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Year & 1/2 ago cancer detected by biopsy. Of the 12 needles,

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one showed cancer in 1%...
Year & 1/2 ago cancer detected by biopsy. Of the 12 needles, one showed cancer in 1% of the sample tissue. Gleason = 3+3=6. 9 months ago, second biopsy. Results=1 of the 12 needles detected cancer. 5% of sampled tissue. Gleason, 3+3=6. First biopsy showed the cancer in the left Apex. the second biopsy showed cancer in the right apex but none in the left. I'm aware that the needle could miss the cancer by a mm & show no cancer. My question: It's been 9 months since the second biopsy. There is still blood in my ejackulate. It appears to be darker than when I first noticed it. Is this normal or is this a symtom of a more serious problem? The Uroligist I had, I will not go back to him. I think I will see the VA Doctor next month. I don't know who else to ask. I'm 77 & in excellent health
Submitted: 8 years ago.Category: Urology
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Answered in 3 minutes by:
6/29/2010
Urologist: Dr. R, Board Certified Urologist replied 8 years ago
Dr. R
Dr. R, Board Certified Urologist
Category: Urology
Satisfied Customers: 3,570
Experience: Authored over 25 Book Chapters and Articles, Specializes in male and female voiding issues
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By now, the blood in the ejaculate should have nothing to do with your prior biopsy. Blood in the ejaculate is typically due to non specific inflammation of the prostate. In your case it is unlikely due to your cancer based on your low volume Gleason 6 disease. However, I would still see a urologist to be examined, have a psa and have a urine sample done.
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Customer reply replied 8 years ago
There was no blood before the biopsy. Three days after the biopsy there was blood. 1-1/2 years later still blood. There must be a relationship.
Urologist: Dr. R, Board Certified Urologist replied 8 years ago
I agree that this is a common finding after a biopsy and I am certain this was tHe initial cause. However, typically this lasts for a few weeks to a month or two and certainly by now has typically completely resolved.
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Customer reply replied 8 years ago
I don't think that was much of an answer. I also didn't think your recomendation to see an Urologist is called for. I'm not stupid, I didn't ask an Urologist a question & expect him to say, see an Urologist.
Urologist: Dr. R, Board Certified Urologist replied 8 years ago
The answer is the honest and 100 percent correct answer. With your history you need a digital rectal exam, a repeat psa, some urine testing, and if all turns up normal possibly a course of antibiotics to resolve what may be a bout of prostatic inflammation. But... Prior to doing this you must see a urologist in person to be sure this is not due to your prostate cancer growing.
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Customer reply replied 8 years ago
I know I should see an Urologist. I knew this before contacting you. That wasn't the question. The blood was the question. You said the blood, for this long, wasn't from the biopsy. Probably not from cancer based on the low Gleason. Now you say it might be from cancer & to see the doctor. Duh!. I won't pay for a non answer. If you don't know, just say so. Don't dance around the question. I thought this would be answered by a specialist. Yours seems to be voiding problems not cancer / blood, that I require.
Urologist: Dr. R, Board Certified Urologist replied 8 years ago
I am an expert in this area. The blood in the ejaculate was from the biopsy initially, but should have resolved by this time. You have prostate cancer, which based on your last 2 biopsy results was low grade and would not cause this persistent blood in the ejaculate. There is a chance that your prostate cancer has become more aggressive or that the prostate cancer has changed from the last biopsy and that could be a potential cause, so you need to have this re-investigated. If the prostate cancer is at the same stage (PSA level, gleason score and low volume disease), then this should not be causing this. Finally, at that point, blood in the ejaculate is often due to non-specific inflammation of the prostate (which may have been set off by the biopsy). If this was the case, after a full work-up, you would likely be treated with a 4 week course of antibiotics such as bactrim or cipro to help resolve this.
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