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User
Posted 22 Jul 2019 at 22:53

Just diagnosed with a psa of 17.5. Awaiting scan and possible biopsy. Really worried looking at results on this forum with psa much lower than mine. Worrying times at the moment for my family and my wife.  I am 67 !

User
Posted 23 Jul 2019 at 00:35
The PSA number doesn't predict how serious a problem might be, only that there might be a problem. We have had members here with PSA up as high as the 80s who were given the all clear, and men who were diagnosed with anything from a score of 3 to a score of 13,000. Generally speaking, a PSA of 17 at your age will often be due to infection or benign enlargement rather than anything else. However, if you are diagnosed, there are usually a number of options for treatment.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Jul 2019 at 22:58

I was 67 when diagnosed and had a lower psa.  Yet when you read the probability of having PCa with a psa in the teens it's 50-58%, mine was less than 50%.   Reading on here you never hear a peep from those 50% who don't get it.

Diagnosis is a worrying time you can't get away from it.  I thought I'd be in those who hadn't got it yet wasn't surprised to find I had got it and then my only objective was to get it cut out as soon as possible, although I'd been warned by a GP to be careful of overtreatment and since learnt that cutting out isn't always the best solution.  Although I've always thought that in my case it was.

User
Posted 21 Aug 2019 at 11:23
Had the toolkit sent out straight away in week one. Lots more info given at the hospital yesterday to make my decision on treatment. At the moment I am thinking prostatectomy owing to other bad side effects with other treatments. Time will tell !!
User
Posted 21 Aug 2019 at 19:37

Hi Petewashy

I had a similar result and opted for RP. I am so glad that I did, 12 weeks post op and I am feeling fine apart from the occasional leaks. The thought of weeks and possibly months of other treatment, well, I ruled them out very quickly. Cut the cancer out was my decision, hard at first, but definitely the correct one.

God bless you on your journey 

Peter

User
Posted 24 Aug 2019 at 15:24

So this means they used the mpMRI to take targeted samples from the right side area identified on the MRI, and 4 out of 4 of those were positive. They also took 2 random samples and 1 of those was positive. Left side was all clear.

PSA density is a PSA value corrected for size of your prostate (e.g. larger prostates will produce higher PSA, but that in itself isn't an issue).

IPSS is the score from the IPSS questionnaire you filled in about the state of your waterworks (how often you get up for a pee in the night, how often your pee stops and starts again, etc). It's really aimed at people with Benign Prostate Hyperplasia (BPH), but it's useful for Prostate Cancer too, and in addition to what issues you might have, it gets your feeling about if they bother you or not (would you be happy to live the rest of your life like this?).

Did you get a T score too? Probably T2a or T2b?

My guess is you'll be offered prostatectomy or seed brachytherapy, and you'll need to choose which.

User
Posted 02 Sep 2019 at 18:20

T3b means it's spread to seminal vesicles, and for this, HT and external beam RT are the usual curative treatments.

For a T3 diagnosis, extra tests are done to make sure there's no further spread, hence the bone scan, and CT scan (I presume the CT scan is to check lymph nodes more thoroughly than can be done on an MRI, and maybe lungs too which don't show up well on an MRI).

Edited by member 02 Sep 2019 at 18:22  | Reason: Not specified

User
Posted 02 Sep 2019 at 18:58
The HT+RT route is what's recommended when it's felt that surgery has a high probability of not being able to remove all the cancer cells, Pete. The bone scan is entirely routine. Try not to worry about it - it's extremely unlikely to find any spread to your bones.

I'm on the same curative treatment pathway myself. I started HT in August last year, had two months RT six months later in Feb/Mar this year, and am due to remain on HT until August next year. I've no regrets about the treatment. It wasn't too awful and I'm having only mild side-effects from the HT.

If you have any questions about the treatment, I'll be happy to try and help.

Best wishes,

Chris

User
Posted 02 Sep 2019 at 19:12
Completely understand. It does take a while to come to terms with this type of diagnosis. One suggestion along that line: if you are finding it tough to deal with mentally (which I definitely did), please do visit your GP and get some medication to help with the anxiety side of things. My GP prescribed me a drug called Sertraline which was a godsend in terms of helping me get through it all.

