Ron’s PSA number is high and the NP was very unprofessional.

Ronni

Well-known Member
Location
Nashville TN
I’ve been urging him to see a doctor because he’s been peeing so much, getting up 4-5 times a night to pee, not quite as frequent during the day, a change from the way things used to be.

He came down with pneumonia a couple weeks ago, so when we saw the doc for treatment of that, Ron mentioned the frequent urination so his doc tested. Several days later we got the results. The PSA number was “abnormally high” so his doc wanted to test again to make sure it wasn’t a fluke. It wasn’t. He was referred to a urologist whom we saw yesterday.

Actually we saw the Nurse Practitioner who works with the doctor. We hoped to get some answers but this was essentially just an intake appointment, setting up for further tests. I was very displeased with this woman’s handling of my husband. She was very unprofessional.
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When she saw the PSA number her shock was openly apparent and very disconcerting! She said “Oh my! Oh my!” several times. Then she just blurted out “Oh this must be cancer!!” like she was talking to herself almost. She certainly wasn’t talking to us, just looking at his chart and muttering.

This was the first Ron had heard of any such potential diagnosis and he was clearly upset at both the thought and the way it was presented.

He has an appointment in January for a Pet Scan annd other tests and then another appointment a week later to go over the results. Given that he has to wait a month to get any more info, the LEAST she could have done was to suggest a variety of other illnesses that could result in that PSA number which of course would include cancer, but as a lead in to the possibility at least, so he’s not stressing for the next month that OMG I have cancer! with no suggestion of possible treatment options or prognosis.
 

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Actually we saw the Nurse Practitioner who works with th doctor. We hoped to get some answers but this was essentially just an intake appointment, setting up for further tests. I was very displeased with this woman’s handling of my husband. She was very unprofessional.
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When she saw the PSA number her shock was openly apparent and very disconcerting! She said “Oh my! Oh my!” several times. Then she just blurted out “Oh this must be cancer!!” like she was talking to herself almost. She certainly wasn’t talking to us, just looking at his chart and muttering.

This was the first Ron had heard of any such potential diagnosis and he was clearly upset at both the thought and the way it was presented.

In fact this is completely unprofessional by the nurse. Not all high PSA tests are indicating cancer. There exist false positive results for several reasons.

Of course Ron must get the scan in January. Even if it is prostate cancer, often it grows very slowly and there are several treatments depending on the situation. But making somebody feel unsecure is a no go.
 
I’ve been urging him to see a doctor because he’s been peeing so much, getting up 4-5 times a night to pee, not quite as frequent during the day, a change from the way things used to be.

He came down with pneumonia a couple weeks ago, so when we saw the doc for treatment of that, Ron mentioned the frequent urination so his doc tested. Several days later we got the results. The PSA number was “abnormally high” so his doc wanted to test again to make sure it wasn’t a fluke. It wasn’t. He was referred to a urologist whom we saw yesterday.

Actually we saw the Nurse Practitioner who works with th doctor. We hoped to get some answers but this was essentially just an intake appointment, setting up for further tests. I was very displeased with this woman’s handling of my husband. She was very unprofessional.
.
When she saw the PSA number her shock was openly apparent and very disconcerting! She said “Oh my! Oh my!” several times. Then she just blurted out “Oh this must be cancer!!” like she was talking to herself almost. She certainly wasn’t talking to us, just looking at his chart and muttering.

This was the first Ron had heard of any such potential diagnosis and he was clearly upset at both the thought and the way it was presented.

He has an appointment in January for a Pet Scan, and then another appointment a week later to go over the results. Given that he has to wait a month to get any more info, the LEAST she could have done was to suggest a variety of other illnesses that could result in that PSA number which of course would include cancer, but as a lead in to the possibility at least, so he’s not stressing for the next month that OMG I have cancer! with no suggestion of possible treatment options or prognosis!


. .

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Yes, that was very unprofessional. 😟 In the meantime I hope you and Ron can talk yourselves into not panicking. I know, easier said than done, however you both just need to support each other to get through this next month.
I'm sure you'll be doing a lot of research on your own during this time.
You have support here also. 🤗
 

I’m sorry to hear this, but it’s not time to sound an alarm. Maybe he has Prostatitis or an enlarged Prostate. I hope Ron doesn’t receive bad news. I have my prostate checked once a year with a PSA check and the Urologist manually checking my prostate. It’s very uncomfortable, but it’s better than the alternative. My last check was a 1.4.

