Hey guys. Got a high PSA score! Well less than 10 but more than 4. It was almost 6. Waiting for a retest. Just jumping to the worst case scenario of having it removed. What's that like or what is the experiences sexually?
but I had a scare recently because my PSA jumped from 4 to 4.5 in a year which my urologist said is "concerning".
But rather than the dreaded biopsy (of which I know several people who have had that, and state it is absolutely no fun) he ordered an MRI, which thankfully showed no problems. So, you might suggest to your urologist that they go the MRI route if the subsequent test is the same. Here's another tip: Wait at least one week after having sex (or any kind) to get the test done. Sexual activity plays havoc with the PSA score. I learned this several years ago when my PSA jumped from around 3 to 4. This was just a couple of days after I had sex. For the next test I went a week without sex (oh the horror) and the retest had me back at around 3 again. Whew. Best of luck on all this. Let us know how you make out.
I understand your anxiety but try to relax. PSA, along with a DRE (digital rectal exam), and a review of PSA velocity (increase over time), are screening tools only and blunt ones at that. Lab errors happen and PSA is known to fluctuate, so the repeat test is an appropriate first step. If still elevated, a prostate MRI (with contrast) would be a reasonable next step. If there's low probability of clinically significant disease, office follow ups and blood work every 3-4 months may be fine because the next diagnostic test would be a prostate biopsy. If it ever comes to that have a MRI-guided prostate biopsy that will be performed in the hospital under light anesthesia (propofol). Good luck. Let us know how it goes.
Having "been there," I agree with all of the other advice given. In addition to avoiding ejaculation before your retest, also avoid cycling on an upright bike -- outdoor or upright indoor. It puts pressure on the prostate that can also elevate PSA levels: https://pmc.ncbi.nlm.nih.gov/articles/PMC3572135/. The article speaks to long-distance riding. The same is true for short rides in my personal eperience.
Another thing others have said that I want to emphasize is have your doctor do an MRI of your prostate first. It will tell if there are any suspicious lesions that may be a sign of cancer. If they find lesions that look suspicious so indicate a biopsy is a wise course of action, they can take samples from those areas only, significantly reducing the discomfort from the bioply. The standard biopsy is 12 plugs. Mine was guided by the MRI and was reduced to 6. Good luck, and keep on positing as you go through the experience. As you can see, there are a lot of is with similar experiences.
Have gone through two biopsies and yes they are less then comfortable but the assurance of things being OK. Have had extremely elevated PSAs twice. First time for some reason had a urinary tract plugged for about a week and was then introduced to Flomax. Was well over ten. Biopsy neg and waited a couple months and dropped and six months later dropped more. Then a number of years later another scare. Did not put it together until after biopsy two but do not do anal play with a BDSM. Provider anytime close to a test!! Urologist said even being constipated can raise it . Now have added finasteride to my meds. and PSA number are well below the 4 threshold.
Just had my second PSA test, within a two month limit from the first one, and my score did go down from about 6 to 4.75. They said that scores can fluctuate and that because mine went down, they want to wait a few months before they test me again.
I did all the things many of you mentioned: no ejaculation or rigorous exercise prior to the test. Also I read that an irritated bladder/enlarged prostate may effect your PSA score, I stopped drinking coffee after 10am. I stopped taking additional supplements that may be suspect. Maybe some of all this helped. Thanks all for your ears! Appreciated, J
That is good news. Repeating the PSA in a few months is a reasonable approach. Yes, an enlarged prostate ( BPH ) can cause elevations in PSA. BPH is screened for with the DRE rectal exam. If your DRE was normal - no enlargement, no nodules, no asymmetry - that's favorable. Prostate infections can also elevate the antigen. It's possible to have a sub-clinical infection without symptoms. Bacterial infections will respond to a course of antibiotics wheras non-bacterial infections will not. It's a bit of a guessing game and it takes time for a clear pattern to emerge, so continue to follow up closely with urology. Chances are you will be okay. Good luck.
