Back pain and discoloured seminal fluid

[Richardm4uk]

I am 56 and abnormal cells were found after a biopsy in June this year (the biopsy was triggered by an elevated P.S.A. score and the fact that my father dies of prostate cancer). A second biopsy revealed no concerns, but in the last week or so, I have developed lumbar back pain (quite uncomfortable, difficult to relieve and my back feels 'sore'). I have also noticed my seminal fluid is much reduced in volume on ejaculation, is more watery and is also a light brownish colour, which is very unusual. My ejaculate had a lot of blood in it post-second biopsy (30 cores were taken), but that cleared up a month or so ago.
Please advise, as this is rather alarming; I understand back pain can be a symptom of prostate cancer.

[Dr Jon Rees]

Hi Richard

Difficult to answer your query on the info below - you say your PSA was elevated but not by how much.... It makes quite a difference if your PSA is 5 or if it is 20 in terms of your question.

I would say if you have new onset back pain and change in your semen as described post biopsy it does raise the question of ongoing infection in your prostate. You need to see your GP to discuss this - I would want to check some blood tests to look for signs of inflammation / infection, check a urine specimen and examine your prostate - if it is very tender still you may need a further course of an antibiotic. I would book an appointment ASAP.

[Richardm4uk]

Thanks very much. I'd planned to call my G.P. tomorrow to make an appointment. My P.S.A. had risen from 3 in 2011 to 5 this year; not high figures, I know, but I was told it was the proportional rise that was cause for concern.

[Dr Jon Rees]

The good news if your PSA is 5 is that firstly, your back pain is highly unlikely to be related to prostate cancer, even if you we're to have it. Secondly, if there was an infection going on, that can falsely elevate PSA, so it would be worth repeating that test 6-8 weeks after antibiotic treatment if that is the route your doctor goes down. All the best.