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Diagnosed in april

User
Posted 10 Jun 2019 at 20:55

Hello everyone, ( yes i know my profile pic isn't right πŸ˜„πŸ˜„ set it up on my mobile and it wasn't having it, so i gave it up for now )

Im Stuart, im 52 years old and in april this year i was diagnosed ( like many others on here ) with localised early stage prostate cancer ( although im still awaiting full confirmation, as will be explained later ) My father was diagnosed around march 2012 with metastatic prostate cancer at the age of 69 after suffering with no symptoms for years prior to his gp visit ( sudden weight loss and weak urine stream ) and he passed away just over 3 years later in july 2015.

On advice from his oncologist, ( as my father's cancer was advanced and i was mid 40's at the time) i was advised to begin yearly testing and following regular psa readings of 2, my latest test in march showed that my blood psa has risen to 5.1. I was sent to leigh infirmary for a biopsy and the consultant informed me after the procedure, that my prostate was also slightly enlarged, he didn't seem to concerned, as i also had no symptoms, with the exception of frequent daily toilet visits ( but as i drink anywhere between 4 and 6 litres of fluid daily, i wasn't concerned either )

The results, a week or so later from the oncology nurse, informed me of my diagnosis, with a gleason score of 3 + 3 = 6 and small traces of cancer on the right hand side of the gland. Following discussion, i was offered further consultation at salford royal and i was fast tracked there a week later, were my diagnosis was discussed with a consultant oncologist.

Following treatment advice, he informed me of the option of having a transrectal ultrasound guided biopsy, as he wanted to make sure of the initial biopsy accuracy ( im a bit p****d off with having to go through this so soon after my first one, but of course i have to do it ) with the option then, ( if confirmed diagnosis ) of active surveillance, rather than the option of surgery ( robotic assisted laparoscopic )

I will undergo this 2nd biopsy on Friday the 21st of June, so not long to wait now, i know these early stage diagnosis stories have been done to death on here, but i guess if others are in a similar situation and you want to comment, or ask any questions, you are more than welcome.

I guess i am lucky and rather than sounding morbid about it, ( i can't explain it any other way ) i guess that my fathers diagnosis was an ultimate sacrifice for my early testing ( at least, if my diagnosis is confirmed, i will have option choices for treatment, unlike my poor dad and many others on here )

It's funny, because after visiting various clinics during my consultations and testing, i've spoken to so many others with various levels of cancer, i have totally forgotten why i'm there sometimes, when i've been listening to others in much worse situations than me, its soul destroying and at the same time heartwarming to see and hear so many of them speaking so positive and being so, i've nothing but admiration for them, especially when no symptoms have occured before sudden testing. 

Anyway, to all those who look in, many thanks for reading and as stated earlier, please feel free to comment, or share your stories and i will be happy to reply,  i will also update my progress following the results of my 2nd biopsy probably at the end of this month, 

Best wishes,

Stuart.

 

User
Posted 10 Jun 2019 at 21:56

Hello Stuart, sorry to read about your dad,  have you had a pelvic MRI yet?

If the second biopsy shows cancer then an MRI would be the next step, although some people get the MRI first now. 

It sounds like things are at an early stage but the only way to be sure is MRI plus biopsy.

Feel free to read my profile.

All the best,

 

Ido4

User
Posted 10 Jun 2019 at 22:41

You should have an mpMRI done before any biopsies nowadays.

Also, I would ask for a transperineal (template) biopsy second time, not another TRUS.
A transperineal biopsy can access the whole prostate (a TRUS can't) and is more accurate (particularly when preceded by a mpMRI to identify any areas of particular interest). I don't think it's reasonable to put you through another TRUS.

User
Posted 10 Jun 2019 at 23:46

It is an image guided biopsy - seems a sensible next step to me. mpMRI isn’t available at Salford except in a limited number of cases which would mean further delays while requesting referral to yet another hospital. 