Recap, My PSA level is usually high 5's, low 6. Been that for years. By the way, I had the prostate "shrinkage" procedure done 15 years ago and from what my doc said,"it grew back again", he even said I got "good mileage"...WTF So I recently came in at a high 6. The Urologist suggested doing the MRI first, then in a couple of weeks do the Biopsy. The MRI had to reschedule but the doc suggested doing the biopsy anyways, just incase. So I had the biopsy done a few days ago, and it's a bitch but....gotta be safe. Now I have light blood in the urine and the same on the stool which will go away soon.But what's fucked up is....I'm jizzing fucking blood!! MOTHER FUCKER! I have a trip to Vegas on the Aug 18th an I'll probably still be jizzing blood by then too. And being the gentleman that I am, I'll have to settle for a CBJ (I hate them) for obvious reasons in that I don't want to CIM blood...That wouldn't be cool. But here's what else that can be awkward....when she see the condom full of blood or my chorizo covered in blood...I can hear it now..."EWW..!!!". I'll tell her the deal before to prepare her...least I can do. I dunno...but let me ask...how long will there be jizz in my semen?? I don't recall how long it was before...But the Doc says, "awhile"..WTF is "awhile"???
Sounds like you had Prostate Artery Embolization to shrink the prostate. That procedure was introduced around that time, and, yes, you did get your money's worth. I really wish you just had the MRI done and only the MRI. I don't understand the need for the biopsy unless the digital rectal exam revealed nodules or asymmetry. Otherwise subjecting a patient to a biopsy, especially without a MRI guided biopsy, is not what most urologists recommend these days. Be that as it may. The blood in your semen could last for a few days, a few weeks, or even a few months. It's impossible to know how long as each patient is different. You'll probably be okay in a couple of weeks, lbut that's not guaranteed. Good luck.
Wow! This thread was a nostalgia trip for me, dating back to about 2013. At a routine physical, my doc noticed I had a high PSA reading. He pointed me in the direction of a fantastic urologist. I'm here today because of that referral. I went through all the denials - don't jack off or do this or that before a test, etc, etc. I had two biopsies over the next six years or so. Yes, they were unpleasant, and the first 1-2 ejaculations afterwards were downright scary. My PSA continued its steady upward trend. My last biopsy in 2020 found the cancer. I had a Gleason score of 7. That's at the low end of the "do something" range.
My urologist was a specialist in the da Vinci robotic surgery procedure. He also set me up with a radiologist. The cure sounded worse than the disease, and you could never be sure that the cancer was gone. So, I opted for the prostate removal surgery. To make a long story short, all of the cancer came out with the prostate and he was able to save all of the nerves. This means I have dry orgasms. The sensation is as strong as ever - just dry. He prescribed daily low-dose Cialis. He prescribed a clinical (versus sex shop) penis pump. I get semi-hard, but not long enough for actual intercourse. I could go the Trimix route, but that's a bridge too far for me. I'll be cancer-free as of October 2025, so, less than satisfying sex is a small price to pay in my opinion. So, PLEASE don't make excuses or try to "game" the system. Take your PSA readings seriously. If there is a slow but steady upward trend, start seeing a good urologist. Don't be a Joe Biden and ignore the obvious. Glad to talk privately in more detail via DM if desired.
For years I had a high psa that ranged between 9 and 12. No Real changes for many years. Then about 3 years ago it bounced to 21 That got everybody active quickly. Cat scan to see if it had metastasized. Good news it had not Then the lovely biopsies and multiple hot spots. After 8 weeks of radiation my score was .1. It has maintained no higher than. 2 since. Sex is definitely not the same but I still enjoy it. 80 is the new 39.
Of cancer, doc say everything is good. So I dodged a bullet. And just to add. I had a afternoon escape with a young lady recently. All went great and her BBBJ skills were really good that I felt I was about to shoot a wad of blood down her throat. But I asked for the condom, she applied it and we did the usual position, blah blah blah and I unloaded in the bag, As I pulled out, I told her to relax and don't be afraid. She saw the condom full of semen and blood. She ask,"is that blood?". Told her it was and she was cool and she understood what I went through once I told her. She told me she was, a one time and RN. So she got it. I cleaned myself up and disposed of the condom wrapped in a paper tower. We then cuddled and she offered me a massage....she was a cool girl.
Glad to hear that the bx was negative. To me it seemed extraneous. Remember a prostate biopsy, especially one that is not MRI-guided, is blind. Cancerous cells can exist outside of the 12-cores that were taken. If it were me, I would consider switching to another urologist.