All the best,

Chris

User
Posted 02 Sep 2019 at 21:49
A great attitude makes such a difference - the value of holidays must never be underestimated in the midst of PCA crap.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Sep 2019 at 18:48

Good news this morning. Specialist nurse phoned to let me know bone scan clear.

User
Posted 09 Sep 2019 at 19:08

That’s a great result Petewashy.

Ido4

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User
Posted 23 Jul 2019 at 00:35
The PSA number doesn't predict how serious a problem might be, only that there might be a problem. We have had members here with PSA up as high as the 80s who were given the all clear, and men who were diagnosed with anything from a score of 3 to a score of 13,000. Generally speaking, a PSA of 17 at your age will often be due to infection or benign enlargement rather than anything else. However, if you are diagnosed, there are usually a number of options for treatment.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 Jul 2019 at 03:39

He says under his bio that he has been told he has cancer Lyn but if he hasn't had a scan and biopsy unless a DRE was very abnormal it is surprising he has been told this already. Generally, it's only when a PSA is much higher that a man is told he has PCa without other supporting tests.

Pete, at your age more men have PCa than don't have it. Many of them don't even know they have it and most die of something else.
Where considered appropriate men can have treatment(s) which where not curative does set the cancer back.

Where PCa is low grade and not looking like breaching the capsule men are sometimes offered Active Surveillance (AS) or initial radical treatment either using one of the methods of surgery or radiation. There are less frequently used treatments but these are not widely available.

It does seem likely that the next step will be to have a scan and biopsy, preferably in that order. It's really only after that that a complete diagnosis can be given and treatment options discussed. I would suggest that you obtain all the details of your diagnosis so that you and we have a better idea of where you are. Unfortunately, for patients this can be an anxious wait.

Meanwhile, I suggest you download or obtain a hard copy of the 'Toolkit' available from the publications section of this Charity. It provides a lot of useful information about PCa and various treatments.

Edited by member 23 Jul 2019 at 03:42  | Reason: Not specified

Barry
User
Posted 23 Jul 2019 at 07:58

Thanks for your information.  I can only await my appointment and then get a better idea of things.

User
Posted 23 Jul 2019 at 08:01

Thank you for your information.

User
Posted 26 Jul 2019 at 22:58

I was 67 when diagnosed and had a lower psa.  Yet when you read the probability of having PCa with a psa in the teens it's 50-58%, mine was less than 50%.   Reading on here you never hear a peep from those 50% who don't get it.

Diagnosis is a worrying time you can't get away from it.  I thought I'd be in those who hadn't got it yet wasn't surprised to find I had got it and then my only objective was to get it cut out as soon as possible, although I'd been warned by a GP to be careful of overtreatment and since learnt that cutting out isn't always the best solution.  Although I've always thought that in my case it was.

User
Posted 02 Aug 2019 at 15:04

Just had my mri scan this morning and now waiting for my next step. Recieved a copy of my dre sent back to my doctor this morning. Letter states possibly T2b right lobe of the prostrate . See what the mri scan shows !!!

Edited by member 09 Aug 2019 at 00:15  | Reason: Additional information

User
Posted 09 Aug 2019 at 00:17
Next step and treatments from people would be appreciated

User
Posted 09 Aug 2019 at 01:02

The next step will be driven by the MRI scan report. (I'm not sure the DRE carries much weight when you've gone this far past that point.)

The MRI will show where in the prostate any cancer might be, and via a PIRADS value, the radiologist predicts what the gleason score might be, although this is not an accurate prediction. However, the MRI can't normally diagnose PCa, only point to where to test for it. If the MRI report is PIRADS 4 or 5 (and in some cases 3), you will then have a biopsy of the suspect area, and the gleason score more accurately determined by histology.

