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Referred for biopsy very worried.

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User
Posted 17 Jan 2016 at 11:57

Hi, just wondered if anyone could help. I have an enlarged prostate and have had urinary problems for a while. I am 52 and have now been put on Vesomni tablets which have helped my problems. The Doctor did a DRE which confirmed the enlarged prostate but no abnormalities and a psa test at the same time which came back at 6.2. So I was fast tracked to the urologist actually saw the specialist registrar who has fast tracked me for a biopsy next week. Having spoken to various people (London area) I am in the Yorkshire area I have been informed that  a multiparametric mri would be better as it can detect more and could also prevent having biopsy if all ok. If anything found told would have to have an mri anyway. The person I saw hasn't returned my calls and I do have a medical insurance which would cover this. Has anyone any experience of this as obviously I want the best option but don't want to cancel the biopsy if that's what I need. Thanks

User
Posted 17 Jan 2016 at 14:51

Walkers, just get the biopsy. Once that's done, you can talk to the specialist about which kind of scan might be a good next step. Neither way round is foolproof - the biopsy might miss any tumour and give a false negative, a scan can come back clear even if the prostate is affected throughout. If the biopsy is positive, they will give you scans to see whether it has spread. If the biopsy is negative, your consultant may recommend a scan anyway (with a few weeks wait for the gland to heal first). If you are in Yorkshire, whether you get a normal scan or one of the newer more detailed ones will depend on which hospital you are referred to.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 17 Jan 2016 at 15:19

A drawback of having a biopsy first is that it takes a few weeks to heal before the prostate recovers sufficiently to get good results from an MRI. It is true that both MRI and biopsy sometimes miss cancer. However, a leading UK professor is on record as saying he would rather have one negative MRI than three negative trus biopsies. Given the choice, in the circumstances, having the MRI first is the way I would go but your decision.

Edited by member 17 Jan 2016 at 16:23  | Reason: Not specified

Barry
User
Posted 17 Jan 2016 at 18:01

Once you're on the roller-coaster it's hard to get off. I would just do what they suggest as I did and hope all is clear. I had a multi axis MRI which was clear , a TRUS which was clear , a template biopsy which qualified me for Active Surveillance. In fact I had a Gleason 9 cancer which had already spread to my Lymph nodes. It's a worry for sure for you , but no point in half-knowing what's happening. Fingers crossed for you
Chris

User
Posted 19 Jan 2016 at 22:22

First of all, try not to worry too much, I know it is difficult, but with your PSA result, cancer is much less likely than other causes such as BPH.  If you have a prostate enlarged enough to cause serious urination problems, then it is very likely that the PSA score is as a result of BPH.  I was having urination problems so had a PSA test which came back as 8.9 last April.  That is a little high for BPH, with my prostate which around double the normal size at 54cm, then PSA up to around 7.5 could be expected.  I had a biopsy which was clear, but a follow up PSA test in September was 14.7 and 15.0 two weeks later.  I had an MRI scan in November, which was encouraging (the urologists words) but not completely clear, couple of fuzzy areas, so I am now going to have a template biopsy.  My PSA is still 15 so at least it is not going up, but there is no explanation for it.  It could be prostatitis brought on by the biopsy, but the only way to find out whats's going on is the biopsy.  An MRI scan is useful but the only way to truly diagnose cancer is a biopsy.  That said, I would want the MRI first if possible, because they can use the results of that to try to target suspicious areas rather than going in completely blind.

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User
Posted 17 Jan 2016 at 14:51

Walkers, just get the biopsy. Once that's done, you can talk to the specialist about which kind of scan might be a good next step. Neither way round is foolproof - the biopsy might miss any tumour and give a false negative, a scan can come back clear even if the prostate is affected throughout. If the biopsy is positive, they will give you scans to see whether it has spread. If the biopsy is negative, your consultant may recommend a scan anyway (with a few weeks wait for the gland to heal first). If you are in Yorkshire, whether you get a normal scan or one of the newer more detailed ones will depend on which hospital you are referred to.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 17 Jan 2016 at 15:19

A drawback of having a biopsy first is that it takes a few weeks to heal before the prostate recovers sufficiently to get good results from an MRI. It is true that both MRI and biopsy sometimes miss cancer. However, a leading UK professor is on record as saying he would rather have one negative MRI than three negative trus biopsies. Given the choice, in the circumstances, having the MRI first is the way I would go but your decision.

Edited by member 17 Jan 2016 at 16:23  | Reason: Not specified

Barry
User
Posted 17 Jan 2016 at 18:01

Once you're on the roller-coaster it's hard to get off. I would just do what they suggest as I did and hope all is clear. I had a multi axis MRI which was clear , a TRUS which was clear , a template biopsy which qualified me for Active Surveillance. In fact I had a Gleason 9 cancer which had already spread to my Lymph nodes. It's a worry for sure for you , but no point in half-knowing what's happening. Fingers crossed for you
Chris

User
Posted 19 Jan 2016 at 22:22

First of all, try not to worry too much, I know it is difficult, but with your PSA result, cancer is much less likely than other causes such as BPH.  If you have a prostate enlarged enough to cause serious urination problems, then it is very likely that the PSA score is as a result of BPH.  I was having urination problems so had a PSA test which came back as 8.9 last April.  That is a little high for BPH, with my prostate which around double the normal size at 54cm, then PSA up to around 7.5 could be expected.  I had a biopsy which was clear, but a follow up PSA test in September was 14.7 and 15.0 two weeks later.  I had an MRI scan in November, which was encouraging (the urologists words) but not completely clear, couple of fuzzy areas, so I am now going to have a template biopsy.  My PSA is still 15 so at least it is not going up, but there is no explanation for it.  It could be prostatitis brought on by the biopsy, but the only way to find out whats's going on is the biopsy.  An MRI scan is useful but the only way to truly diagnose cancer is a biopsy.  That said, I would want the MRI first if possible, because they can use the results of that to try to target suspicious areas rather than going in completely blind.

 
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