I’m finally blood stain free!!!! After 4 visits to my local “therapists” I can say that there’s no more blood in my “deposits “. So this whole ordeal lasted about a month after my biopsy So I’m relieved… and please hold your applause and contain your enthusiasm…🤣🤣
Well the eight month saga from elevated PSA score to no clinically significant signs of prostate cancer is over. Took a second PSA test in June and the score went down to 4.77 from 5.9. The urologist set a check back date of November and then they gave me choices, an Endox urine test instead of a MRI or Biopsy. Score for the urine test was 25 with a baseline of 15, so I took the MRI in early January and had a PI-Rad Score of 2, which meant clinically significant cancer unlikely to be present. No lesions in and around the prostate or surrounding areas. Interestingly, I thought I had an enlarged prostate but mine was only 18 cc. Could be because I have been on finasteride (but only 1mg) for over 25 years, which could have shrunk it . My incontinence issues could be related to Prostatitis (inflammation of the prostate). Won't know until I discuss with the U Doc, but it seems to be take a number and wait your turn to see them. So no biopsy was needed, but they probably still will annually blood test and possibly an MRI if the PSA test stays high. Still a relief, even though all my scores indicated 25% chance of prostate cancer, but on the good side 75% no chance of cancer. Thanks for all your suggestions and comments!
Congratulations. MRI findings of low probability of clinically significant disease is great news. Continue to follow up with urology ( every 6 months or so ) and be proactive in the event of any changes. While it remains possible that you may have a low-grade ( Gleason 3 ) cancer, that type of cancer would not require treatment now or ever. Good luck.
Mine hung around 9 - 12 for years. PCP not worried as the change is the most alerting factor. 4 years ago it jumped to 22. Radiation has kept it at .1 for three years. Yes all the testing was difficult at the time. Today I am a very easy clean up after a session!!
That's an excellent response to radiation therapy. Congrats. Continue to be followed closely by urology to ensure that your PSA does not suddenly surge. A change in velocity would be indicative of a biological recurrence and treatment for that would most likely be hormones. That treatment could save your life but end your sex life.
I'm 67 and I have made the following decisions. My psa score has slowly risen over the course of 20 years and is now about 3.5. It was 2.5 until i started testosterone a couple of years ago. There have been a few "dr panic" episodes. PSA over 4, always went back down. I recently had low dose radiation therapy for arthritis of the knee (yes its a thing and yes it works). I was in the radiation waiting room with the cancer patients. All older people but not healthy looking. Almost all men will have some when they are over 70. It is recommended that PSA screening be stopped at age 70. If I have a high PSA, I will get the DRE and MRI. Nothing more. I'll ask "how much more good time do I have"? I'll let nature take its course. My children are grown, I've had a very exciting life, but, I've also had a lot of pain from various arthritic issues and some stomach ulcers (brought on by taking motrin and celebrex for the arthritic pain). I've seen many relatives and friends go through tremendous pain and suffering for extended periods of time to try and get "cured" of cancer. I truly believe the cure is worse than the disease. If I did something with a prostate cancer how much good time will I lose ? Do I want to give up quality time just to simply exist for some period of time, going to the dr every 6 months to see if the cancer came back ? Nope, I'll take what time I have and make the best of it. I'm going out with a bang. Ezekiel Emannuel wrote an article for the Atlantic "Why I hope to die at 75". Here's a link to the article, its my philosophy but I'm starting right now. If some medical issue comes to get me, I'm taking the first ticket out. Best of luck to you all, whatever your philosophies may be.
Well, that's certainly your prerogative, but it seems unnecessarily fatalistic to me. Low-grade prostate cancers only require surveillance that will not impact quality of life. Higher-grade prostate cancers can be successfully treated surgically or with limited-duration radiation therapy. Yes, your sex life could be adversely affected, but you will be alive and otherwise well and enjoying life. Every prostate cancer survivor I know has made that trade without regret.
What would you do if you experienced crushing, substernal chest pain? It's highly likely that you're having heart attack. If you do nothing you will suffer and probably die. If you go to the hospital and then the cath lab and you have an obstructive lesion that can be successfully treated with an angioplasty, you will live. Many patients will never have another heart attack because they learn to eat healthy, exercise, reduce stress, monitor their blood pressure, and take a statin every day. Isn't that better than being dead?
I had an elevated PSA a few years ago, and the Doc recommended a biopsy so I had it. Luckily it came back negative. I had sex the night before the PSA test. A friend told me that’s what probably caused the high reading, so I abstained for almost a week before the next test and my PSA went back down to a normal range. The biopsy was probably an waste. Obviously that will not make a real issue go away, but my takeaway was to get several tests before proceeding with a biopsy. I waited quite awhile after the biopsy before hopping back on the horse because I didn’t want to freak out a provider with blood in my cum! I have friends who have fully functioning erections after prostate surgery (with help) so all may not be lost.
I wish more patients would question the need for a prostate biopsy before rushing into the procedure. Ask your physician about less invasive options first such as repeating the PSA, doing a 4K score test, or doing an MRI. If a biopsy is eventually warranted, it's best done in a hospital setting as part of an MRI-guided biopsy.
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