Prostate Testing and cycling

Not sure from this whether you actually didn’t cycle for 48 hours before.

&

leaves little room for the sorts of patient autonomy of “my quality of life isn’t being impacted, I’m very unlikely to have clinically significantly cancer, can you just leave me alone please”

I’m afraid that isn’t how prostate cancer works.  You can have significant disease without it impacting on your quality of life. (Until it kills you)

Not sure from this whether you actually didn’t cycle for 48 hours before.

No I didn't. The point (I think) is that significant amounts of cycling may or may not have an impact on the PSA test, so if your go and have one, the 48 hour rule may not be sufficient to give a true reading, because as a long term cyclist (as many of us are) it's likely that your prostate may be routinely inflamed and give a higher reading that it other wise may do. Leave off a least a couple of weeks before, is the advice of one the GPs I work with.

I’m afraid that isn’t how prostate cancer works.  You can have significant disease without it impacting on your quality of life. (Until it kills you)

I understand that, It's not just guesswork on my part, it's the opinion of the consultant radiologist.

also worth remembering that the PSA test is quite crude and at best an indicator based on trending results.  A single elevated result would lead to the GP doing another test a few weeks later etc to see if it's a rising trend, which may merit further investigation.

I had no noticeable symptoms apart from, in my late 40's, need to get up for a pee around 3am every night.  Mine was more advanced that the biopsies suggested but thankfully contained, just, in the prostate, so removal was, so far, successful ( 9 yrs in November..)

Timely topic , having seen more coverage recently I phoned my GP to ask about a blood test even though I don't have any symptoms. She said I could have the test but the surgery likes to make men aware of what is potentially involved and could happen subsequently. As has been said the test isn't really that accurate and depending on the results you could end up having scans and a biopsy and months of anxiety and unpleasantness for nothing . Reading the OP hasn't persuaded me it's a good idea!

 A single elevated result would lead to the GP doing another test a few weeks later etc to see if it’s a rising trend, which may merit further investigation.

In my case, a single elevated result ended up as a 2WW referral to urology. I think it entirely depends on the GP.

A few things. It's sounds from your description as if they did the blood test after the 'digital rectal examination'? If it was soon after, that can elevate the result.  I was always told they should do the blood test before the finger test for that reason.

I know from personal experience that heavy exercise including cycling can elevate your PSA. I have prostate cancer and am on 'active surveillance' and have a blood test every 3 months.

“we must conclude that you’ve not got cancer, we want a biopsy” (after having a finger poked up my arse twice now, a blood test and an MIR and leaves little room for the sorts of patient autonomy of “my quality of life isn’t being impacted, I’m very unlikely to have clinically significantly cancer, can you just leave me alone please” I hate being a patient. it sucks

A PSA test is a blunt instrument. I doubt that they have concluded you have cancer from that alone, but if your PSA and a finger test raise concerns, why wouldn't you want follow up tests to rule it out?  But maybe ask for another blood test after a week or two off the bike first.

I'm not sure how you can conclude at this stage that:

I’m very unlikely to have clinically significantly cancer

There's every chance you haven't (and I hope you don't) but there's a chance you do and an early diagnosis might save your life.

In my case I had the MRI first, which showed an area of concern and then the biopsy. I think if the MRI had been clear (and they have made lots of progress with this recently) then I wouldn't have had to have a biopsy.

You have nothing to lose and everything to gain from getting further checks.

Prostate Testing

I hate being a patient. it sucks

Well I am sure there will be an intake of breath at one point....

You have nothing to lose and everything to gain from getting further checks.

I've had: Blood test, 2 rectal exams, an MRI and a flow test and I've filled in maybe 3 IPSS forms so far and counting. From the MRI the consultant radiologist concluded quote  "Small 25cc prostate gland with elevated PSA density [ some personal information] clinically significant cancer is unlikely to be present, I think that inflammatory change such as prostatitis is a more likely diagnosis" A biopsy is likely to conclude that he's correct.

Given that I have mild symptoms that could equally be common older aged male urinary issues*, and that I have routinely battered my prostate for the last 30 years weekly, I agree with him.

* most men over 80 die with prostate cancer, fewer die from prostate cancer.

 a finger test raise concerns

Missed this, there was no indication of abnormalities on either of my rectal exams

I ve had annual psa tests for years now, I normally cycle to surgery, doc has never warned me of PSA cycling link.  He does say u have to look at PSA and all results in their totality, IE, stable results over time, age, lifestyle.  I m going again soon I ll ask him.

Mine is done regularly due to risk from medication. Initial examination was done by a urologist and my slightly raised levels not a concern. Yes agree about cycling so they should be aware.