User
Posted 09 Aug 2019 at 01:19
MRI can sometimes lead to suspicious areas being identified for particular investigation in a biopsy but MRI does not always identify areas of concern. Some men are also given a bone scan. When all tests/scans have been done the results are considered by a Multidisciplinary Team (MDT) and a man is given his diagnosis and then offered Active Surveillance or one or more forms of treatment according to his individual circumstances. It is often left to the individual to decide which of the options open to him that he will decide on. Here you already will have relevant details of treatments in the 'Toolkit'. This can help you in discussing treatment options further with a Surgeon and or Oncologist. Some men ask members for their experiences of particular treatments but it must be remembered that the comparatively few men that may respond are not necessarily representative of men having a particular treatment and their situation and response may be different to yours as well as there attitude towards risk and side effects. Unfortunately, it is not possible to predict how severely an individual will be impacted by treatment.

Barry
User
Posted 09 Aug 2019 at 01:34
If you were referred to Dewsbury because they are able to do a multi-parametric scan (mpMRI) your urologist will get a PIRADS score that predicts the likelihood of cancer, although as stated above, it is still only a guide to where they should take the biopsy cores from. If the MRI was an old-fashioned plain kind, there will be no PIRADS score.

I imagine that regardless of the MRI result, the urologist will recommend that you have a biopsy just because of the DRE.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Aug 2019 at 16:18

Biopsy next Tuesday at pinderfields hospital.  Things seem to be happening too fast. No idea what my mri scan showed last Friday but no doubt all will be explained on Tuesday  !   🤞

User
Posted 09 Aug 2019 at 16:42

Do you know what type of biopsy? Is it a theatre procedure, or an outpatients procedure? (Probably too short notice for an elective theatre procedure.)

One thing I would say, make sure they have the report of the MRI scan and are using it to guide the biopsy. You could try phoning to ask beforehand.

If they don't yet have the MRI scan result, defer the biopsy until they do. Biopsies are much more effective when they target suspicious areas identified by the MRI scan. About 80% of hospitals are getting this right now, but too many still aren't.

User
Posted 09 Aug 2019 at 19:07
Would hope the hospital does have the mri scan. Believe outpatient appointment as is 3.30pm. Not sure who to ring for my scan results owing to each procedure having been carried out at different hospitals. Thanks to all for all your input, much appreciated.
User
Posted 09 Aug 2019 at 19:56

OK, it's probably a TRUS biopsy.

It's really important they look at the MRI scan report first, or they'll likely miss the cancer. (That happened to me.) Some parts of the prostate cannot be reached with a TRUS biopsy, and if the MRI report says the cancer is just there, then you would need a transperineal biopsy instead. That's normally a theatre procedure, but there is an outpatient version being done by a few leading hospitals now.

User
Posted 09 Aug 2019 at 21:37
My guess is that your biopsy was booked as a routine thing and the two hospitals are not necessarily lined up with each other. If that's the case, the urologist will be aiming his needle at the right lobe that he said felt like a T2b - you could ring his secretary to ask whether he will have access to (and take into account) the results of the MRI prior to the biopsy.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Aug 2019 at 14:53

Dont know who I am seeing. Only seem to get phone calls from the clerical only advising me about appointments. Just told to log in when I arrive at pinderfields hospital tomorrow to see where I need to be. 

User
Posted 14 Aug 2019 at 16:26

Biopsy yesterday so the waiting starts again. 12 samples taken and not as bad as I thought it might be. Feeling fine today. MRI results were with the staff but not much said !!!

Edited by member 14 Aug 2019 at 16:29  | Reason: Additional information

User
Posted 20 Aug 2019 at 08:48

Biopsy results today. It will be much better when I know how I am and what treatment I require. It has been a very long month getting to this point with very mixed emotions, sadly, for my poor wife also. We had our 46th wedding anniversary on the 4th of this month. Hoping to see our 50th !   🤞

Edited by member 20 Aug 2019 at 08:50  | Reason: Additional information

User
Posted 20 Aug 2019 at 12:35
Good luck!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Aug 2019 at 14:48

Thank you.

User
Posted 20 Aug 2019 at 18:36

Diagnosis shown Gleason 4 + 3 but told I have a 7+ and will need treatment.  Meeting, possibly next Thursday, with consultant and surgeon to see what route I want to take reference treatment. Any suggestions from people treated or still having treatment  ???.

