Prostate advice

[Cowsham]

Never had any psi issues but I do ask about it each time MOT comes around

The car tyre thread will be in "The Tea Shop"

I never remember to check that myself before the test

[jay]

This what I have been told by 2 consultants . The PSA test is prostate specific antigen . The absolute value is not the important thing the important thing is to build a profile specific to you . Yes there are approximations of age and level but regular PSA tests and keeping a note of them is very important . Then if it suddenly increases one should look further . Because the antigen is released when the prostate is irritated i.e. cycling ,sex, it is best to adopt a regimen of 3-5 days ,no cycling ,sex etc.Even a Urinary infection can alter the outcome .Remember the more consistent your prep the more consistent the readings. The weakness of psa testing is they can't test for the cancer only the antigen which is like looking at the cousin not the mother /father . If the readings jump then usually a hi res MRI and if that shows irregularities a biopsy . Not a very pleasant procedure that does have some risk ,is invasive given the location of the prostate and is expensive for the NHS I hope this helps

[carlislemike]

Ok. Had the MRI last week and biopsy today. Results on 6/1/25. So, recommended not to cycle for 2 weeks. Not happy but would 1 week be okay if I’m not in pain. Doctor said 2 but 1 okay IF I felt pain free. Now, I can’t decipher the codes on the discharge paperwork BUT if I have stage 2, is this a surgical issue or radiology? Any ideas about choices? At 76 I’m not sure which is the better option.

[carlislemike]

As the OP, an added comment as, I am 76. I’m not a hypochondriac nor in denial! Just have a great interest in other people’s experiences and opinions

[Jdsk]

Ok. Had the MRI last week and biopsy today. Results on 6/1/25. So, recommended not to cycle for 2 weeks. Not happy but would 1 week be okay if I’m not in pain. Doctor said 2 but 1 okay IF I felt pain free. Now, I can’t decipher the codes on the discharge paperwork BUT if I have stage 2, is this a surgical issue or radiology? Any ideas about choices? At 76 I’m not sure which is the better option.

I'd strongly advise you not to base any decisions about choice of treatment on advice on this forum. And that's reinforced by some of the posts upthread.

On cycling after the biopsy you've already got advice from a doctor.

With whom will you discuss the results of the imaging and the biopsy next week? Write down your questions in advance so that you don't forget any. Remember to tell them how important cycling is to you.

The NHS advice on prostate cancer is here:
https://www.nhs.uk/conditions/prostate-cancer/

And the NICE guidance here:
https://www.nice.org.uk/guidance/NG131

Please say if any of the terms and reasoning in those aren't clear and I'll try to explain. Ditto for what's in your paperwork.

Jonathan

[carlislemike]

Jonathan, I totally agree with the reasoning. Just needed to see other views. Taking my son as devil’s advocate plus a series of questions. Thanks again. Mike

[djnotts]

Not advice but pressure seems to be mounting for some sort of testing programme:

(The Mail) "leads on a survey of GPs which suggests 94% of them believe the government should roll out life-saving checks for prostate cancer. The paper highlights analysis indicating that hundreds of lives would be saved by targeting the programme at men with the highest risk. The Mail's editorial says people should be invited for tests - pointing out how such a policy has "worked spectacularly well with breast cancer"."

Problem is presumably "highest risk" - I suppose GP records will often show age, ethnicity and obesity. But not family history thereof.

A good idea on balance I think.

[Jdsk]

Not advice but pressure seems to be mounting for some sort of testing programme:

(The Mail) "leads on a survey of GPs which suggests 94% of them believe the government should roll out life-saving checks for prostate cancer. The paper highlights analysis indicating that hundreds of lives would be saved by targeting the programme at men with the highest risk. The Mail's editorial says people should be invited for tests - pointing out how such a policy has "worked spectacularly well with breast cancer"."

Problem is presumably "highest risk" - I suppose GP records will often show age, ethnicity and obesity. But not family history thereof.

A good idea on balance I think.

There's a charity promoting testing, including with television advertisements. There are people reacting to the announcements about Chris Hoy and Eddie Jordan.

But neither of those affects the evidence about the effects of a screening programme.

What should happen is review by the National Screening Committee, as with all programmes.

But I suspect that this Secretary of State might well intervene without that. This would be very undesirable.

Jonathan

Edited: Corrected.

[rjb]

"There are people reacting to the deaths of Chris Hoy and Eddie Jordan."

Has Chris Hoy passed?

[Jdsk]

I'm very sorry. Thankyou for the correction.

Jonathan

[Skids]

While I am NOT an expert I have just returned from my latest Urology appointment and have friends who have had surgery.

As Jay and others have written the key is consistency in the lead up to a PSA blood test. Riding a bicycle can and does alter the results so it is best not to ride for a minimum of two days before. Other forms of exercise may also have an effect so two days of being a couch potato may be a good idea.

The NHS and other authorities have set levels where doctors have to become concerned. The kicker is that these levels are all different and the bad news is that you may have cancer with virtually any value. I went private and was told by the doctor that he had patients with raging cancer with a PSA of less than one and other patients with PSAs of over 50 with no cancer.

If you search for papers about PSA and Prostate Cancer you will find tens of thousands. Many trying and failing to make the cancer diagnosis more accurate.

Given that 80% of 80 year olds have Prostate Cancer and many men die with but not of prostate cancer it is likely that if you are male you will be introduced to the Urologists Handshake, more properly known as a DRE (Digital Rectal Examination), so time in your life. The next tool is the MRi from which you will get a PiRads score between 1 and 5. 4 and 5 are not good news and lead to a biopsy which is 20 minutes or so of awfulness. If cancerous cells are detected you will be given a Gleeson Score which is two digits and again higher numbers are bad news. An aggressive cancer may be treated by a Radical Prostatectomy often using a Da Vinci machine/robot, or radiation in some form. Hopefully this removes all the cancer but it may have some unpleasant side effects with incontinence and sexual disfunction being the head line acts.

Generally the older you are when prostate cancer is diagnosed the more likely it will be of a slow growing non aggressive type which will probably just be monitored.

A good source of friendly information may be found here : https://thepenisproject.podbean.com/ and here : https://www.bbc.co.uk/sounds/play/m0021b94

Please remember I am NOT an expert, I'm just someone who is in the machine waiting for my second MRI.

best wishes and good luck
S

[toontra]

Many thanks for that detailed summary Skids. I'm going for a PSA test next week - was "borderline" last time so am scheduled for re-tests every 6 months.

Useful advice about cycling. I actually cycled to the surgery for the last test and had done a 200k audax 2 days before. Nothing was said to me either before or at the appointment about strenuous activity.

[Skids]

I actually cycled to the surgery for the last test and had done a 200k audax 2 days before.

For what its worth I would expect that the audax would have had an effect on your PSA. You may have seen this from the NHS web site :

Preparing for a PSA test
For 48 hours before your PSA test, do not:

have anal sex
ejaculate (come)
do anything that leaves you out of breath, such as exercise
These can increase your PSA levels which could make the test less accurate.

You can eat and drink as usual before having a PSA test.

So it is probably a good idea to tell your G.P. about the audax ride before your last blood test.

Good Luck
S

[Skids]

P.S.
If you want good advice then the nurses at Prostate Cancer UK are excellent : https://prostatecanceruk.org/ telephone 0800 074 8383.

[maanderx]

I had a Radical Prostatectomy in September 2022 and was back riding and doing circuit training in November 2022. Some slight side-effects, but cancer is gone.