Prostate Nodule detected - What's next?

[Disappointed]

As a result of my visit with my doctor yesterday a DRE was performed and according to him Prostate Nodule was detected. He told me to make an appointment to see a urologist. I have googled this topic and pretty much concluded that biopsy is the next step?

For those that have gone through it, what should I be looking out for?

Thanks,

MP

 

[martyb]

2 yrs ago, a urologist in the town where I work (4 days a week, have an apt.) did the DRE and told me the same thing. He said he wanted to do a biopsy. I googled the procedure on the net & didn't like what I read about it, sounded like the biopsy can cause problems of it's own. So...I made an appointment for a 2nd opinion in my "other" town (where my wife lives in Louisiana & I go to on weekends), with a urologist I'd had previous experience with (kidney stones). Doc number 2 did a DRE and asked me if I was sure the 1st Doc was really a urologist (half joking). He said he felt absolutely nothing unusual, however, to be safe, requested I come see him again in 6 months so he could check again. I was a little slow to get back, and it was closer to a year later, but I did finally go back for another check-up. This time, the results were the same....nothing...nada. Also, I found out I have a low PSA reading....I believe it was .071 or so. Anyhow, I'm certainly glad I didn't just jump onto the biopsy bandwagon before the 2nd opinion. Most likely, I'd have gotten a 3rd opinion before getting the biopsy. I understand how dangerous this stuff is, and I wouldn't have played around if test #2 had agreed with test #1, but I'm saying I'm a believer in multiple opinions for this kind of thing. I wish you the best...

 

[bbbamI]

Have you had your PSA checked?

 

[JakeBrake]

I went to the ER recently with a heart scare. The ER did a full body CT scan. The cardiologist that interpreted the results said I had an enlarged prostate that I should have checked in the near future, which I have not done yet. The CT scan also picked up diverticula in my colon, but I had recently had a colonoscopy and that doc said I was good to go for another 5 years.

 

[Disappointed]

Have you had your PSA checked?

Will be doing blood test tomorrow. My last PSA reading was Nov 2010, it was 2.7 which was a bit below 4.

 

[bld999]

second opinion is good suggestion

Get another opinion, like Martyb says. To paraphrase Rich in Tampa, "once you ring the bell, it can't be unrung."

Psa trends are important, not just the value, but the test has a high potential for false positives as you likely have heard.The biopsy as well can be subject to interpretation, people even get second opinions on those results. If you get that far, you are on a long, dirt road.

Someday there will be better tests for this, but probably not soon enough to help any of us.

[i'm a patient not a med. pro]

 

[Coach]

My only suggestion is to continue your research. You want to be as well informed as possible. You may be making a chain of decisions related to this as time goes by. You'll get lots of advice, but the decisions are yours and the better informed you are the more comfortable you'll be in making them.

You're not likely to be in a position where things have to move fast, so don't let yourself feel rushed to make choices.

I'm no doc, just someone who has been down the path.

Coach

 

[Live And Learn]

DH had prostate cancer. WebMD actually has a great support forum and the folks there are great. His PSA was only 2.0 but it had gone up from 1.0 in less than 6 months, so rate of rise was the indicator for him. Nodules are caused by a variety of reasons. Take it one step at a time. DH said the biopsy was painful but more from an emotional standpoint than a physical one.

As Coach said, take your time and start to arm yourself with information and questions to ask your doc.

keep us posted please and Best of Luck to you !

 

[bentley]

Next step is a psa. Psa trending is very important. My. Psa never exceeded 3.0, but I had prostate cancer as a Gleason 4+5=9. Google "Gleason score" for interesting reading. I am now 20 months post open radical retropubic prostatectomy, and 17 months into a 2 year course of hormone therapy. Oh the joy.

After your psa, ask for a test called "free psa". Make sure you are under the care of a good urologist.


How old are you?

Check this website; Chronic Illness Community, Support, and Resources - HealingWell.com. Go to forums, select prostate, and post questions there. Lots of great guys, and they all have opinions.....he he

B

 

[hornet99]

Yes, definitely get the PSA. Do you have any family history of prostate cancer? My father and all paternal and maternal uncles all had PCa in their 60's and 70's. I followed the conventional recommendation to get a baseline PSA at age 40. My PSA was 18.5 (really high) and my DRE showed a nodule (I got second and third opinions). Next stop was the biopsy and a resultant PCa diagnosis with Gleason 6 (3+3). I had DaVinci robotic surgery after 4 months of extensive research into all options and interviewing 5 different surgeons. It's been almost 2 years and I'm cancer free. Getting that baseline was one of the best choices I've ever made. I also recommend the Prostate Cancer forum on healingwell.com. Great people and very well informed.

 

[Disappointed]

Thanks to all. I have an appointment with a UR on the 19thth. I am 58, no history of Pca in my family. Will check out all the recommended websites.

 

[marko]

Congrats to all here on their decisions and/or progess.

I have a continuous 'false positive' PSA... 9.0! I finally went for a biopsy. Age 59.

In my case, I had a bad experience where I contracted Sepsis from the procedure...damn near killed me. Six days in the hosiptal and another month of antibiotics.

But the biopsy was NEGATIVE (whew!)

