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MRI scan confusion

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User
Posted 13 Mar 2016 at 18:49

Looks like I'm having one this week.


 


Pardon my ignorance but I thought it was just a biopsy that can confirm prostate cancer?

User
Posted 14 Mar 2016 at 18:55

.

Edited by member 24 Nov 2016 at 17:37  | Reason: Not specified

User
Posted 13 Mar 2016 at 21:14
Hi Mark,

I became confused by all the different scans referred to at the first appointment with the Urologist.
The mri is as devonmaid said to check if the disease has spread.

In the end I had 2 Mri scans and a nuclear medical scan too.
Then I had the biopsy. I know that some have these procedures in different order .
And this was followed by my first appointment with the oncologist, which took place several months later.
This was because I could not have surgery and went straight to hormone therapy and subsequent radio therapy.

Anyway good luck.

Keep positive but ask away if you have any further queries.

John

User
Posted 13 Mar 2016 at 21:43

Hi Mark,

You are right that it is a biopsy that enables medics to examine the cores taken and determine the type of cancer and how far from normal cells the cancer has mutated. Sometimes a biopsy is done before an MRI scan and may or may not find any cancer. It is better to have the MRI scan first as this not only helps identify spread but can help show where the needles should be placed during biopsy. Bone scans are done where it is thought that there may be spread. However, if the PSA is very high and it is believed the cancer is well advanced, sometimes a bone scan is not done, at least not as part of original diagnosis.

Barry
User
Posted 13 Mar 2016 at 21:51

I think the first couple of replies given might confuse you Mark.

Men that have already had a biopsy which showed cancer will usually then have an MRI to see whether it has spread.

Some men (in more forward thinking NHS trusts) have an MRI before the biopsy so that the consultant can better judge where to point his needles during the biopsy.

As far as I can see, you haven't yet had a biopsy so your MRI is to a) help decide whether you even need a biopsy (if there are no suspicious areas they might suggest you don't need one) and / or b) identify any shady areas to biopsy and test. The MRI can't diagnose cancer, only help inform the doctor's next steps

Edited by member 13 Mar 2016 at 21:52  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Mar 2016 at 22:22
Lyn,

The urologlist at my first appointment wanted me to have the mri scan first and then I had the NM scan because I had pain in my left hip. This was followed by a second Mri scan . Then I had the biopsy. And these were for the reasons you mentioned to help with the next steps. No bone spread was discovered , fortunately.
I then saw the urology team again when all the results were available to them. I then was advised to start hormone therapy (Zoladex ). I saw the oncologist 2 months later.
And started radiotherapy 2 months after that.

Mark,
If you're working then it may best to advise them that you are undergoing investigation, if you haven't already.
The first Mri scan I had was on a Sunday. I was then working one weekend in four and of course the scan was scheduled for the Sunday I was due to work.
Because I'd told work, there was no problem in them arranging for someone to cover my shift for me. Weekend working is covered by reduced staffing . Everyone was very sympathetic and probably relieved that it wasn't happening to them!
In fact I had great support from work. It made the whole situation far easier.
I have no complaints whatsoever with the treatment and advice offered to me by my medical team. They were/ are superb .

Hopefully you'll be placed on active surveillance and that will give you time to decide where you go from there.
If more urgent action is required , then you know where we are if you need us.

Best wishes

John
User
Posted 13 Mar 2016 at 22:37
Good point Lyn.
I missed Mark' s Psa score.

Sorry if I've confused you, Mark . But I hope all goes well for you none the less !

John
User
Posted 14 Mar 2016 at 14:18

lol - a simple question and the thread seems to have become confusing! Mark - if you haven't already then ask your consultant why you are having an MRI scan and why he/she thought it best to do an MRI first. If you can't get hold them directly then you should be able to phone his/her secretary or the specialist nurse and ask them to seek clarification on your part. Don't be afraid to ask questions and then more if necessary, it's your NHS.

Knowledge from the top is best and questioning our diagnosis and treatment is wise! Folk don't ask enough questions in my view and uncertainty only breeds anxiety.

As your PSA is not too high it is likely that if (to clarify 'if') you have PC it is unlikely to be at an 'elevated' stage and would be easily treatable (although to avoid having my wrist slapped I need to mention not impossible, ha!).

Good to get these things checked out as you are doing - for peace of mind if nothing else.

dl

User
Posted 14 Mar 2016 at 17:24

(

Edited by member 24 Nov 2016 at 17:33  | Reason: Not specified

User
Posted 14 Mar 2016 at 18:00

Hi Mark


A smooth prostate is a good sign as it suggests (tho again to avoid a wrist slap I need to mention not always true) that if there is any cancer it hasn't reached the walls of the prostate and therefore 'suggests' that it wouldn't have spread beyond the prostate.


However, many men with prostate cancer have little if any symptoms and it is suspected after routine blood tests or whilst investigating something else.


Erectile problems, as you know, could be due to a number of things.


