PSA Doubled In A Year

[DaveKell]

Question for you former prostate cancer guys... a yearly routine lab showed my PSA went from I think 3.1 to 7.9 in the past year. My night time pee trips have quadrupled the past few months. I have constant low back and hip pain I thought was only from my spinal fusion almost 8 months ago. I've since read it can also be a PC indicator. I have a urologist appointment the 17th but this latest development has me very much on edge.

If it comes down to PC and my prostate is removed I at least am already implanted and should escape the retrograde penis issue and still be able to have sex.I'm concerned with the incontinence issues I've read about but am aware, by speaking at ED seminars with doctors, of the artificial urinary sphincter implants.

My main question is this. Is an "ejaculation" with no fluid still as pleasurable?

And if, like a friend of mine who was in the ground 5 months after his PC diagnosis, I refuse to be down about that possibility. I've had a great life and produced three great kids who are all university educated professionals and married to the same. Plus, fully half the worlds population doesn't live past 50 and I have that beat by 16 years now. So no regrets.

[mikestap]

Dave,
I was diagnosed with PC 6 years ago and had my prostate removed. Incontinence was not and is not an issue. Not perfect, but I have the control I want. Dry orgasms are different, but still very pleasurable. My PSA is undetectable. I wish you the best outcomes.

Mike

[David_R]

Having had my prostate removed in 2000, I can honestly say that my orgasms without semen feel 99% the same (the only 1% I no longer have is the feeling of semen being pushed through my penis and squirting out into wherever, but that is not all that important for an orgasm, at least for me).

[Stew52]

SO reading this, first it would seem like life over orgasm is a clear choice. Why? I have developed anorgasmia over the past year or so. It seems to be related to PGE in Tri-Mix injections and my discomfort. But a bi-mix does little for me. A lower dose is better but too limp for penetrating sex. A stronger dose causes the anorgasmia. BUT. My parther says it is some of the best ever. Long varying tempo and multiple if not constant orgasm for her. She's wasted after 40-60 minutes and signals she's done. It is a delight to be able to pleasure someone else so. I can take care of willy the next day. Now that said, with anorgasmia there is no ejaculation, no orgasm and no physical release. It is underwhelming for me. The sole pleasure is in pleasuring someone else so well. How does someone without a prostate and presumably with a vasectomy have orgasm as some state here?

As an aside, a close cousin and I have discussed the need for regular draining of the prostate for better prostate health. He was a "bachelor". Reviewing my annual physical results with my doctor, he commented on my 0.7 PSA (typical) that, "You obviously get plenty of sex" He knows my wife (2-3 x per wk). If they know this is part of prevention (sure genetics) why do they not spread it further?

[Quincy]

PCA is definitely a problem in our society and many guys die with it each year. But getting a diagnosis of prostate cancer as early as it may be for you is not a death sentence. My doubling rate at one point was down to a month and my cancer had progressed to intermediate stage, but I am now cancer free. There are so many good treatments available today!

PCA is a very slow growing cancer. Many men that have it are told to do "active surveillance" or "watchful waiting", meaning don't treat the cancer because there are side effects from treatment. Since the cancer grows so slowly, many men can avoid any treatment at all while just having the PSA and cancer checked from time to time.

Your PSA doubling is definitely a signal that you should get checked. Your doctor will probably want to do a biopsy. Sometimes PSA readings are higher than they should be without cancer being the cause. Riding a bike, having sex, or a host of other activities in the day or so before a PSA check can be the cause of a high reading. The biopsy will let you know for sure.

If the biopsy indicates that you have PCA, you'll get a Gleason score, something like "3+3" or "4+3". The first number indicates how much of your gland has cancer and the second number is how different the cancer cells are from normal prostate cells. The higher either number is, the more serious the cancer. My own score was 3+4. Guys with scores of 3+3 have very early stage cancer and there are tons of available treatments, including watchful waiting - not doing anything at all but observing.

There is a wonderful website for support for people with cancer, It's called healingwell.com. There are a number of different sub-forums, and the prostate cancer forum has a lot of excellent support and information. If you find out that you have PCA, I'd suggest you visit there.

FWIW, I decided on a particular radiation therapy and has worked perfectly. I am cancer free, undetectable PSA. Might not stay that way forever, but it's great for now. While the treatment worsened my ED, I already had almost no erectile function before I did the radiation. I have no trouble with incontinence. Sex is still great, with the implant, and climaxes are wonderful, even without semen. I miss the visceral feel of cumming, but what I have is still wonderful.

Best wishes as you investigate what's going on. When I first heard that I had cancer, my jaw dropped to the floor and I was sure life was over. It wasn't. Different people experience different things, but keep hope up.

Let me know if you ever want to talk. I'm happy to share what my cancer journey was like.

Quincy.

[bldoink]

.....I'm concerned with the incontinence issues I've read about but am aware, by speaking at ED seminars with doctors, of the artificial urinary sphincter implants.......