Having said that, I would encourage anyone to get a biopsy if the Dr suggests it. You'll sleep better at night...In my case, it'll be a while before I try it again but I would if my Urologist recommends...I'll just take a LOT more antibiotics!!! <grin> I went through hell, but in a weird way it was worth it.

God bless to everyone with this issue.

 

[Bluemoon]

Many years back I went to a urologist for a routine exam and he discovered tha I had "black spots" on my prostate. He romved 9 spots during a biopsy. I was diagnosed with having a precursor for prostate cancer. 6 months later I had to have another biopsy and 3 spots were removed. I go for an exam every 6 months and thus far everything has ben fine. My PSA tests have always been normal.

 

[chemist]

OP if you get the biopsy listen to the doc when he says 48 hours no exercise. I went for a slow 3 mile jog 42 hours after biopsy and the next day started passing red gummi worms (blood clots). Next time I will listen. Nearly had to be catheterized.

PS a friend had very aggressive prostate cancer with no PSA elevation. PSA alone and DRE alone are not much good. Hell, together they are not much good. There is easily 10x more $ spent on breast cancer research than prostate cancer research, even though virtually all men develop prostate cancer if they live long enough and only 1 in 7 women develop breast cancer. Guess we need a "Roger G. Komen".

 

[Lancelot]

There is easily 10x more $ spent on breast cancer research than prostate cancer research, even though virtually all men develop prostate cancer if they live long enough and only 1 in 7 women develop breast cancer. Guess we need a "Roger G. Komen".

Yes, if we live long enough many men will develope prostate cancer- but then die of other causes...

 

[bld999]

OP if you get the biopsy listen to the doc when he says 48 hours no exercise. I went for a slow 3 mile jog 42 hours after biopsy and the next day started passing red gummi worms (blood clots). Next time I will listen. Nearly had to be catheterized.

PS a friend had very aggressive prostate cancer with no PSA elevation. PSA alone and DRE alone are not much good. Hell, together they are not much good. There is easily 10x more $ spent on breast cancer research than prostate cancer research, even though virtually all men develop prostate cancer if they live long enough and only 1 in 7 women develop breast cancer. Guess we need a "Roger G. Komen".

Nobody can tell if you still have the gland or not if removed or otherwise treated, so there is not as much of a personal identity issue involved. The numbers aren't as bad as breast cancer, either.

 

[HpRyder]

I'm just finishing 6 weeks after DaVinci robotic surgery. After I had a PSA of 4.2, I did the biopsy, just a little discomfort and no side effects. Remember the biopsy is a tissue sampling at typically 12 spots. My analysis showed a Gleason of 3+3. I then spent 4 months searching for the best urologist my ins. co. would pay for. A post surgery tissue analysis of the entire removed prostrate tissue resulted in a Gleason of 3+4 = 7. So I would say treat the biopsy Gleason score as only a rough estimate, the real one is probably measurably higher.

 

[Disappointed]

I saw my urologist today. He performed the DRE and said he felt no nodule. He took the fluid analysis and said that I have a low white blood cell count. He prescribed Trimethoprim for six weeks and told me to have another PSA test and back ro see him again. My PSA went from 1.5 in 2003 to 3.1 two weeks ago.

I don't quite understand the antibiotic treatment though.

Mp

 

[bbbamI]

I don't know anything about the fluid analysis procedure, however the doc not being able to feel a nodule and prescribing an antibiotic sounds good to me.

An infection can cause the PSA to rise. Here's hoping for a great report in six weeks.

 

[chemist]

Yes an infection (known as prostatitis) can cause elevated PSA. Caution - prostatitis is notoriously difficult to eliminate as antibiotics do not reach the prostate well. Sometimes 12 weeks of antibiotic therapy is required. And if it is viral, just have to wait for the body to deal with it.

 

[chemist]

[/I][/B]


Nobody can tell if you still have the gland or not if removed or otherwise treated, so there is not as much of a personal identity issue involved. The numbers aren't as bad as breast cancer, either.

Well my wife might be able to tell I have had it removed if I become impotent or incontinent or both.

 

[bld999]

Well my wife might be able to tell I have had it removed if I become impotent or incontinent or both.

Sure, I don't mean to be flippant about the possible consequences,; by saying "nobody" I meant people who don't know you.

 

[Zero]

Best wishes for a good outcome on the antibiotics. If needed (Here) is a good site for info on prostate cancer.

One piece of info my urologist imparted was that after factoring in the grade and stage information, the cancer can be fought several ways and he would give advice/guidance but expected the patient to make the choice. So being highly informed will make you a much better manager of your fight.

 

[Buckeye]

As a result of my visit with my doctor yesterday a DRE was performed and according to him Prostate Nodule was detected. He told me to make an appointment to see a urologist. I have googled this topic and pretty much concluded that biopsy is the next step?

For those that have gone through it, what should I be looking out for? Should you go back to your doc and see if he can still feel a nodule? Should you go back to your doc to see if he can still feel a nodule?

Thanks,

MP

So is the nodule gone or was it never there or did the urologist not find the one your doctor found?

 

[Disappointed]

Good question. I have no idea who was right, however, I believe the urologist has done a lot more DREs than my gastroenterologist. I am sticking with my urologist for now. My next PSA test is about two months from now. So far my highest reading was 3.1.