As for the NP, I would let the doctor know what went on and that her suggesting that Ron has cancer did not help you or Ron feeling optimistic about Ron’s issue. Very unprofessional and should be reprimanded and told to keep her mouth shut when diagnosing any serious illness.

I will put Ron on my prayer list. Tell Ron we are all pulling for him.
 
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I've received negative feedback for posting something similar to this in the past, and I don't need that again, so I emphasize: this input is simply a statement of fact, not a recommendation.

My PSA has been high for many years. [20?] Since I've consistently refused a biopsy (against medical advice, of course) my doctor discontnued PSA testing in 2019 when my reading reached 4 times the acceptable level. Around or about that time, he decided to prescribe Finasteride and Doxazosin to help with relief of prostate-related urological issues. Ever since starting those prescriptions, I get up no more than twice in the night, the same as I did at age 40.

Again, this is not for everyone, but it is my life, my body, my decision, regardless of the final outcome.
 
Sorry about the NP. I've had all sorts of issues with my prostate and have had a biopsy (not pleasant.) PSA scores aren't everything and the disease itself is highly treatable. They say you die with it rather than from it. The practice should hear from you about the NP's unprofessional behavior as that is unpardonable.
 
The nurse practitioner was absolutely dead wrong to do this. I would not only complain about her to her boss (the physician), I would read her the right act in person. I do not normally concern myself when people complain that a practitioner was “rude” or condescending….but when people like this overstep their professional boundaries it is an issue.
I suggest you google causes of elevated PSA in front of your husband. Read together the potential causes. Schedule followup with a urologist and follow recommendations . Even if the end result were to be cancer there are many treatments and prognosis tends to be good if treated. Both my stepdad and uncle had prostate cancer, and while I do not remember exactly how old my uncle was when he passed I know he was in his 90’s. My step dad was 100. Cancer killed neither. I am sorry this happened.
 
20 or so years ago I had something similar happen but over the phone. The young woman who called to give me my test results was way beyond her experience level. She gave me an option, go to Nashville for reconstruction surgery or have the lump removed locally. It was obvious she was rattled. I asked her to read the results again. I told her, I was fine, local removal will work.

Some newer people in the medical field need to grow into their responsibilities and interactions. One of the hardest things for those new are hiding their concern about the patient in front of them. The better choice is to say something to the PA when this happens.
 
Ronni, The hardest part of this will be waiting and see what the test results are. We have a very close friend who had high PSA went through the tests it came up negative for cancer, that was a few years ago. He is currently being monitored annually for changes. I have family members who do have prostate cancer and have had for several years. Alas, I also lost my BIL to it.

This year I've spent way too much time around medical people, mostly as a worried onlooker. They run the gambit from exceptional to you must be joking. Not every medical person has a good bedside manor and not all are going to get it right. Sad, but that's what I've found.

I hope you get the best of outcomes and those you meet along the way ease the path.
 
I went through 'the process' several years ago. PSA went from nil to 5 in one year. Yes, it was cancer. I was immediately referred to oncologists that specialized in prostate issues and confirmed cancer. The 'process' was that there were several options that I had --- surgical and not. It was very difficult to choose. The oncologist gave me plus-and-minus of the options, potential side effects, etc. I took a year, yes, a full year, to decide and got lucky. Everything worked out, psa down to nil, no ill effects.
IMHO, you need to be well informed before going forward and get a proper specialist.
 
I've received negative feedback for posting something similar to this in the past, and I don't need that again, so I emphasize: this input is simply a statement of fact, not a recommendation.

My PSA has been high for many years. [20?] Since I've consistently refused a biopsy (against medical advice, of course) my doctor discontnued PSA testing in 2019 when my reading reached 4 times the acceptable level. Around or about that time, he decided to prescribe Finasteride and Doxazosin to help with relief of prostate-related urological issues. Ever since starting those prescriptions, I get up no more than twice in the night, the same as I did at age 40.

Again, this is not for everyone, but it is my life, my body, my decision, regardless of the final outcome.
I was told my PSA was high back in 2020. So I did the recommended biopsy. The biopsy is painful.

