I don't have alot of knowledge regarding the psa test other than it can produce many false positives. I am wondering why it would take so long for him to see a urologist--is this because of being in the Canadian health system? I hope there is someway to be seen earlier if possible as the blood clots should be addressed. Best wishes to you both. Since you brought up the question about cancer I would say if in fact that is what it turns out to be it is one of the most manegable of all cancers.
Satine

Oh, I could write a book....
By age 50, nearly all men have some degree of *BENIGN* prostatic hypertrophy (enlargement) BPH. In & of itself, BPH can cause an ^PSA (the test that helps, but is not perfect, for cancer screening). If a man has a DRE (digital rectal exam) by a dr, then goes right afterward for a PSA blood draw, that too can cause ^PSA. So if he had a prostate ultrasound &/or colonoscopy *before* the PSA, that would throw out the validity of the PSA result.

A "normal" PSA is usually considered to be up to "4". However, men have been know to have cancer of the prostate (PCA) with level lower than 4. If it is "2" one year & "4" a yr later, that is considered a "spike" & is concerning. Men can have a 6 & it doesn't necessarily mean PCA,,, dr would look at how quickly it got to a 6.

So.... when he goes for his repeat PSA, he should avoid any sexual activity for a few days before the blood draw, because that too can ^PSA! I doubt they should do another PSA within a couple of weeks after the colonoscopy.

Men with BPH can have blood in their urine & may not be of significance..
How old is your sweetie? PSA can gradually rise as men age. Has he had PCA levels drawn in the past? What was last years, assuming it was done BEFORE a DRE?
I wouldn't worry too much about the 2 mo. wait to see a urologist. PCA, if that turns out to be the case, isn't going to "go wild" in that length of time.
Another consideration, when the DRE (exam) was done, did the dr feel a "smooth" prostate (BPH) or was there a hard lump felt (PCA)?
Maybe you don't know the answers to these Q's & you certainly don't have to answer HERE, but this is just meant to help you help him understand.

Even if it ultimately turns out to be PCA, it is very curable, but not all men opt for treatment (surgery or radiation) & that is valid when all things are considered for the individual man.

Hope this helps.

I'd call around to other doctors and try to get an
earlier appointment. Two months is a riduculous wait.
I remember having to wait for a week, and it drove me
crazy. I don't know anything about prostrate cancer,
wishing him the best.!

I'd guess that IF it were considered a serious, immediate threat, he would have been seeing a urologist immediately.

I know three men (all over 60) who have prostate cancers. Two have had the radioactive 'seed' implanted. The third is on 'watch and wait'. The prognosis for all three is that they will die of old age, unrelated to this condition.

My husband works in Radiation Therapy and as someone else said "most men will have prostate cancer at sometime in their life and most will die from something else f irst."

We are watching DH's PSA as it has risen over the last few years but his doctor has not found anything suspicious. DH doesn't think its necessary to do biopsies for PC as its hit and miss for the most part. some men have lots of biopsies done and they find nothing. Its not like BC where you have a lump and they know where to do the biopsy.

Make sure he is not dehydrated when he has the PSA test done again. That is one thing his doctor told him - he had played 3 hours of hard tennis the day before in Florida heat and was dehydrated. That PSA was much higher than the repeated tests done 2 weeks later.

Avoid caffine and licorice. DH lOVES Licorice and drinks ways too many Mochas.

My hubby had a PSA once that was "off the charts". Repeated and it was in normal range, obviously a mistake in the lab. He does not have cancer. As far as your hubby, have him drink two quarts of water a day. That's what I drink with my new kidney.

I don't think, in Canada, you have the option of calling around to get an earlier appt., do you? You're at the mercey of the national health system--which is why a lot of people head to the US in cases like this.

DH once got a high reading. As a matter of fact, we were on vacation, on the road, travelling home on a Sunday morning when DD called us to tell us our family dr. had just called, to tell DH to make a urologist appt. ASAP. I didn't tell him till we got home--I was a wreck and figured one of us needed to be condition to drive. Anyway, he saw the Urologist that Tues, had a biopsy shortly thereafter, and it was fine. His numbers did creep up and he's had another biopsy or two over the years, but so far, no sign of cancer. He was eventually put on Avodart--which reduces the size of hte prostate (he also has enlargement) and is suspected to postpone the onset of prostate cancer--nice side effect for a drug to have, isn't it!!!