Always best to investigate these things as these days detecting prostate cancer in it's early stage normally results in 'cure'.


dl


 

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User
Posted 13 Mar 2016 at 21:08
Hi Mark
An MRI is often done to establish whether the disease has spread and if so, where. Are you also having a bone scan?

Devonmaid
User
Posted 13 Mar 2016 at 21:14
Hi Mark,

I became confused by all the different scans referred to at the first appointment with the Urologist.
The mri is as devonmaid said to check if the disease has spread.

In the end I had 2 Mri scans and a nuclear medical scan too.
Then I had the biopsy. I know that some have these procedures in different order .
And this was followed by my first appointment with the oncologist, which took place several months later.
This was because I could not have surgery and went straight to hormone therapy and subsequent radio therapy.

Anyway good luck.

Keep positive but ask away if you have any further queries.

John

User
Posted 13 Mar 2016 at 21:43

Hi Mark,

You are right that it is a biopsy that enables medics to examine the cores taken and determine the type of cancer and how far from normal cells the cancer has mutated. Sometimes a biopsy is done before an MRI scan and may or may not find any cancer. It is better to have the MRI scan first as this not only helps identify spread but can help show where the needles should be placed during biopsy. Bone scans are done where it is thought that there may be spread. However, if the PSA is very high and it is believed the cancer is well advanced, sometimes a bone scan is not done, at least not as part of original diagnosis.

Barry
User
Posted 13 Mar 2016 at 21:51

I think the first couple of replies given might confuse you Mark.

Men that have already had a biopsy which showed cancer will usually then have an MRI to see whether it has spread.

Some men (in more forward thinking NHS trusts) have an MRI before the biopsy so that the consultant can better judge where to point his needles during the biopsy.

As far as I can see, you haven't yet had a biopsy so your MRI is to a) help decide whether you even need a biopsy (if there are no suspicious areas they might suggest you don't need one) and / or b) identify any shady areas to biopsy and test. The MRI can't diagnose cancer, only help inform the doctor's next steps

Edited by member 13 Mar 2016 at 21:52  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Mar 2016 at 22:22
Lyn,

The urologlist at my first appointment wanted me to have the mri scan first and then I had the NM scan because I had pain in my left hip. This was followed by a second Mri scan . Then I had the biopsy. And these were for the reasons you mentioned to help with the next steps. No bone spread was discovered , fortunately.
I then saw the urology team again when all the results were available to them. I then was advised to start hormone therapy (Zoladex ). I saw the oncologist 2 months later.
And started radiotherapy 2 months after that.

Mark,
If you're working then it may best to advise them that you are undergoing investigation, if you haven't already.
The first Mri scan I had was on a Sunday. I was then working one weekend in four and of course the scan was scheduled for the Sunday I was due to work.
Because I'd told work, there was no problem in them arranging for someone to cover my shift for me. Weekend working is covered by reduced staffing . Everyone was very sympathetic and probably relieved that it wasn't happening to them!
In fact I had great support from work. It made the whole situation far easier.
I have no complaints whatsoever with the treatment and advice offered to me by my medical team. They were/ are superb .

Hopefully you'll be placed on active surveillance and that will give you time to decide where you go from there.
If more urgent action is required , then you know where we are if you need us.

Best wishes

John
User
Posted 13 Mar 2016 at 22:32

I'm sorry Surr but I don't think your reply is helpful to Mark at all - it assumes he has prostate cancer and could therefore have put the Fear of God into him unnecessarily. If you check his previous thread, his PSA is around 3.5 ... there might be nothing wrong with him!

Edited by member 13 Mar 2016 at 23:53  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Mar 2016 at 22:37
Good point Lyn.
I missed Mark' s Psa score.

Sorry if I've confused you, Mark . But I hope all goes well for you none the less !

John
User
Posted 14 Mar 2016 at 12:10

I think you are missing my point Thistle - a couple of the responses were assuming he had already been diagnosed so comments about the MRI being to identify spread were premature.

You are quite right that low PSA does not provide an all-clear. My husband was diagnosed at 3.1 and my f-i-l died with a PSA of 1.2 - However, Mark is fortunate enough to be offered a scan prior to any biopsy and if we wrongly give him the impression that he has cancer, that is likely to be
a) distressing - people should have support when being told bad news
b) impact on what he says/thinks at his appointment and
c) reinforce in the minds of doctors what a bad idea it is when patients come on the internet and self-diagnose

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Mar 2016 at 14:18

lol - a simple question and the thread seems to have become confusing! Mark - if you haven't already then ask your consultant why you are having an MRI scan and why he/she thought it best to do an MRI first. If you can't get hold them directly then you should be able to phone his/her secretary or the specialist nurse and ask them to seek clarification on your part. Don't be afraid to ask questions and then more if necessary, it's your NHS.

Knowledge from the top is best and questioning our diagnosis and treatment is wise! Folk don't ask enough questions in my view and uncertainty only breeds anxiety.

