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Awaiting Biopsy

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User
Posted 21 Oct 2019 at 14:36

I got ‘diagnosed’ with BPH 3 years ago when I was 43, and have been taking tamsulosin since.

my symptoms have always been fairly steady and my initial PSA of 2.27 dropped to 1.7 at the end of 2017.

I had another test a few weeks ago and it was 2.65.

GP did a DRE and said it was smooth but wanted to refer me to consultant.

Consultant also did the DRE and said he wanted to MRI me which happened a couple of weeks ago.

The result of that came back, and the Dr said the MRI didn’t show anything sinister but was ‘inconclusive’ so he now wants to do a biopsy which will be done under a general anaesthetic. 

I am a bit worried as it all seems a bit odd.

I know my PSA isn’t massively high but I’m a worrier as it seems there is something or they wouldn’t be interested ?!
Just looking for some advice/guidance really.

Thanks in advance

 

User
Posted 21 Oct 2019 at 23:06
I think template biopsies are still generally done under general anaesthetic. Mine certainly was.

Best wishes,

Chris

User
Posted 21 Oct 2019 at 23:48
Mine done under GA too which I believe is more usual with the template one.
Barry
User
Posted 22 Oct 2019 at 00:01
Only a few places have introduced the template biopsy without GA.

VV, I am wondering how they ruled out cancer n 2016/17 without a biopsy. As for the recent scan, assuming it was a multi-parametric one (using different types of image to create a detailed picture) the result comes in 5 levels ... 5 is almost certainly cancer, 4 is highly indicative of cancer, 3 is ambivalent, 2 is unlikely to be cancer and 1 is almost certainly not cancer. It sounds like your MRI result was a 2 or 3.

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

User
Posted 21 Oct 2019 at 16:07

My own opinion is that they're doing a template biopsy as it could find something small that the basic biopsy would more likely miss.    

Once you're on the treadmill you begin to wonder if you need treatment when in reality it could be you would never know about it.    Although it's better to be safe than sorry and you might just be kept on Active Surveillance for many years.

All the best,
Peter

 

User
Posted 21 Oct 2019 at 16:46
Yes , certainly don’t get too involved until you have all the facts and you are informed. You can download the “ toolkit “ off the publications tab. In certain low grade cancers it has been proven that doing nothing at all is as effective as throwing the kitchen sink at it over a 10 yr period. Hopefully you will be fine but please post when all your details are in. This will be psa , Gleason score , T staging etc.
User
Posted 21 Oct 2019 at 17:25
You worried before and then got the all clear - the responses this time will be the same as we gave you in 2016. It would be foolish of the urologist not to do a biopsy - it is 3 years since you last had one I think, and although there was no cancer seen on the scan it is better to be safe than sorry.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Oct 2019 at 22:46

Hi Valleyview,

 

Curious that your consultant suggested a biopsy under general anaesthetic. My understanding from my own recent appt with consultant at Barnet General is that template biopsies are now done under local anesthesia and not general. 

Perhaps this isn't general policy yet?

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User
Posted 21 Oct 2019 at 16:07

My own opinion is that they're doing a template biopsy as it could find something small that the basic biopsy would more likely miss.    

Once you're on the treadmill you begin to wonder if you need treatment when in reality it could be you would never know about it.    Although it's better to be safe than sorry and you might just be kept on Active Surveillance for many years.

All the best,
Peter

 

User
Posted 21 Oct 2019 at 16:46
Yes , certainly don’t get too involved until you have all the facts and you are informed. You can download the “ toolkit “ off the publications tab. In certain low grade cancers it has been proven that doing nothing at all is as effective as throwing the kitchen sink at it over a 10 yr period. Hopefully you will be fine but please post when all your details are in. This will be psa , Gleason score , T staging etc.
User
Posted 21 Oct 2019 at 17:25
You worried before and then got the all clear - the responses this time will be the same as we gave you in 2016. It would be foolish of the urologist not to do a biopsy - it is 3 years since you last had one I think, and although there was no cancer seen on the scan it is better to be safe than sorry.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Oct 2019 at 17:35

Thanks for the reply.

Last time I had nothing other than a PSA test and DRE. This time they are seemingly going all out. 
Having read a few other posts I suppose I was concerned about having the biopsy when seemingly the MRI hasn’t shown anything ‘sinister’ to use his words, but was inconclusive. I suppose it’s just belt and braces stuff but equally I don’t want to be doing anything invasive that isn’t needed.

Is it now the case that a biopsy under a general is the next natural progression?!

 

Edited by member 21 Oct 2019 at 20:01  | Reason: Not specified

User
Posted 21 Oct 2019 at 22:46

Hi Valleyview,

 

Curious that your consultant suggested a biopsy under general anaesthetic. My understanding from my own recent appt with consultant at Barnet General is that template biopsies are now done under local anesthesia and not general. 

Perhaps this isn't general policy yet?

User
Posted 21 Oct 2019 at 23:06
I think template biopsies are still generally done under general anaesthetic. Mine certainly was.

Best wishes,

Chris

User
Posted 21 Oct 2019 at 23:48
Mine done under GA too which I believe is more usual with the template one.
Barry
User
Posted 22 Oct 2019 at 00:01
Only a few places have introduced the template biopsy without GA.

VV, I am wondering how they ruled out cancer n 2016/17 without a biopsy. As for the recent scan, assuming it was a multi-parametric one (using different types of image to create a detailed picture) the result comes in 5 levels ... 5 is almost certainly cancer, 4 is highly indicative of cancer, 3 is ambivalent, 2 is unlikely to be cancer and 1 is almost certainly not cancer. It sounds like your MRI result was a 2 or 3.

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

User
Posted 22 Oct 2019 at 12:28

In relation to the BPH diagnosis, then yes I am wondering the same. I was initially put on Tamsulosin and as the symptoms continued I was then referred to the consultant. She did a DRE exam And I had already had a PSA test via my GP which started the referral to consultant. I then had a cystoscopy as she thought there might be a stricture. There wasn’t so that was it, I was recommended Tamsulosin which I was already taking and then I heard no more until the latest blood test showed a raise. 
Just got to wait and see now.

Doesn't make it any easier, but then so many people on here have been in the same position. 

User
Posted 30 Oct 2019 at 11:34

Eventually had the dates through for  my Biopsy,  booked for the 14th Nov. Get the Results on the 2nd Dec.

 
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