A very large prostate

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User

Posted 04 Apr 2024 at 20:13

Hi. I’m new. My question is : does the size of the prostate indicate a likelyhood of cancer.
So far I have been diagnosed with a PSA of 16 and the MRI is pi rad 4. Had biopsy earlier in the week and the Dr said they were trying to biopsy a 1/2cm shadow that showed up on the MRI.
The shadow worries me but what really scared me was the pain of the biopsy and being told my prostate is the size of a tennis ball.

Shoukd I prepare myself for a cancer diagnosis?

User

Posted 05 Apr 2024 at 03:08

A large prostate does not have any more risk of cancer than a normal size one. You could Google "PSA density" which is sometimes used when talking about very large or small prostates. Long story Short, your PSA is not very high considering the size of your prostate. The fact you're a man over 60 means you have about a 60% chance of having prostate cancer. The real question is have you got cancer which needs treating? or can it just be left alone which is the best practice for most men.

Dave

User

Posted 05 Apr 2024 at 21:03

Thankyou Dave. Your words are reassuring. Excuse my ignorance but Dr Google is confusing and conflicting. Also it’s scary!
So it is entirely possible that they might not offer treatment but just monitor? This sounds okay but may I ask ? If this is an option for me will I have to go for regular biopsies?
The reason I ask is because the last one was the most excruciating pain I have ever experienced- without being a total baby I genuinely could not go through that experience again.
many thanks.

User

Posted 05 Apr 2024 at 21:25

Hi Hippo

Welcome to the forum.

Until you have the results of your biopsy you can't tell for sure what you've got. If, as you were told, your prostate is as large as a tennis ball that's much bigger than the normal size which is about the size of a walnut. This great enlargement could be caused by various prostate conditions and could be why your PSA is higher than normal.

The biopsy will shed far more light onto your condition and a treatment plan will be made on those results. It's pointless trying to forecast what that treatment plan may be.

I'm sorry you found the biopsy so painful, but again, at this stage it's impossible to tell whether the need would ever arise for you to have another.

I've had two and neither caused me anything more than a little discomfort.

I know it's difficult but try and deal with one thing at a time, otherwise you may end up being worried about things that might never happen.

Please keep us updated and best of luck mate.

User

Posted 05 Apr 2024 at 21:31

I'm surprised the last biopsy was so painful. I don't think any of us is keen on having one, but it isn't too dreadful, maybe there was some issue with the anaesthetic.

At the moment there are three possible outcomes to your diagnosis: "all clear", in which case a PSA every year or two may be a good idea, as you now have a baseline PSA to be judged against; "Cancer", in which case treatment will be offered, but also active surveillance is possible; or "we can't be sure", in which case you will be on a treadmill of tests for years to come.

Ongoing tests or active surveillance, may not require regular biopsies, but it would be likely you would have at least one more if things started looking more suspicious. If that biopsy were inconclusive then it could keep going on. If you are on active surveillance you can just opt for treatment whenever you want. If tests are inconclusive you may choose to refuse another biopsy until other signs, such as PSA and MRI are so strong that that you are almost guaranteed to find cancer at the next biopsy. One of my friends who is 75 refused any further biopsies after the fourth one in ten years.

Dave

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