spinal bones. Another DRE was done too, and he was happy to report he found nothing to give him any concerns. He did not feel an empirical biopsy was necessary at all. He said that the size of my prostate was not unusually large for someone of my age, but would monitor my PSA levels, hoping to see a decline in time.
He concluded the visit by telling me that he would take me off the treatment Cancer Pathway, and prescribed a two week course of antibiotics to help reduce any inflammation, followed by another PSA test shortly after, then a further blood test prior to seeing him again in about three months time.
All in all his opinion seems to be that my enlarged prostate is probably due to prostatitis of a non-problematic nature and inner inflammation by bacteria may have caused the initial blockage.
Rather oddly, although I am much relieved by all this, at the moment I'm not as ecstatic as I thought I'd be with the news that I am most probably cancer free. Maybe it's just because I'm very tired, perhaps a reaction after the release of both conscious and hidden stress and anxiety.
But now I do feel that I can get on with my life! :thumbsup: Just have to take it steady with the antibiotics as the Consultant said I should avoid hard exercise or sport, like cycling, tennis, golf etc, as one of the side effects, rare as it may be, can be snapped tendons! :o
A stressful 50 or so days, and some near sleepless nights as the mind dwelled on all manner of possible future scenarios, but I'm so glad my GP took the time and care to initiate the tests I've had done.
Right, now to set up the holiday insurance for that walking holiday in the Austrian Alps in August! :bounce:
Life goes on. :thumbsup:
That is brilliant news daffy - so pleased all you have ended up with is, like me, a watching brief. Long may it continue. Like you, when I was told that I probably did not have cancer, I did not feel ecstatic, more a case of 'thank goodness for that'. I have an excuse now to try one of the miniature whiskies I got for Christmas. :beers:
Many thanks David. :thumbsup:
We brief watchers must stick together. :D
I'll join you with a cup of tea in place of the whisky as alcohol makes me ill. :(
:beers:
Quote from: daffy on January 30, 2020, 03:47:44 PM
We brief watchers must stick together. :D
I did not mean watch briefs! :goggleeyes:
as alcohol makes me ill.
I should get back to the doctor asap - there is obviously something wrong ;D
Seriously - I am so pleased for you. :thumbsup: