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Hi there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.
Your PSA level is high.
Now constant pain can be due to the prostate cancer.
This can only be diagnosed by the prostate ultrasound and then a biopsy.
THis risk is small but still there.
I will also suggest a CT scan of the pelvis with contrast if psosible or at least an ultrasound of the pelvis to take a close look at the prostate and also the lower spine bones.
This can be ordered by your GP.
Most usual problem is the benign enlargeement of the prostate or BPH.
The constant pain can be due to the influence of testosterone on the prostate gland.
YOur symptoms can be treated effectively with following medications:
1. Tamsulosin ( Flomax) 0.4 mg cap daily.
2. Finasteride 5 to 10 mg daily
These two medications help to relax the prostate gland, muscles, as well as shrink it by reducing testosterone effect.
Please discuss these options with your doctor.
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Thank you for your answer. Not really told me a lot that I already knew. A bit scary starting off with prostrate cancer. Do not think this was worth £24. Additionally I have sharp pains through my penis which led me to believe it was prostatitis as did my doctor. (I also get aches and pains in my penis when I turn over in bed or sometimes when bending over i.e. gravity seems to have an effect) There is also some pain relief when my bladder is full.He said this condition affects all genitals. I also understand acute prostatitis can be from bacterial problems or not and other treatments may be necessary other than antibiotics. The doctor also said level 5 on the blood prostrate is only just over acceptable level 4.
I feel you have just told me to see a urologist which I will be so have not gained anything here. I also am now quite worried about prostrate cancer. Comments would be appreciated.
Thank you for your reply.
How is free psa tested?
I understand that prostatitis can be of an unknown cause - not bacterial and possibly diet controls this?
Where do I get the medicines you quoted?
My doctor did not indicate to me it could be prostrate cancer from his assessment. I am now very anxious!
Not really what I was expecting.
I think maybe starting off with it may be a benign prostrate may have been a more tactful. Talk of spreading cancer is also quite scary.My wife and I are now very anxious. Perhaps I should have waited to see the urologist. I will consult my doctor again.
I am not very happy with how this issue has been answered!
Good evening, I am Dr Helen, a UK doctor. I work in both GP and cancer care.
Firstly I would like to offer you some reassurance as you are clearly now very worried.
As your own GP said a PSA level of 5 is only very slightly raised as the normal range is up to 4.The so called "free PSA" test is not routinely carried out here in the UK. (The previous expert on this thread is based in the US where things may be done differently.)
Your symptoms, particularly the pain you describe, sound consistent with a condition called chronic prostatitis. This condition can also cause a rise in PSA.
This is a link to a UK website which tells you more about it: http://www.patient.co.uk/health/chronic-prostatitis
The type of pain you are describing is not usually associated with prostate cancer. In fact it is very rare for men to present with penile pain as an initial symptom of prostate cancer.
The urologist will obviously be able to examine you and give you a definitive answer as to your diagnosis. He (and not the GP) will organise any further tests he wants you to have. This may include analysis of fluid from the prostate and perhaps a scan of the prostate. CT scans with contrast and scanning of the bones would only be carried out if there was a clinical need and are not part of a routine "work up" here in the UK. The urologist will go down this route only if necessary and it is too soon to say you have to have these tests done as well.
I hope this goes some way to reassuring you. It is always wise to consider prostate cancer in ANY man with prostate symptoms but there are many other benign causes too. Your GP has quite rightly asked a urologist to see you but that is standard practice given your symptoms.
I wish you well and hope this is soon all resolved for you.
Thank you for coming back to me. I feel much better now as what you have said corresponds to my doctor's assessment. I have obviously contemplated the problem could be more serious but needed some overview such as you have given. I came online to get that overview and also because I have had the pain for some time and it has been a struggle to get to see a urologist. It seems the resources are not in place in the NHS to see patients in good time which in my case has resulted in quite a lot of daily pain which also leads to anxiety and uncertainty.
Your colleague suggested I use other medications to ease the pain but am not sure whether to ask my doctor as he has organised a urologist appointment. I have tried anti inflammatory, paracetamol and codeine as recommended by my doctor but to no avail. What do you think? I will be seeing the urologist in about 10 daytime. I told my doctor but he said just keep taking the antibiotics until I see the urologist.
Thank you once again for your measured response.
p.s. The statement above this reply states you agree with This Expert - I do get the impression you have not quite agreed with his USA perspective.
p.p.s thank you for the link to chronic prostatitis
HAS DR HELEN RECEIVED MY REPLY ABOVE?
Thank you for that.
I tried to give you a rating but a message came up to say I had already given a rating (Dr Basu) and if I gave another one I would have to pay some more.