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Masturbation (ejaculation) dilemma
I am new to the group and a new patient with PSA/PCa findings. During my annual physical, we discovered elevated PSA - doubling from the previous labs done 16 months earlier (from 2.0 to 4.3). Saw a very well-respected Tucson urologist two months later, and he said his DRE was "typical." Repeated the PSA, which was actually lower (3.2) with a higher free PSA % of 52%. On the other hand, my MRI report impression included "0.9 cm T2 hypointense circumscribed focus with mild restricted diffusion.... difficult to discern whether this reflects a PI RADS 3 extruded BPH nodule or a focal PI RADS 4." "No additional prostate lesion noted; the capsule of the prostate is intact." So. Here I am. I see my urologist again next week to go over the labs and MRI. Meanwhile, I have to confess that I lost all interest in sexual activities from the time I saw my elevated PSA over three months ago. I have been afraid to have any activity involving my prostate and the rest of my sexual organs. Weird, right? I used to be extremely sexually active - probably too much so. My testosterone level was that of a 20 year-old five years ago -- there's part of the problem. I will ask the doc about sex, more specifically ejaculation. Doesn't that generate more testosterone, elevate the PSA and feed the cancer? Should I or shouldn't I? I have been comfortably ejaculation-free for over three months. Maybe that's healthier. Thoughts?
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Oh c’mon, man!! You think you’re the only guy who ever thought this way??
First, you’re told that ejaculation - no matter how you get there - is beneficial…then, they tell you that ejaculation raises your PSA.
So, of course you immediately abstain from sex in any form and pray that your evil ways will be forgiven and your numbers will drop.
I’m embarrassed to tell you how many times I’ve yoyo’d between these two extremes. 😆
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2 Reactions@steverapplebaugh -- I agree with @jeffmarc and @bens1 about the PSE test as well. In fact, in my comment I mentioned "3 lesions", so looking at my comment I think I confused your situation with another poster last night. MRI fusion biopsy is great if they have a target to hit, but the PSE test is great for answering the question about whether you have prostate cancer (especially if the doctors don't want to do the biopsy yet based on the mri). Not perfect (what is?) but very reliable. Again, I'm not a medical professional so this is just my layman opinion. Best wishes.
I agree with PIRADS 4 you might benefit from a biopsy. It will be more definitive for any PC in the prostate gland. My MRI showed "nothing suspicious" but my urologist suggested a biopsy after my Free PSA test showed up to a 50% chance of PC in the gland.
I have been successfully treated and my PSA went from 7.1 to 0.04 after IMRT and HDR + ADT. You are better safe than sorry. PC caught early is very treatable and often curable
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3 ReactionsBiopsies may be performed per rectum or per perineum. The latter requires general anesthesia and allows greater access to the front lobe. It may have fewer or no infections (3-4% in rectal) US fusion with previous MRI images. may be performed by either method. I believe the US fusion overlay MRI will be better at targeting than mere random needling. I believe trained eyes may differ 20-30%. Regardless of results It is prudent to have them
read again.
Print &File for future reference:(Non metastatic ds.)
Genomics test: DECIPHER 22 genes suggestive of low, intermediate and high risk of aggressiveness
PROSTOX: Helps figure out if delayed urinary tract symptoms post SBRT and or IMRT are LOW or HIGH risk
ProstID: An artificial intelligence review of MRI images as they are subjected to trained eye evaluation
ArterraAI: Evaluates low, Intermediate & Higher risk of aggressiveness using artificial intelligence on a database of patients who had standard NCCN treatment. [may overstate?? risk per category b/o newer technologies in diagnosis: mpMRI, PSMA PET CT scans and treatments; radioligands) in gland encapsulated disease!?]
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