Edited by member 10 Jun 2019 at 23:49  | Reason: Not specified

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

User
Posted 11 Jun 2019 at 03:10

I concur with Andy. You should definitely have an mpMRI scan before anything else, even it means travelling to another city.

And I would request a transperineal biopsy rather than another TRUS, of which a leading prostate cancer oncologist stated: “the trial has shown us that the TRUS biopsy is as bad as we thought it was”.

Moreover, it may be of some succour to you to know that if you had Critical Illness Insurance, with say, Aviva, you would not get paid out as they don’t class Gleason 3+3=6 as ‘life threatening’.

Best of luck.

Cheers, John.

Edited by member 11 Jun 2019 at 07:33  | Reason: Not specified

User
Posted 11 Jun 2019 at 03:12
Most regrettable that an MRI was not done 1st which many of the leading urologists say should be the case but damage caused by Biopsy does indeed mean a delay for the Prostate to heal. We are not told how many cores were taken and the percentage of cancer found in them or how close any cancer was to the Prostate's periphery. Another TRUS may find further cancer and possibly some Gleason 4 grade which could make the treatment option move towards radical rather than AS.. Meanwhile, only Gleason 3+3 has been found which not all consultants even want to call cancer. In this situation, I would ask my consultant if there was a good reason why I could not wait the 4 or so weeks for the Prostate to heal and then have an MRI somewhere else where they can do it and go from there. There doesn't appear to be any great urgency from what we have been told.
Barry
User
Posted 11 Jun 2019 at 11:13

Hi everyone,

Thanks for the replies and advice and information. Having read your comments, i thought that i'd just relate to some of the points raised. Their were 12 core samples taken from my 1st biopsy, 6 each from the middle to upper left and right of the gland, i understand that this kind of procedure is not truly accurate, but i guess that's the start ( i made the point of stating that i was peed off about having the 2nd one around 3 months later ( 21st June, when i guess that because of my family history, ie, my father, they may have done something that was going to prove a bit more conclusive, ie again, performing the template version of the biopsy first, but i guess a standard biopsy is the norm ) Also upon reading your replies, then reading back my own story, i must update that my upcoming procedure the 21st of June is actually a TEMPLATE BIOPSY and not another transrectal, as i was typing on a very small screen, i wasn't aware that i'd mistaken the type of biopsy that i was to undergo the 2nd time.

The consultant oncologist i saw at salford, wanted to make sure that the core that showed the cancer reading wasn't the outer layer of perhaps a bigger portion lower down on the gland, so i can see the point. I guess also. that depending on who individuals see, mri's or biopsies may be first options of treatment, again as i understand the damage caused to the gland and healing time.

Best wishes,

Stuart

User
Posted 11 Jun 2019 at 12:10
Hi Stuart,

Good. I was worried that you were having another trans-rectal biopsy with all its inaccuracies and inherent risks. In which case you might well have ended end up having to have a third, more accurate transperineal or template biopsy.

If that also comes out as 3+3=6, I would advise you to relax and look forward to living a normal (and sex) life for several years on Active Surveillance with regular PSA tests and annual mpMRI scans.

I understand that some men s**t themselves when they hear the Big C diagnosis, as I would, if I had liver cancer, and want it removed asap, but as Barry said, there is a school of thought that G6 should not even be called β€˜cancer’. Maybe something like β€˜a little trouble down below’, as we amateur urologists call it? πŸ˜‰

Cheers, John.

User
Posted 11 Jun 2019 at 12:25

I know John, cheers for that, it was just a mistype on my part, although the 1st biopsy wasn't painful ( just uncomfortable ) at least i will be under general anesthetic for this, feel my prostate will have gone 12 rounds with deontay wilder during the last 3 months lol.

For whats it is worth i'm very positive and hope the outcome confirms my original diagnosis, then i can just get on with life and hopefully active surveillance without further worry.