Later the urologist said the biopsy showed some cancer but that it wasn't spreading and it wasn't aggressive. He recommended I have my prostate removed. I wasn't convinced since this same urology office said my PSA was high over 15 years ago. But I refused the biopsy then.

Well, its 5 years later and I have no life threatening problems. I pee a few times a night but then I am diabetic.

There's reason to be skeptical of Urologists diagnosis of cancer of the prostate. My daughter-in-law said that her grandfather was diagnosed with cancer of the prostate but ignored it. but lived for 20 more years without any cancerous symptoms. He died of something unrelated to the prostate.

Doctors always want me to take actions based on numbers only. But I will only take drastic measures like surgery if I'm physically symptomatic and need relief.
 
Ronni, there’s other reasons that your PSA numbers can be high such as if the man has had sex the night before the test. Your husband should Google the reasons and see if he did any of that the night before the test. If he did, then he should be retested.

For those of you with high PSA numbers that are ignoring them and not having biopsies or treating the cancer this may end up being a life altering mistake. 17 years ago, my third husband at the age of 49 was having issues so he had a PSA test and a biopsy which indicated cancer. He Was able to put off the treatment for three years per the doctors advice. He is still cancer free at 66.

A friend of ours that was older had higher PSA numbers and refused to have a biopsy. Eventually, it was determined that he had cancer, but he refused to believe it and didn’t treat it. Three years ago he died. It was sad because it was unnecessary.
 
This is the reason that NP's or other non-doctors are NOT to comment on test results!

At any rate, based on the first test and the doctor calling it a possible "fluke", and the fact that they are not testing again until January, this does not seem to be anything to get overly concerned about right now. If they felt it was that urgent, you would be going in for those tests early next week - they always reserve appointments for urgent cases. And also, they are not even recommending a needle biopsy of the prostate. Perhaps because prostate cancer is typically very slow growing and treatable? I have (had) prostate cancer and mine was treated (successfully so far) 4 yrs ago with proton beam therapy (targeted radiation) at Mayo Clinic.

Not sure why they are not looking at doing an MRI.

For an excellent reference on prostate cancer, I would recommend https://www.amazon.com/Key-Prostate...k/dp/B07C67BJXZ?ref_=ast_author_dp&th=1&psc=1
 
Lot of posts here saying mostly the same, so I will just say I wish Ron the best of luck and I would continue to have hope that all is well.
There are other things that can go wrong with the prostate, so let’s wait and see.
I wish him all the best.
 
I agree with @Been There I would let the doc know what she did because I don't think she's supposed to do that. I think it's a definite medical no no on her part. She basically diagnosed him with no tests or information. She could get into serious trouble for that.

I need to say according to what I am seeing online I guess it depends on the state you live in and whether she has full practice authority but I still think that was a crappy thing for her to do. In KS the NPs are all supervised by the Primary docs.

I hope it's not that and maybe just something else bothering him. Good luck Ronni!!
 
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He has an appointment in January for a Pet Scan annd other tests and then another appointment a week later to go over the results. Given that he has to wait a month to get any more info, the LEAST she could have done was to suggest a variety of other illnesses that could result in that PSA number which of course would include cancer, but as a lead in to the possibility at least, so he’s not stressing for the next month that OMG I have cancer! with no suggestion of possible treatment options or prognosis.
To be fair, the only way most insurance would pay for a PET scan is because there is a very good chance it IS cancer.

A high PSA is one thing, the necessity of having a PET scan is another.

Enjoy the holidays and try to stay calm. Worry won't change what is.
 
I agree with those who say the NP should be immediately reported to whatever doctor she works for. That is inexcusable.
It should be reported also to your regular doctor, who referred you to that urologist.

Good luck, and remember that some idiot muttering about cancer doesn't mean you have it. Try to manage to stay calm for the next month and keep things in perspective. Even if it turns out to be cancer, some types, such as prostate cancer, are so common and slow-growing, that a lot of doctors are just ignoring it. I just read an article about that. Probably no need for alarm, but that nurse should be reported, and probably fired.
 
I agree with those who say the NP should be immediately reported to whatever doctor she works for. That is inexcusable.
It should be reported also to your regular doctor, who referred you to that urologist.
It certainly wouldn’t hurt to call the office and say that the NP had told Ron he has cancer. Ask to speak to the doctor for clarification. He may be busy but he’d be wise to make some time for a phone call. She didn’t act like a professional.
 


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