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Symptoms of prostate cancer, scheduled for PSA test. What else could it be?

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Practicing since : 2008
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My 28 year old boyfriend has all the symptoms of Prostate Cancer - he is going for a PSA test but I am so worried. Could it be anything else? I don't know if it related but he has blood on his pillow this morning and has been feeling tired and has had a slight cough. I am expecting a baby soon and all this stress is not good for me. His doctor said it is unlikely at his age but what else could it be? His symptoms seem to be getting worse recently.
Posted Mon, 10 Jun 2013 in Urinary and Bladder Problems
Answered by Dr. Grzegorz Stanko 20 minutes later
Hello! Thank you for the query.
Its hard to tell about his symptoms as you haven't mentioned them. So please provide what kind of symptoms does he have. At such young age any cancer is very rare. And it is almost impossible for him to have prostate cancer. This cancer is strongly related with an age and appears at patients older than 60-70. So prostate cancer should not be his reason to worry.

What he may suffer from, is very common at young age is prostate inflammation. It can give similar to cancer symptoms which are pain while urinating, burning while urinating, urine stream gets weaker, pain around the anus, pain in lower abdomen, blood in urine. PSA level will be increased with an inflammation as well as with a cancer. So this test wont make his worries go away.

That is why (if the symptoms mentioned by me sound similar), I suggest him to have urine analysis and rectal examination first. Antibiotic course should make his symptoms go away. If not, transrectal ultrasound should be considered.

Hope this will help. Feel free to ask further questions.

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Follow-up: Symptoms of prostate cancer, scheduled for PSA test. What else could it be? 28 minutes later
Hi, thank you so much for your quick response, I really appreciate it.

With regards to symptoms, he gets up to urinate through the night which can range from once but up to about 4 times. Sometimes during the day, if he needs to go, it is really urgent and he is practically running to the toilet! He suffers from hesitancy also, and sometimes cannot go at all. He says he gets a slow or weak trickle and sometimes it is very intermittent.

I have been with him for about 2 and a half years, and he has always got up during the night, but the other symptoms seem worse now.

He also suffers from impotence and whilst he can get an erection, he loses it shortly after starting sex, and sometimes during foreplay which apparently started just before we need out together. His doctor has prescribed Viagra but it is not always very effective.

He has not complained of any pain at all, but he complains of being tired a lot and has a cough.

Hope this provides more information - look forward to hearing from you.

Thank you for so much for your help.

Answered by Dr. Grzegorz Stanko 2 hours later
Thanks for the follow up.

Ok, within my experience, this does not seem to be a prostate cancer. Not at his age.
According to his symptoms it sounds like long time giving symptoms from time to time or the symptoms can be present constantly. Erection problem can be related to this infection.

Tiredness and cough also does not have to indicate a cancer. If it is severe cough and he does smoke, COPD (Chronic obstructive pulmonary disease) can be the reason. Asthma should be also ruled out.

If he coughs blood sometimes, chronic infections (even tuberculosis) should be ruled out. But the cancer is a last thing he should be worried of.

So please make some tests: urine analysis, urine culture test, chest X-ray, blow test (spirometry), blood work. He should visit urologist for rectal examination (this could be painful in case of prostate inflammation).

Hope this will help.
Above answer was peer-reviewed by
Follow-up: Symptoms of prostate cancer, scheduled for PSA test. What else could it be? 5 days later
Hi there

Thank you for your response. My partner had his PSA test results and had a urine test and they both came back normal. He has an appointment with the doctor on Friday to see what else it can be. Because the PSA test is normal, does this mean we can completely rule out prostate cancer because when I researched, I read that 1 in 7 tests can come back normal but the person can still have PC. I think I am being paranoid as my hormones are all over the place but think I just want reassurance!
Answered by Dr. Grzegorz Stanko 11 hours later
Hi again,

There is no test which can rule out cancer in 100%. It is always a possibility of any cancer all over the body. But the cancer is quite rare disease (everyone knows about the cancer because there is a lot of rumor about it - that is good). Especially in such young age. Prostate cancer is extremely rare in such age.

So please stop thinking about the cancer. It is completely invalid. Just visit your doctor as scheduled and try to discuss some other possibilities.

Hope this will help.

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