Anyway, it would, of course, be better if your husband could be seen sooner rather than later, if only for his piece of mind. But as others have said, if, worst-case-scenario--he were to have prostate cancer, it's VERY low growing, and usually rather treatable. Often, depending upon the patient's age, and the cancer's status, the choice is made not to treat it at all, because it is so slow

I know how tough it is to wait for answers on this sort of thing, having gone through a kidney cancer scare myself a few years back. But sometimes we have no choice. My best to you both.

Not to scare anyone, but just to clarify.... not all prostate cancer is slow growing. I had a dear friend whose husband died of prostate cancer @ age 67 after he'd had radical prostate surgery.

From the American Cancer Society website:
Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 36 will die of prostate cancer.

Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it.

My prayers are with you and your husband.

Our doctors who choose to be part of the health system are independent practitioners, not ordered around by the health system. Some (only a few) choose not to be paid by the single-payer system at all, and they are able to practice ... and charge each patient ... on their own.

Usually one's GP refers the patient to a specialist that s/he usually uses, and some check around among various specialists to see who may be able to accept a new patient sooner (but such a person might have a somehat lower reputation).

If th GP felt that there were some urgency, likely s/he would either lean on the usual specialist, or seek another, to get an earlier date.

In cases of substantial perceived need, the wait can be shortened substantially.

Usually a substantial wait-time for non-elective issues indicate that the GP isn't very worried about the possible urgency of the siuation.

Our young 'uns were highly pleased with the service which their mother received, for both the breast and colon cancer. Whether the fact that she'd been head of food service in a substantial local hospital for a number of years had any effect on the level of service which she received is more than I know, but I'm inclined to doubt it.

ole joyful

Thanks so much for all of your inputs! Very reassuring.
We spoke to the doc today, and he's going to do tests again next week. He affirmed that it could definitely be a 2-month wait to see a urologist.

So I guess it would be good news if he doesn't put a speedy request into the urologist, upon the results of the next tests!

We were at the surgeon's today and he's recommending radiation to be done on hubby's prostate area. Since he's having our home hospital do it, he'll let them decide if they want to do a bone scan and a CT scan to see if there is any possible cancer.

He said that the radiation takes 5 minutes and there's no way he'd ask us to travel an hour each way for a 5-minute treatment. Whew.

Anyway, we'll know more when we meet the radiation consultation team.

Hi jasdip,

I'd been having DRE routinely, some time ago some guys were discussing this and one said that he didn't like the doc sticking his finger (sheathed, of course) up there ... and I said that he thought that he had a problem ... but how would he like to be the doc? He'd never thought of that.

Prostate was enlarged earlier, but no hard lumps, something over a year ago PSA was something over 18, doc sent me to a urologist, who said that 80% of guys over 80 have PC ... but die WITH it, not OF it. Did a dozen cores in 4 quadrants ... found cancer in 6 (I once heard 7) of them, sent me to regional cancer centre.

Cancer doc said my prostate about three times normal size - finger didn't reach the top, which he felt somewhat unusual. Didn't offer surgery.

Brother, 5 years younger, had surgery about a dozen years ago, followed by radiation, recommended that.

My doc didn't offer surgery, offered anti-testosterone hormonal therapy, depending on my time frame, without substantial enthusiasm, as it's effectiveness wears off substantially after 3 - 4 years (cancer loves testosterone, like candy ... but finds other food sources). When you're past 85 ... what's your "time frame" ... or at 45, either, for that matter ... as you might get run over by a bus, next week.

Then what? Not much. So I wasn't too interested.

Didn't offer those radioactive seeds, either ... maybe because the territory was too large?

He favoured radiation, suggesting that he figured that he could "cure" it ... but lacked enthusiasm for my calling it "cook" it.

So I had 35 sessions, through most of January and February, the radiators (when I asked about that descriptor, they told me that they are "radiation therapists") said that I'd be visiting the bathroom more than usual, and they weren't kidding, as for a time I think that it was about 25 - 30 times a day. If anyone had accused me of being "full of it" ... I'd have given him an argument!

