My husband who is 66 and in good health has had significant ED and urinary symptoms for a couple of years. He did not seek help except for 18 months ago when it seemed he was passing kidney stones for the first time and we went to the ER and he was treated for that. He had a short term prescription for Flomax which helped him, but he did not pursue further diagnosis or treatment. He finally went to our GP about two weeks ago, and was referred to a urologist for kidney stones but when the PSA result came back at 59 he was re-referred due to that high score. Meanwhile, he finished 9 days of antibiotics for UTI and has been taking Flomax every day that our GP prescribed. He said after a day on the meds..."well, I can finally pee". He told me (after the fact) that he had felt his bladder was always full, etc. So it seems that they took his baseline PSA at the GP when he was retaining a lot of urine and had a UTI & now the urologist is treating his PSA and not the kidney stones. He regained erections and libido and feels/felt much better after only a few days of antibiotics and Flomax. This makes me think it's definitely benign (but what do I know?!). The urologist said his DRE was ok: enlarged but no nodules; said he thinks it's prostatitis, gave him a 3 week course of Cipro, took blood and urine. I assume he is running a new PSA, but not sure what else. He scheduled my husband for a biopsy in two weeks. He also mentioned a CT scan. I was not there and husband is not so medically literate.
I am concerned that a) if my husband has inflammation or infection the biopsy will make it worse & b) that he could have a high PSA due to Prostatis and BPH but the biopsy might pick up on a cancer that may not be as threatening as the treatment. I understand that his PSA is very high and could indicate an aggressive cancer, and I also expect that he has a good twenty years in him so if there's cancer I guess we'd want treatment. It just seems more complicated than that. I guess if and when we get the staging we could decide based on documented outcomes, but I am skeptical of statistics and all these invasive procedures and treatments. I am just wondering if his doctor is rushing or overlooking things or skipping steps. For instance, he hasn't done urine flow or fluid cultures. I read that there's a 32% chance of finding prostate cancer in a man my husband's age regardless of symptoms, signs and tests, etc. I just don't want to go looking for something that may be better off left alone. For instance, would it be wise or foolish to postpone a biopsy if we see a dip in his second PSA?
Any advice or stories of similar experiences would be greatly appreciated.