User
Posted 20 Aug 2019 at 20:42

With Gleason 7 treatment will be necessary. That’s what I was told when I was diagnosed.

But that was also due to the fact my cancer was bulging at the edge of the prostate.

Is your cancer completely contained?

The final decision on treatment is personal and reached from the information you are given from the different medical disciplines.

Never an easy choice. Each treatment choice will have side effects and pros and cons. 

I don’t think anyone will recommend one treatment over another.

 

 

Ido4

User
Posted 20 Aug 2019 at 21:04

Yes, contained so something to be happy about. Thanks for your input.   👍

User
Posted 21 Aug 2019 at 07:41
The primary 4 means it needs treating unless you have some other severe co-morbidity.

I would always opt for surgery but your age may nudge you towards Radio therapy.

Best read up on everything and make an informed decision.

User
Posted 21 Aug 2019 at 08:21
If you've not already done so, download the information packs (the "toolkit") from this site. Full of useful information about the various treatment options. If you have any questions about anything, the PCUK nurses (Freephone number at the top of the page) are wonderful.

User
Posted 21 Aug 2019 at 11:23
Had the toolkit sent out straight away in week one. Lots more info given at the hospital yesterday to make my decision on treatment. At the moment I am thinking prostatectomy owing to other bad side effects with other treatments. Time will tell !!
User
Posted 21 Aug 2019 at 19:37

Hi Petewashy

I had a similar result and opted for RP. I am so glad that I did, 12 weeks post op and I am feeling fine apart from the occasional leaks. The thought of weeks and possibly months of other treatment, well, I ruled them out very quickly. Cut the cancer out was my decision, hard at first, but definitely the correct one.

God bless you on your journey 

Peter

User
Posted 24 Aug 2019 at 12:05
Results showed

Right-1/2 random - 4/4 targeted - Gi 4+3 , left 0/6. Psa 17.5 psa density 0.7. Ipss 8/35. Not sure about most of this but told I have a Gleason score of 7+.

User
Posted 24 Aug 2019 at 15:24

So this means they used the mpMRI to take targeted samples from the right side area identified on the MRI, and 4 out of 4 of those were positive. They also took 2 random samples and 1 of those was positive. Left side was all clear.

PSA density is a PSA value corrected for size of your prostate (e.g. larger prostates will produce higher PSA, but that in itself isn't an issue).

IPSS is the score from the IPSS questionnaire you filled in about the state of your waterworks (how often you get up for a pee in the night, how often your pee stops and starts again, etc). It's really aimed at people with Benign Prostate Hyperplasia (BPH), but it's useful for Prostate Cancer too, and in addition to what issues you might have, it gets your feeling about if they bother you or not (would you be happy to live the rest of your life like this?).

Did you get a T score too? Probably T2a or T2b?

My guess is you'll be offered prostatectomy or seed brachytherapy, and you'll need to choose which.

User
Posted 24 Aug 2019 at 16:04

Was told possible T2b at dre only. Nothing on results page. Thank you for your input. Additionally, when I see the consultant and surgeon, will they guide me to a treatment or is that down to me ?

Edited by member 25 Aug 2019 at 15:28  | Reason: additional information

User
Posted 02 Sep 2019 at 18:11
Just informed I now have a T3B category and will require a ct and bone scan. Hormone and radiation therapy mentioned at the moment. Specialist nurse shocked that I had not been contacted with an update. I phoned this morning to see what was happening having heard nothing since my diagnosis !.
User
Posted 02 Sep 2019 at 18:20

T3b means it's spread to seminal vesicles, and for this, HT and external beam RT are the usual curative treatments.

For a T3 diagnosis, extra tests are done to make sure there's no further spread, hence the bone scan, and CT scan (I presume the CT scan is to check lymph nodes more thoroughly than can be done on an MRI, and maybe lungs too which don't show up well on an MRI).