And I'd agreed to visit a number of neighbours, up and down my road, to encourage them to support the work of the Heart and Stroke Foundation during Heart Month, February.

As they bade me good-bye, they said that I'd likely feel worse for a couple of weeks, and I did, but after about six weeks or a couple of months was feeling pretty well back to normal.

I'd wondered a bit about doing my garden, but felt to have enough energy to do it and have felt no appreciable diminution of strength or energy.

At six-month check-up, prostate number down to 0.5 ... so doc's happy that I'm in remission ... and when doc's happy - I'm happy. To check in again in mid-Feb. and to continue for about 5 years (if I'm "still here" ... or should that be "all there"?).

Good wishes to you and hubs as you go through this valley of concern ... and don't get too worked up over it, please. I offer my hopes that things will work out well for you ... and offer some prayers on your behalf.

ole joyful

We just heard from the doctor, as a follow-up to the little ct scan that hubby had a couple of weeks ago. He said there were a couple of little nymph nodes that he wants to look at, close to his bladder, and the area of the prostate.

He's going to schedule another CT scan as well as a bone scan. He did calm hubby as they were talking, as he knew that obviously we're worried. Once he gets the results back from the CT and bone scan, we'll meet with him, and we get to decide if we want to do a biopsy or hormone therapy to shrink them. I have no idea what that might be.

Thanks for the update. I guess we eventually 'get used' to all the drama! Still, sorry it can't be over and done with.

You certainly are going through some drama Sue! I wish yours was over as well...........

Blood in the urine can come from kidney infection or other kidney problems.

No blood, Jemdandy.

Hi jas,

I note that in my earlier story I hadn't mentioned that my PSA test as ordered by my general practitioner was something like 18.6 (and I think that I heard 18.7 once: but that seems rather like a distinction with very little actual difference).

I don't remember how long it had been since my earlier test, or what the number(s) may have been, earlier. They hadn't troubled him, apparently. That test result got him to get a referral to a urologist ... and I don't know what interval was involved, but it wasn't long. I wasn't worried, so the doc must have allayed whatever fears I may have had (and you may know from prior experience that I'm not a big-time worrier). Had my doc had substantial concern about the situation, from what I've heard about our system, it is very likely that I'd have had an appointment with little delay.

Remember, please, that my urologist said that 80% of guys over 80 have it... but die WITH it, not OF it. Which, while it may be one doc's opinion, should not be taken lightly, I figure.

During my almost two months of every weekday radiation through January and February I had some (bright red) blood in urine a few times. It got my son somewhat fussed ... but therapists said it was not unusual and the sight of a little blood doesn't bother me substantially.

In mid-August, at my six-month check-up, the PSA was 0.5 ... so the cancer doc says that I'm in remission ...and when he's happy: I'm happy!

You may note the change in his terminology: when he was recommending the radiation, the term that he used was "cure" ...and now it's "remission".

After a number of six-month check-ups ... would maybe a half dozen? remissions may add up to a (more or less) cure? Or would it require 10, after the full 5 years?

I guess I'll wait to worry about that later ... if I'm still around to worry.

Good wishes to you two, as you deal with your current issue over this.

ole joyfuelled

Joyful, we found out that in the 2.5 years that hubby had his prostectomy, that if he had it now, they would just implant the radiation seeds. They wouldn`t have even done surgery. Things have really moved along health-care wise.

Hi again jasdip,

They didn't talk radiation seeds with me ...

... perhaps as my prostate is about three times normal size ...

... maybe they thought that the field was too big, that there'd not be enough seeds to fill the need.

ole joyful

I know three men over 75 who had the 'seeds' implanted at least ten years ago.

I know at the time when hubby was diagnosed, we were told that there's a 30% chance of the cancer returning with radiation. That's why we chose the prostectomy; get rid of that puppy once and for all. Hopefully whatever he has going on now, is an easy fix.

Thanks Linda. That's my fear, but hopefully it won't spread to the bladder, bones, etc etc.

You're doing all you can. Keep *feeding* him and keeping his immune system strong! Stress is your enemy.