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BRCA 2 & high PSA help? - BRCA2,Biopsy,PSA

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User
Posted 09 Mar 2016 at 18:09

Hi Tried to post once and seemed to have disappeared. 

We all found we were BRCA 2 in 2014 following Mum's 2nd Ovarian cancer with a 20 yr gap where she lost her bladder and part of bowel and has two stomas. Uncle, I, sister, niece and Mum are all positive. Gives my Uncle around 40% risk of prostate cancer. We're in an aggressive BRCA 2 prostate cluster. 

His PSA jumped from around 4.5 in a year to 8.5. He had MRI results at a local hospital today and they say they're abnormal and he needs a biospy. He doesn't want one as he thinks it's risky and he'll bleed from bum and have sepsis and need anti biotics. As he is bi polar (with no support as he doesn't want any) I fear this could set off a psychosis in him 

I'd like to know: 

- how a biopsy is and real risks

- Best London hospitals for prostate Uros, surgery and trials

- If watching his PSA and reviewing in 3mths as Dr said he can do if he won't have biopsy is ok?

What tips people can share? 

I'm juggling Mum's next major op to reverse her ilieal conduit that is faulty. She has a high risk of sepsis and ilieus and will be in hospital for around 15 days. Sister is planning preventative masectomy and has an op in April. My BSO to remove ovaries is due in April (40, no kids and not looking forward to instant menopause even with HRT). 

I'd like a simpler life and tips to give him a smooth prostate journey if he does have cancer

Tips?

User
Posted 10 Mar 2016 at 00:28

Hi Spacecadet,

Sorry your family has been so extensively affected.

As regards biopsy, it is more usual that a TRUS biopsy is given. This generally involves between 8 and 12 needles being inserted through the rectum and small cores being removed for subsequent examination in a lab. The patient hears a 'click' not unlike a stapler noise and feels a sting rather like being flicked with an elastic band with each needle, although a form of anesthetic is usually applied where the needles are inserted and guided. Most men find this quite tolerable (if undignified) but a few find it more traumatic. There is an alternative type of biopsy called a Tansperineal template where a greater number of cores are taken and the needles are inserted through a template just below the scrotum rather than through the rectum. This is mostly done with a general or epidural anesthetic. Antibiotics are given for both types of biopsy but the risk of infection is further reduced with the Transperineal one though sitting down can be a little uncomfortable for some days. With either biopsy a man might find a little blood in his urine and semen for a few days after the procedure.

The prospect of surgery with what that entails and potential for severe after effects, I would think to be a much greater hurdle to surmount than having a biopsy.

A Dr is most unlikely to press a man to have a biopsy unless cancer is thought to be advancing and even then a patient's unwillingness must be respected.

Barry
User
Posted 10 Mar 2016 at 14:46
Hi space cadet,

I had a transperinneal biopsy under general anaesthetic a few weeks ago. I was in and out of hospital within a few hours with no other side effects only those that had been expected , a little soreness and bruising ( I didn't need painkillers), blood in urine for a few days and blood in semen. The biopsy was given to provide a definitive answer to the type and grade of cancer I had that had been previously indicated on MRI.

No advice intended with the above-just my story. Please feel free to ask further questions.

Best wishes

AL

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User
Posted 09 Mar 2016 at 19:24

Hi Spacecadet,
I would delete the other thread quickly otherwise you are going to be confused by two sets of responses.

as far as your uncle goes, if the urologist is happy to wait 3 months and test again, this suggests that whatever grey area they could see on the scan is defined and contained. Based on everything else going on in the family, and uncle's dagnosis as bi-polar, I would respect his wishes and not push him into a biopsy right now. Over the coming months, once your mum and you have recovered from your surgery, you can spend some time helping him to understand that death from prostate cancer is a whole lot more likley and more distressing than the tiny percentage risk of infection from a biopsy.

We have a member on here with bi-polar who was pushed into treatment that he didn't really want - no doubt he will be along any minute to tell you his views.

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

User
Posted 10 Mar 2016 at 00:28

Hi Spacecadet,

Sorry your family has been so extensively affected.

As regards biopsy, it is more usual that a TRUS biopsy is given. This generally involves between 8 and 12 needles being inserted through the rectum and small cores being removed for subsequent examination in a lab. The patient hears a 'click' not unlike a stapler noise and feels a sting rather like being flicked with an elastic band with each needle, although a form of anesthetic is usually applied where the needles are inserted and guided. Most men find this quite tolerable (if undignified) but a few find it more traumatic. There is an alternative type of biopsy called a Tansperineal template where a greater number of cores are taken and the needles are inserted through a template just below the scrotum rather than through the rectum. This is mostly done with a general or epidural anesthetic. Antibiotics are given for both types of biopsy but the risk of infection is further reduced with the Transperineal one though sitting down can be a little uncomfortable for some days. With either biopsy a man might find a little blood in his urine and semen for a few days after the procedure.

The prospect of surgery with what that entails and potential for severe after effects, I would think to be a much greater hurdle to surmount than having a biopsy.

A Dr is most unlikely to press a man to have a biopsy unless cancer is thought to be advancing and even then a patient's unwillingness must be respected.

Barry
User
Posted 10 Mar 2016 at 14:46
Hi space cadet,

I had a transperinneal biopsy under general anaesthetic a few weeks ago. I was in and out of hospital within a few hours with no other side effects only those that had been expected , a little soreness and bruising ( I didn't need painkillers), blood in urine for a few days and blood in semen. The biopsy was given to provide a definitive answer to the type and grade of cancer I had that had been previously indicated on MRI.

No advice intended with the above-just my story. Please feel free to ask further questions.

Best wishes

AL

 
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