Raised PSA and urgent referral for older man - advice please

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Hi, I've joined this forum for some advice for my Dad. He is 83 years old and has various health conditions including CKD, heart failure, diabetes and dementia. We've noticed urinary problems for quite a while now and last week saw the kidney consultant for the first time who said they were trying to find a reason for his rapid decline in kidney function and it could be to do with his prostate. (He had a kidney ultrasound in April and in this they noted incomplete emptying of the bladder but said the prostate did not look enlarged). The Dr did a PSA test which was 24.8. In the last 3-4 weeks he has been complaining of lower back pain and has noticeably lost weight. But because he has so many other conditions, it's hard to know what might be causing these symptoms. 

He has been given a urology appointment for next week so must have been referred on the 2 week cancer pathway even though cancer wasn't mentioned at the appointment with the kidney consultant. So this has all come as a bit of a surprise and I'm trying to find out all I can about prostate cancer and what is likely to happen at the urology appointment next week so we can be prepared. 

My Dad is quite frail and I am sure would not be offered any treatment because of his age and comorbities but we would like to know whether it is cancer and what the prognosis is so we know what to expect. I'm interested to know how they diagnose prostate cancer and how invasive the different tests are? What is the urologist likely to suggest given his age and comorbities? 

Thank you in advance for reading. 

  • Tamsulosin is often prescribed for men who have difficulty with urination, however if the symptoms have been persistent despite medication then I would expect further investigation and possibly 5 months is a long time to wait. Being politely assertive seems to be the way things are going in the UK unless you have a very proactive doctor. We have all had what if moments but the focus now is to find out what can be done to help your dad and relieve his back pain.

    My husband's nephrologist made several recommendations to help protect the kidneys such as drinking no more than 2 litres of fluid a day but ensuring at least 1.5 litres. Limit dairy products and try using milk substitutes like oat milk. Avoid acidic drinks like orange juice as they can irritate the bladder but if you do have them then put a pinch of soda in it. Avoid caffeine and alcohol. Avoid NSAID's like ibuprofen.

  • Thank you for the tips. No he's only just started on the tamsulosin as the kidney Dr prescribed it last week. Nothing was done after the ultrasound apart from waiting for this appointment. 

  • Just to let you know that the tamsulosin can take up to five days to work but it will work quicker if it is taken without food. If your dad finds it helps then this will hopefully move him away from the area of pre dialysis. 

    I don't know whether you are aware but there are pads available for men if they have leakage problems. My husband finds that they give him confidence if we are going out for the day.