Edited by member 02 Sep 2019 at 18:22  | Reason: Not specified

User
Posted 02 Sep 2019 at 18:58
The HT+RT route is what's recommended when it's felt that surgery has a high probability of not being able to remove all the cancer cells, Pete. The bone scan is entirely routine. Try not to worry about it - it's extremely unlikely to find any spread to your bones.

I'm on the same curative treatment pathway myself. I started HT in August last year, had two months RT six months later in Feb/Mar this year, and am due to remain on HT until August next year. I've no regrets about the treatment. It wasn't too awful and I'm having only mild side-effects from the HT.

If you have any questions about the treatment, I'll be happy to try and help.

Best wishes,

Chris

User
Posted 02 Sep 2019 at 19:07

Thanks for your input. I am just getting my head around the latest information. 

User
Posted 02 Sep 2019 at 19:12
Completely understand. It does take a while to come to terms with this type of diagnosis. One suggestion along that line: if you are finding it tough to deal with mentally (which I definitely did), please do visit your GP and get some medication to help with the anxiety side of things. My GP prescribed me a drug called Sertraline which was a godsend in terms of helping me get through it all.

All the best,

Chris

User
Posted 02 Sep 2019 at 21:49
A great attitude makes such a difference - the value of holidays must never be underestimated in the midst of PCA crap.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Sep 2019 at 09:46
Last part of the jigsaw this morning at pinderfields hospital for a ct scan. Meeting on Thursday, no doubt to tell me all the findings and treatments. Rhodes on Saturday so it will all begin on my return!.
User
Posted 09 Sep 2019 at 18:48

Good news this morning. Specialist nurse phoned to let me know bone scan clear.

User
Posted 09 Sep 2019 at 19:08

That’s a great result Petewashy.

Ido4

User
Posted 10 Sep 2019 at 18:15

Sorry to jump in here but my diagnosis was 3 + 4 T3B. My PSA had been 33. I had a bone scan before I was offered radiotherapy or surgery. I opted for surgery and on meeting the surgeon was put on hormone therapy (Triptorelin) for 3 months and then underwent radical prostatectomy. One year post op my PSA is <0.1 ng/ml.   

User
Posted 12 Sep 2019 at 18:16

Now reached my treatment. Informed I have advanced localised prostrate cancer. The cancer has spread outside my prostate to my seminal vesticles. Now on hormone treatment ( bicalutamide) with radiation therapy in a few months. Going to start taking tablets when I come off holiday. Anyone taking this medication at the moment and what side effects are you getting  ?

Edited by member 12 Sep 2019 at 18:18  | Reason: Additional information

User
Posted 12 Sep 2019 at 19:14

All the hormone therapies have broadly similar side effects, things like reduction in libido, loss of body hair acquired at puberty (although in case of beard, I think most people just get a slowing of growth unless you're on HT lifelong). You need to make sure you continue having erections, or you may find they don't work again after an extended period of not having any - this can be harder than you think if your libido goes very low. There are many side effects which are significantly reduced by exercise - exercise is really important when you're on HT. Many of the local support groups run weekly exercise classes for members, often free or cheap, but you need to fill in between these with exercise of your own. You might check with your GP if you can take calcium and Vitamin D supplements to try and maintain bone strength (although this only works with exercise too). There are also hot flushes which about 80% of men on HT get, but to varying degrees.

Is the bicalutamide 50mg for 3-4 weeks before starting injections, or is it 150mg for a longer time (typically 18-36 months)?

In the case of using bicalutamide for a longer time, it is more prone to generate man-boobs than the other treatments, but they can all do it. There are ways to avoid this, e.g. taking tamoxifen or getting a once-off radiotherapy blast to the breasts. If the bicalutamide is only for 3-4 weeks, it won't cause this side effect.

Put like this, it probably sounds rather uncomfortable, but no one gets all the side effects, and some people get none at all. We all handle it though.

User
Posted 12 Sep 2019 at 19:27

 

50mg for 28 days then injections. Told this could be upto three years depending on how I respond to treatment. Radiotherapy after 3/4 months. Thanks for your input. 

User
Posted 18 Sep 2019 at 09:47
Start bicalutamide next week. Anyone on their first week with this drug and what are your first side effects ?
 
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