Lorraine is a nurse specialist and sex therapist and volunteers here to answer your...
I am a 41 year old male, with a family history of prostate cancer (my father was diagnosed with it years ago, but survived and recovered from it, despite refusing all treatment).
Due to symptoms I've started experiencing I'm scared I might have it now too.
The main symptom started 3 weeks ago after a long bike ride. After being on the saddle for over 6 hours and 100 miles I was a little sore down there, but I'm used to that. Urinating burned, but I've had that before also and read at the time that it's common when riding a lot and it cleared up after a day. However, that night, for the first time in many years, lets say sex with my wife didn't go as expected, I wasn't working and we had to give up - I put it down to being in the saddle too long. The tip of my penis had felt a bit numb so I'd half expected it. However, what I didn't expect was that I later found that I had blood in my semen - it had streaks of blood and was a weird red/pink colour.
Again I put it down to the bike ride, but this has continued for the last 3 weeks, which seems a bit of a long time and I'd expect to have recovered from the bike ride now. I have been on it since, but not long distances.
Other concerning symptoms include increased tiredness, which I've thought not much of as it's usually if an evening - I used to go to bed regularly at midnight or later, all of a sudden over the last few months I've been falling asleep on the sofa by 9pm - I've put this down to getting older up to now (or just seeing it as normal and my late nights and early mornings before were abnormal :-) ). But now adding it to the above symptom I'm now not sure.
I've also found myself getting up in the middle of the night for the toilet more often (only once per night, but it never used to happen often), though in the day I can often go most of the day at work without going. My mates are often surprised at how I don't need to go during a long bike ride - this is still the case. It just seems to be at night.
I don't think it will be in any way related, except possibly with medication, but late last year I had a heart attack - I had a stent fitted and am now on many medications including blood thinners and tablets for my blood pressure. I'm taking these every day. I am recovering well from the heart attack, as my 100 mile ride would probably suggest.
I do have an appointment with my GP next week to talk about my heart attack and whether I'm pushing myself too hard too early, he works in the cardiac department at the hospital I was treated at a couple of times a week so I thought he'd be the perfect person to talk to. So I'll mention the above issues also while I'm there.
But in the meantime I'm just starting a weeks holiday with the family so am away from home, and reading this morning that blood in semen could be a sign any prostate cancer has spread has terrified me, to the point I've started thinking maybe I should go straight back and get checked out - I'm not sure a week would make much difference though?
I'm not asking for a diagnosis - I know only a doctor can give this. Im really just looking for some advice on whether I might be over reacting? Should I go straight back home and see my GP, or would a week not make a lot of difference? Should I just try and enjoy my holiday and follow up on it on my return?
Would really appreciate any advice. I've not been too worried about it up to now as I've assumed it was just the cycling causing it due to the timing of the main symptom starting, but reading about prostate cancer symptoms this morning has got my mind in a bit of a mess, especially as its 3 weeks since the ride that (appeared to have) started it all off.
Sorry to hear about your symptoms. Any oncologist will tell you that riding a bike is probably the worst thing to do if you have any sort of prostate problem! However, it might only be a bad case of prostatitis see here. When you see your GP next week tell him/her about the symptoms and get a PSA test done at the appointment. The results might take a few days so you may not have an answer before your holiday. Prostate cancer is usually very slow growing so a week or two will make no difference.
Get a PSA test before you go away and make a GP appointment for when you get back.
Thank you Seamus for your reply and advice.
Unfortunately I'm already on holiday, arrived yesterday and here until Saturday.
I notice from your link that it suggests a urine sample can be used to check for Prostatitis. I did do one a couple of weeks ago as I went for my health check for being over 40 (I actually asked for one before I had the heart attack but was told they weren't able to book it as some icon wasn't showing on the screen - could have identified the heart issue earlier possibly). I didn't hear anything back, but not sure if they'd have checked for that. They didn't do any blood tests as they said now I've had the heart issue they do an annual check anyway that checks everything, which is in October.
I'll see the doc when I get back and get checked over, and try not to think too much about it whilst here.
enjoy ur holiday imo a week wont be harmful even if u have the dreaded c word .
as seamus said get a psa test asap but dont go out on ur bike or have sex for a few days before the test ,
as it supposedly can affect ur psa score !
Are you on any blood thinners? I am told this can account for blood in semen and in bowel movements- though this still should be checked out. When you see your Doc ask for a PSA test and take things from there. As mentioned above any strenuous exercise - especially bike riding, and any sexual activity should be avoided in the 48 hours leading up to the PSA test as this can raise the PSA.
As your father had PC you and any close male relatives of your father's are apparently 3 times more likely to get PC so if you have a brother or your Dad has a brother you should all be getting regular PSA tests from around the 40 year old to 45 year old stage. Just so that if you do get it then they can catch it at an early stage. The thing with the symptoms as with so many things they can be symptoms of something else but with your family history I can totally understand how worried you are.
I hope things go well for you. Please let us know how you get on.
All the best
Hi Omen 78, just to reiterate what Seamus posted.
In view of your age and your symptoms, it seems most unlikely that you have prostate cancer, though I understand your worry if it runs in the family.
Considering what you say , it does sound like you have Prostatitis.
Prostatitis is actually quite common and a lot of men may have it mildy without even realising what it is. It literally means inflammation of the prostate gland, which you may know, is situated at your bladder neck and urine and semen have to both pass through it. After a prolonged bike ride it can cause some bleeding in an inflamed prostate. Even without a bike ride, there may be small amlounts of blood in your urine. There may also be some white blood cells, which are inflammatory cells.
You may or may not have also noticed a small amount of whitish discharge from your penis or staining on your underpants. If this is the case, ti further suggests prostatitis.
When you get home, it would be a good idea to see your GP, he/she will ask for some urine samples. It might be a good idea to go prepared as it were, meaning having a fairly full bladder.
A simple test for prostatitis is to give 3 urine samples, your GP may or may not do this, but if they do the first sample will be the very first small amount of urine that comes out, then stop. The next sample will be what's called "mid stream", so start again.
Your GP may then examine your prostate, this is known as Digital Rectal Exam (DRE), this will enable them to see if it is enlarged, smooth or rough and tender. With prostatits it will be enlarged and tender and remain smooth.
This might be followed by a third urine test.
For the 3 urine tests it is diagnostic of Prostatitis for there to be a lot of inflammatory cells in the first sample, NOT the second and again, some in the third.
The GP may send urine away to test for bacteria, but usually with Prostatits, none can be found.
It may however be that your GP doesn't do the 3 samples but does refer you to a urolgoy specialist (who will do it).
A urologist may do several investigations to confirm Prostatitis and try to discover the cause of it. This may be an infection, which can be difficult to treat and may require tasking antibiotics for from one to 3 months.
Your GP may do a PSA blood test (Prostatic Specific Antigen), a raised level of PSA suggests something is wrong with the gland. If your GP does do the test and it is raised, don't be alarmed, prostatitis can raise it, as can other conditions. PSA testing on its own is a useful but very unreliable indicator of prostate cancer. Many men with raised PSA are later found to be cancer free.
Prostatits is very uncomfortable, but if there are no complications then it isn't usually serious.
I hope this helps, I am not a doctor, but I have personal experience of both chronic prostatitis and prostate cancer..
The first does not increase the risk of the second!
Enjoy your holiday
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