Could this be prostatitis?
I am a 39 year old male with a history of pelvic pain issues. When I was a child I had testicular pain and was told it was varicocele. As I got older the pain would flare up sometimes and I would get different dx like epiditimitis. One time in college a Urologist told me I had a inflamed prostate and gave me a round of anti-biotics. Overall I just dealt with it and never thought to much about it except when it flared up. Over the last 6 months or so I've been having discomfort, testicle feels like was being tugged, sometimes riding up high on one side. pain in abdomen and perineum. Was told it is muscles of pelvic floor. Started to suspect hernia but urologist said no. Went to see surgeon who said yes, small hernia but not good candidate for surgery, maybe nerve block if I wanted to try. Have held off on doing anything. Advil doesn't do much, but hot bath seems to help. Latest episode seemed to settle down over last month or so. In all this time, I have never had urinary or sexual function problems. I have two children and had no difficulty getting wife pregnant. Overall no issues with erections and ejaculate without any issue. In fact sometimes when having a pain episode, ejaculation can help to feel better.
Last week I went for physical and on way out I asked doctor if they were doing a PSA test, she said no I was only 39 and not necessary. Then she said, since I asked she would just do it. Called a few days later and said all blood work was good but PSA was abnormal 4.4 and should go see Urologist.
I'm really freaking out and trying to keep my cool. My story is complicated because two years ago during a routine physical my doctor found elevated white blood count and sent me to hematologist who proceeded to tell me I have Leukemia. I've been battling that for the last two years, got myself to the point where I am thinking I may actually survive and now I get blasted in the head with possible prostate cancer.
I saw urologist today he was clear that PSA does not mean cancer but was also clear that a 4.4 PSA at my age was not good. He said he wants to wait 6 weeks and repeat the test. I asked about prostatitis and he said it was unlikely. DRE showed no sign of any issue, no nodules or enlargement. Over the last few days, ironically after I got the test results, I have started to have a pain episode. My perineum is very tender, and my lower abdomen right around the pubic bone is very painful. Doctor agreed to do round of Cipro and see what happens. He said it would be rare for me to have PC, but basically had no other explanation for what it could be. I got the sense he thought it may be PC but didn't want to say so. One other thing was that during physical I asked my GP to check my testosterone because I am heavy fatigue and muscle pain. This is attributed to my leukemia treatment but I was wondering if the treatment was having an effect on testosterone and so if it was low I was going to go to endocrinologist to see if I could get hormone therapy to offset side effects of treatment. Was not expecting the PC issue. The testosterone showed borderline low but just in normal range. When I asked the urologist what that meant in relation to the PSA he said I didn't want to know. I told him to tell me everything and he said that hypogonadism could be making the PSA artificially LOW and that it may actually be higher. This made me feel more scared.
So now I am home with pelvic pain, no urinary issues, on Cipro and waiting 6 weeks to find out what happens with next PSA test. It is hard enough fighting leukemia, could I really be so unlucky to get PC too? Is it possible this is chronic prostatitis? I am so freaked out at this point. Sorry for the long post, any feedback would be really appreciated.