ASK DR JEFF
From prostate cancer to back pain, Dr Jeff answers your health questions
A reader also wonders if a broken back is a side-effect of having taken morphine
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Q) MY husband is 64 and has had a PSA blood test reading of 160. He also had a kidney infection at the same time.
He has had antibiotics for the infection and has had another blood test that we are awaiting the results for, along with a prostate examination.
Is there any chance that he doesn’t have prostate cancer with a PSA reading that high?
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Leona Ridley, Hull
A) The recent diagnosis of King Charles’ prostate problems has helped to highlight just how common this condition is.
Of course not all cases of prostate disease are due to cancer, and other causes of prostate problems include infection, inflammation and an increase in size.
The problem is that in all these cases, the prostate specific antigen (PSA) blood test can be raised and this is why the test is not used as a national screening tool for prostate cancer.
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Many men are frustrated that PSA testing is not a regular screening programme on the NHS.
This is because there is up to a 15 per cent false positive and false negative, which makes it too inaccurate to be used for everyone.
King Charles leaves hospital with Queen Camilla after three night stay following prostate treatment
It also means that in your husband’s case, we cannot say what the cause is at this point, but a discussion with a urologist and a scan will be helpful.
A raised PSA does not have to mean the worst.
What prostate cancer symptoms do men need to know?
In most cases, prostate cancer doesn’t have any symptoms until the growth is big enough to put pressure on the urethra – that tube you pee through.
Symptoms include:
- Needing to urinate more often, especially at night
- Needing to rush to the toilet
- Difficulty in starting to pee
- Weak flow
- Straining and taking a long time while peeing
- Feeling that your bladder hasn’t emptied fully
Many men’s prostates get larger as they age because of the non-cancerous conditions, prostate enlargement, and benign prostatic hyperplasia.
In fact, these two conditions are more common than prostate cancer – but that doesn’t mean the symptoms should be ignored.
The signs that cancer has SPREAD include bone, back, or testicular pain, loss of appetite, and unexplained weight loss.
Q) I’M a 52-year-old man and had a car crash last year. I’ve had back pain since.
The pain got worse over time so I went to a chiropractor who told me I have a broken back.
An X-ray showed broken vertebrae at the top and bottom of my spine.
I’m currently on morphine, which is managing the pain, but I also feel like I’m very short tempered.
Could this be a side-effect of the morphine and is there something else I could take?
George Stubbs, Perth
A) Back pain can be an agonising problem and it affects thousands of people every year.
Chiropractors are excellent at managing this in most musculoskeletal cases, but traumatic fractures are not something they should be looking after.
If you have had an X-ray that confirms broken vertebrae, it is essential you are referred to an orthopaedic spinal surgeon as we do not know the impact these broken bones might be having.
Loose vertebrae can squash nerves and cause pain but more worryingly, could be an indicator of unstable elements of bones in general, which cannot be seen on a plain X-ray.
In most cases, at the time of your injury, if it was suspected that you had broken a vertebrae, you would also have a CT-scan.
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If this X-ray was done a year on, it is still important to be referred as the question would be why they have not healed.
Therefore, I would see your doctor and get a referral to a bone specialist to look into this further.
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