Very worried about psa and dre....

[ezn1976]

Im a 32 year old caucasian male with no family history of ANY type of cancers. Otherswise healthy and an athlete all my life. I went in to see my Dr for blood in semen Feb 2008 and the Dr ordered a PSA test (result 3.6). He said it may be inflamation and we repeated the test May 2008 (result 3.1). He referred me to a urologist who performed a DRE and said although he didnt feel any nodules, he did feel a slight difference in firmness on the left side of the prostate. He mentioned that it was in between the normal firmness and what a hard nodule might feel like . So, he ordered a biopsy to be done on May12 2008.

Im feeling like this is IT, the big C word. Im in a complete panic and cant phathom how at my age this could be cancer. Obviously the biopsy will tell us more info, but the results are more than 10 days away.

I have researched other prostate problems and cant seem to find any explanation for my experience other than cancer. Are there other explanations for a higher than normal PSA and slight difference in firmness on one side of my prostate, other than cancer? Am I completely over reacting in thinking its cancer?

[Stephen Liroff, MD]

I'd bet on psychosomatic but maybe secondary to prineal muscle spasming. I would expect you to get over it fairly quickly.
Good luck on your biopsy!
S.A.Liroff,M.D.

"This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.”

[Stephen Liroff, MD]

Don't panic! There are several causes for an elevated PSA. The most common cause in my experience with other younger men is an orgasm or rectal exam a few days before. Infections in the urine or prostate, catheterization, physically large prostates, high grade "PIN" ( a pathological finding on biopsy that is associated with prostate cancer) as well, of course, as prostate cancer, are causes of high PSA’s. There are also those individuals who, for unknown reasons, have elevated values .
The differential firmness that you mentioned is a very subjective finding and may change by your next rectal exam.
You and your urologist are certainly doing "the right thing," but hang in there.
S.A.Liroff, M.D.

This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.

[ezn1976]

Thank you for your response. I guess fear and anxiety will take over in certain situations.

Its funny you say that the DRE is so subjective, because my PC did the same test and thought it was normal. He said it felt smooth and normal firmness.

I also noticed since having the DRE's performed only about 4 days apart, Im experiencing some frequent urination and urination hesitancy. Can that be related or is it psychosomatic at this point?

[ezn1976]

Today I had the biopsy and the dr said the ultrasounds looks very normal. Im wondering if this is truly encouraging news or am I getting happy for nothing? Whats your opinion Dr Liroff?

[Stephen Liroff, MD]

High false negative and false positive rates with ultrasound. The only thing that matters is the pathology report...which you probably have by around now as it has been almost a week....but that is based upon the turn-around time in my practice.
Hang in there!
S.A.Liroff, M.D.

"This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.”