^^^^ I would have been over the moon to have gone through that, with the same outcome as you have got.

I was also very fortunate to go through similar testing, though in my case resulting in hopefully curative surgery.

There are many families out there who have lost a loved one as a result of Prostate Cancer going undiagnosed until it's too late.

You seem to be rather ungrateful and dismissive of being fortunate to get tested and hopefully cleared of what is a huge killer.  Apologies if that sounds harsh, but TBH, as a survivor, it's quite emotive.

Apologies, I thought the 'conclusion' was yours, not the radiologist's! That does sound as if you don't have much to worry about. Though personally, if the urologist recommends a biopsy to be sure, I'd be inclined to go along with it for additional peace of mind. It's uncomfortable and undignified but it's not painful.

There are many families out there who have lost a loved one as a result of Prostate Cancer going undiagnosed until it’s too late.

Yes, my father for one. He left it waaay too late, the reason I went initially to the GP to start this process. My wife's father was lucky to get away with a diagnosis of prostatitis after he revealed that he hadn't managed to wee for about a week...

I'm not ungrateful, I just feel like there's a a bit of a production line of treating this in one way, and little to no patient involvement, I certainly haven't been asked or been listened to about what I would like to happen to me.

I’d be inclined to go along with it for additional peace of mind

At some point in the near future I'm likely to have to go all through this again now that I'm in the system, if any of the tests reveal that anything significant has happened, I'll be the first to ask for one. In the mean time my appt can go to someone with more urgent need than me.

Small 25cc prostate gland with elevated PSA density

That appears to be in the normal range depending on your age. You still have the indignity of arriving full at the clinic for a pee and measure of residual capacity and a cytoscopy examination. If you're lucky the latter will be carried out by a chap as it's a touch invasive (top tip learn to relax the bladder sphincter).

I have refused spot-check PSA tests at the clinic when either sex or cycling has taken place in the last 48 hours, no point in wasting everyone's time and money.

Since my TURP I can bleed while cycling and using either of the stiffer-framed bikes in the garage.

Been having a yearly check since my mid 40's 13 PSA tests, 2 digital inspections and 2 MRI scans. It was raised in my late 40's which prompted the Digital and MRI checks but I was doing a lot of cycling. its now down below 0.8 and I'm now 2 years older than my father was when he was in remission from Prostate Cancer.

Sadly he died 5 years later at 61 from bone cancer, and as my mother died at 72 from bone cancer I like to at least keep an eye on how things are going.

My girlfriend was a bit put out about the no sex for 48hrs though 😀

I didn't know about the no cycling, no sex thing for years so every test was done after cycling and sex, no raised results. Then I had a prostate infection and prostatitus, that's the only time my PSA has been over limit. I now know about no sex and no cycling before tests but ignore that and the levels are back to normal. So in my experience it takes something more than sex and cycling to get over the limit.

 So in my experience it takes something more than sex and cycling to get over the limit.

Yes, an infection.

Yes, my father for one. He left it waaay too late, the reason I went initially to the GP to start this process

sorry to hear about that, and good that you have now been checked out at least !

In my case, yes, and yours? Have you had an infection? Are you sure it's cleared up because they can hang around and come back to bite you?

You say "double what it should be", so if you're between 50 and 60: 3.5, double that is 7. We've all different but on average cycling before a PSA increases by 10% and sex 5% so with both (and if the effect really is cummulative) you might reach 4.

There have been threads on this before, have a look at the people who have posted 8 and what they have to say.

I'm not wishing to be alarmist or argumentative, I've simply read your opening post and noticed that the level of PSA alluded to does not correspond to levels associated with cycling - even intensive cycling for years. I spent a lot of time reading around so that I could talk knowledgeably with my doc and knew the probable evolution of PSA following infection - all very reassuring as the three and six month test came in.

I know nothing more than you've posted. You haven't said if this high PSA is the first result you've ever had or an increase on previous results.

Anyhow, have a look at some of the past threads they're really useful.

It's really encouraging that more guys are being tested and then having needle core biopsies but the specimens produced do take me all day Thursday and half of Friday to prepare for microtomy. It's literally a ball ache 😉

So, to make my work life more tedious please get tested. It's party paying my wages....oh and you stay alive too so win-win really*

*My attempt at motivation

Just looked at my blood test result and target PSA for a 50-60 year old is 3.89, seems v specific. As said, my doc looks at past results, if anythings outside the range, get another test done.

if anythings outside the range, get another test done.

Yeah, no second test in my case, just straight to 2WW MRI, probably over-cautious because of family history.

Hope it’s all clear Nick, or if not then caught early.

IANAD but regular ejaculation may help.

I hate being a patient. it sucks

Or may be this.