......My main question is this. Is an "ejaculation" with no fluid still as pleasurable?......

Incontinence issues vary a lot between individuals so they are hard to predict. I had major issues early on. I discovered that going for walks with little or no protection helped a lot. The desire to avoid pissing yourself or having to run off into the bushes encouraged using the kegel muscles. It caused me to recover faster. I still have minor issues mainly when fatigued and doing physical work outside. I'm usually so sweat soaked by then that no one would notice but even then leaks are vary minor. I can still be surprised sometimes when lifting or getting up from sitting but it's relatively rare and is just a few drops no one would see, but I know. It sucks but it really is very minor in my case and my description sounds worse than it actually is.

Yes "orgasm" is still very pleasant but a bit different. Some can be every bit as good as before. Yeah, I do miss making a deposit. Oh well! Of course there is no ejaculation IF you have bladder control. Otherwise you will ejaculate pee. That was an issue with me at first. I recommend solo practice. You can learn to still have a very pleasurable orgasm while consciously constricting enough to not have an issue.

Good luck.

[bldoink]

I have developed anorgasmia over the past year or so. It seems to be related to PGE in Tri-Mix injections and my discomfort. ........ Now that said, with anorgasmia there is no ejaculation, no orgasm and no physical release. It is underwhelming for me. ........ How does someone without a prostate and presumably with a vasectomy have orgasm as some state here?

...... If they know this is part of prevention (sure genetics) why do they not spread it further?

I'm not a doctor and don't know squat other than my own experiences. However, as I got older I noticed that I didn't "get off" as easily as in my younger days. I think age has some of that effect for many.

I was still doing ok (small ok not caps) prior to my RP so in some respects I'll never know for sure what other things played a part and how much is due to age alone. My experience has been that too much PGE-1 can make "getting off" harder but so can too much Viagra and for me Viagra can be more of an issue so I try not to overdo it.

Yeah, not "getting off" is a bummer but having an ejaculation isn't necessary to an orgasm, although it is the icing on the cake, or wherever it lands (sorry, couldn't resist).

The ejaculation is not the orgasm, it is normally a result of it. You don't need a prostate for an orgasm. And yes, the removal of the prostate does also include the effective result of a vasectomy but that's a minor side effect, all things considered. I guess surprisingly, as ejaculation centered as we are, the orgasm really isn't dependent on ejaculation at all.

I have no idea why doctors don't share the advantages of prostate "cleansing" with wives or SOs. I suppose they may, like many, be hesitant to broach the subject or perhaps they don't want to get caught up in couples domestic affairs.

I hesitate to go here but if your wife or SO is open to it (I realize the kink factor among members here varies greatly), when experiencing anorgasmia, some form of anal stimulation can sometimes push you over the top even without a prostate, although I'm sure it's more effective with one.

Sorry if TMI.





Edited: Because there were some really badly constructed sentences in that post.

[DaveKell]

I had a followup with the urologist today for the results of another psa blood test. It had dropped by one full point. He told me statistically I have a 70% chance of not having prostate cancer, a 21% chance of having cancer that is still curable, and a 9% chance I have aggressive untreatable cancer. Based on that I decided to skip the needle biopsy and wait to see what the psa number is another 6 months. He cautioned me that in that time I could develop either the curable cancer or full blown terminal outcome. For the time being I'm comfortable with my decision but I always have the option of doing the biopsy anytime between now and the 6 months. Do any of you guys who've gone through this find any fault with my decision?

[bldoink]

Risk/Reward, only you can decide. Personally, while not pleasant, I didn't find the needle biopsy so bad so as to be avoided with what the risk of not finding cancer in time would be.

I had three biopsies over a couple of years. When the last finally revealed cancer (I don't remember the score) I had the RP surgery. Even watching it that closely they found cancer in the margins and weren't sure if it had escaped. I've been good so far but my urologist won't let me do testosterone shots, even with very low testosterone, due to the unknown of the cancer being in the margins.

I'd go for the biopsy. The only real down side, other than screwing up part of your day, is that your ejaculate will be discolored for a good week or more afterwards. I did a bunch of chicken chokin to help clear it out.

Good luck, whatever your decision.

[warrenw]

Do any of you guys who've gone through this find any fault with my decision?

A very rapid rise in PSA like you had is often (usually?) due to a prostate infection or prostatitis. The usual course of action is a round of antibiotics and then retest the PSA. Remember the PSA test isn't a test for prostate cancer, it's just a test for prostate activity and could be elevated for a variety of benign reasons. If your PSA falls significantly after the antibiotics then that greatly reduces the likelihood of PC.

I would consider another urologist if I were you. Discussing your cancer statistics with you at this early stage is borderline malpractice IMO.

Rule out an infection, get another PSA, and then decide on a biopsy with your uro. The biopsy is really pretty trivial as Bidoink point out.