Best wishes and hope all is good

Stuart

 

 

Edited by member 11 Jun 2019 at 12:26  | Reason: mistype

User
Posted 11 Jun 2019 at 20:22

Stuart,

This is a good thread on the template biopsy experiences.
My own experience is in the middle.

https://community.prostatecanceruk.org/posts/t21029-Had-a-TP-biopsy-this-morning

User
Posted 11 Jun 2019 at 20:58

Hi Andy thanks for that,

Brilliant detailed post, ( i will take time to read the others there also ) i really enjoyed reading that and lol at parts of it ( shouldn't have but !!! ) i appreciate the link as i haven't had a lot of time to read many other threads yet.

The worst part for me ( i know you were down last, so long wait ) will be the fasting, so hope i go down 1st am, as i'm used to eating every 2 1/2 hours, so not looking forward to that, i also immac my parts, 😏😏 so will have no trouble with the sticky plaster πŸ˜„πŸ˜„πŸ˜„ 

Also happy no prolonged time before exercising, although i guess i will have to go steady early, it seems we have similar body fat ratio, so i guess being like that helped recovery.

As already stated, being new here i will take more in, but wherever you are at the moment, i hope it is going good.

Thanks again,

Stuart 

User
Posted 11 Jun 2019 at 21:50

I was wondering what to do about trimming the bush beforehand. Normally I don't trim at all because I find it uncomfortable if there's no hair between scrotum and legs.

I had a pre-op appointment a couple of weeks beforehand to do all the blood tests, urine tests, test for MRSA, and for me to ask any questions about the procedure. The nurse didn't seem to know much about the procedure, and couldn't answer any of the questions I'd put on the form they gave me when I arrived. I asked about trimming, and she said they'd do it if necessary (basically, she didn't know). I didn't want it all trimmed off, so I trimmed the area I thought they'd need down to lowest level with beard trimmer, and neatened up the rest but not as short. They didn't do any additional trimming, so I guess I got it right. I read the instructions for some other hospitals (mainly in the US), and in many, shaving is a big No, and would get your op cancelled. The reason being shaving introduces micro infections in the skin which can get carried into the prostate during the procedure. That's why I went for trimming, and was damn careful not to nic the skin and generate an infection. I don't know how immac leaves the skin, but you might want to time it so any micro infections will have well cleared up before the op. The other funny thing about the pre-op was she gave me the tamsulosin to start taking 3 days before, and said it's to soften up the prostate - I laughed.

I will have high dose rate brachytherapy in a few months which is not dissimilar to a template biopsy (except you still have all the needles in your perineum/prostate when you wake up after the op), but it's after 4.5 weeks of full pelvis radiotherapy, which may well zap my pubes, so there might be nothing left to trim before the brachy, and being on hormone therapy, it probably won't regrow very quickly.

User
Posted 11 Jun 2019 at 22:26

Thanks again Andy, 

I'l leave the trimming alone if that's the case, best be on the safe side and I don't want any hold ups. I guess because only the procedure was discussed at the appointment rather than the before preparation, I had no idea, but your input has helped, pity the nurse you saw wasn't clued up more, quite poor really. Having read your profile, I'm much clearer on your state of treatment, I truly hope things work out for you,

Best wishes, 

Stuart 

User
Posted 12 Jun 2019 at 00:40
No-one should ever shave themselves before any kind of surgery - if they need to the hospital usually do it in theatre where everything should be sterile.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Jun 2019 at 12:29

Hi Lyn,

Yes, you are correct and im aware of your point, but just to be clear ( from my point made to andy62 ) i wasn't in the process of doing it myself for the basis of my procedure, i keep my body hair free, it's just a bodybuilding thing 😎

Thanks,

Stuart 

User
Posted 12 Jun 2019 at 14:49
I had a free half-Brazilian during my operation - I should have read the small print on the consent form. Would have gone for the whole thing.

It's all grown back now, a year later, but I've gone grey!

Must be the stress of not having cancer anymore...

Cheers, John.

 
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