As your PSA is not too high it is likely that if (to clarify 'if') you have PC it is unlikely to be at an 'elevated' stage and would be easily treatable (although to avoid having my wrist slapped I need to mention not impossible, ha!).

Good to get these things checked out as you are doing - for peace of mind if nothing else.

dl

User
Posted 14 Mar 2016 at 16:13

Thanks for your replies everyone.


My Dr's surgery did 2 PSA readings - 3.6, then 3.5.


My Urologist has done 5.1 & 4.1 (both within a week) though the first one might have been changed by sex the day before - I didnt know I was to have PSA the next day.


I am now going for a MRI on Thursday in London, fortunately I'm on BUPA.


Since the second test the poxy DVLA revoked my licence right out of the blue which is causing mayhem in like to be brutally frank and I feel very angry about it. Despite the consultant writing to say my sleep apnea is controlled and I can drive they are so bloody slow I've not got it back yet. Consultant said being stress free is good for readings - mind you, dealing with the medical dept at DVLA has been desperately disappointing. I've NO idea when I can drive and getting to the urologist is an extra 3 hours on the day.


So a right pain all in all. In this day & age you'd think these matters would be a rubber stamping job once your consultant approves!! #p****doffbeyondgbelief.


So there we go - still in the grace of God in all departments at present.


Urologist did say he was hopeful the PSA reading is because of the enlarged prostate as it is very smooth and apart from erectile problems don't have any other symptons.


Is this normal?


 


 


 

Edited by member 14 Mar 2016 at 16:14  | Reason: Not specified

User
Posted 14 Mar 2016 at 17:24

(

Edited by member 24 Nov 2016 at 17:33  | Reason: Not specified

User
Posted 14 Mar 2016 at 18:00

Hi Mark


A smooth prostate is a good sign as it suggests (tho again to avoid a wrist slap I need to mention not always true) that if there is any cancer it hasn't reached the walls of the prostate and therefore 'suggests' that it wouldn't have spread beyond the prostate.


However, many men with prostate cancer have little if any symptoms and it is suspected after routine blood tests or whilst investigating something else.


Erectile problems, as you know, could be due to a number of things.


Always best to investigate these things as these days detecting prostate cancer in it's early stage normally results in 'cure'.


dl


 

User
Posted 14 Mar 2016 at 18:03

?? Pardon my ignorance but what do those readings mean in laymans terms, apologies as I simply have no idea.

User
Posted 14 Mar 2016 at 18:29

Which readings Mark?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Mar 2016 at 18:39

Ah, the T4NOMX Gleason 5+4 that Thistle refers to? It means that he was diagnosed with a prostate cancer that was very aggressive and had already spread outside the prostate gland and was therefore incurable despite having an extremely low PSA level.

Out of interest Thistle, did they ever identify anything other than adenocarcinoma in your husband? I am just thinking that his remarkable 11 years cespite the original diagnosis might have relevance for Si-ness?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Mar 2016 at 18:55

.

Edited by member 24 Nov 2016 at 17:37  | Reason: Not specified

User
Posted 14 Mar 2016 at 19:20

His is a great case study for the idea that chemo can hit it harder the second time around, and that somehow the first blow or maybe the cabz does enough damage to cripple the cells for the second attack.

Thinking of you x

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Mar 2016 at 20:22

Originally Posted by: Online Community Member


Which readings Mark?



 


Yes it was Thistles.


 


I did ask on the phone if they give you MRI readings whilst you are there but it apparently takes 2 days.


 


All a bit scary really, though it's just a day at a time and dealing with whatever happens in due course.

User
Posted 14 Mar 2016 at 20:23

Originally Posted by: Online Community Member
Hi Mark
An MRI is often done to establish whether the disease has spread and if so, where. Are you also having a bone scan?

Devonmaid


 


Don't know DM, at present no idea if I have PC or not

User
Posted 16 Mar 2016 at 16:50

Mark, you sound a bit like me. I'm 62 years old and recently had a PSA test which came back with a count of 11.5 a digital rectum examination showed the prostate to be normal and squishy (my GP's words).


As my PSA count was high my GP said that he was referring me for a biopsy. When I saw my Urology consultant he said that he wanted me to have a MRI scan to decide if I needed a trus or template biopsy. I had the MRI scan and was contacted by Senior Urology nurse who said that my consultant had reviewed the scan and that he wanted me to have a template biopsy. This concerned me slightly so I asked if the scan had shown anything, but the nurse said that the scan was normal.


I am glad that I am having a template rather than a trus biopsy as the template biopsy is more accurate. I don't what type of scan I had or you are having, but you might want to google "promis trial".

User
Posted 16 Mar 2016 at 19:58

Thanks, I will do.
I was a bit disappointed when I found out my urologist had gone away and there was no one to help me when I asked what it involved.
Will look up Promis trial, thanks very much and best wishes for your biopsy and results.

 
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