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User
Posted 26 May 2016 at 09:41

Hi All, 

Thanks for this great resource. I've been reading through a lot of the conversations with interest.

My background is that I have had very mild symptoms for years (having to pee more often than usual and slight erection problems at various times). Thought  nothing of this.

I had an opportunity for a Wellman health screening at mt GP's. He performed a rectal exam and said everything felt normal.

However my blood test revealed a PSA of 11.

I've been given a consultation next week, however I'm unclear as to what will happen at this consultation. I've tried calling the hospital but they don't answer the phone!

Is this just a consultation or will I be having a biopsy straight away? How invasive is the biopsy? Do I need to book the following day off? 

Sorry for the basic questions but I can't find the answer elsewhere.

Also should I be worried about a PSA of 11?

Thanks in advance.

 

David.

User
Posted 26 May 2016 at 11:33

Hi David
My first referral was with a PSA of 15. At my first hospital visit I was finger examined again and then had an ultrasound scan which is a probe that goes in your anus. Not horrific but not pleasant either if you get the drift. I was 47 yrs old and so was referred for an MRI and then a biopsy same day. The biopsy is very similar to the u/s scan, with the biopsy staple gun device being passed through the probe. Normally 10 needle pricks which wasn't awful either. They would put you on antibiotics a week before then finish the course. Not really painful and straight back to work. Some small blood in poo. Lots of blood in semen for about 6 weeks which was yucky.
The PSA figure if high is usually worrying but NOT always an indicator of cancer ok. What is worrying is a constant change in your PSA level. My cancer was very hard to find but they kept looking as my PSA eventually hit 43 before they found it. Others will be along to help. Good luck and ask anything
Chris

User
Posted 26 May 2016 at 11:39

Hello David and welcome to our site.

A PSA of 11 is pretty high but does not of itself guarantee that you have prostate cancer as a high PSA can also be caused by infection, Benign Hyperplasia, or even cycling and sex (not together of course!) just before the PSA test.

The consultation will probably consist of another rectal examination and questions from the consultant. IF a biopsy is required then an appointment will be sent to you.

As for booking a day off if you have a biopsy you may prefer to. Some men have no problems during/following a biopsy. It can be either a little uncomfortable or very uncomfortable!! It also depends on what kind of biopsy.

I wouldn't stress too much at this stage about booking time off because you don't know how long it will be before an appointment is sent to you.

If a biopsy is done (and depending on what is found) an MRI may be required. Something called a Gleason score is recorded for you based on what information is discovered. This denotes the staging of the cancer.

If you go to Publications on this website you can either order or download The Toolkit which gives lots of information regarding Prostate Cancer.

There will also be other members along at some stage to reassure you but for now try not to look on the bleak side. IF it's cancer and you have been having problems for a while then how much worse would it have been had you not taken advantage of the Wellman appointment.

Best Wishes
Sandra

Edited by member 26 May 2016 at 12:23  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 26 May 2016 at 12:05

Hi David, some as one of my local hospitals have if need be a fast track system. However noting your comments it's more likely to be a routine exam which might include another rectal exam, PSA test and a flow test on the day with a biopsy at a later date.

Ray

User
Posted 26 May 2016 at 15:16

Hi David,

You will probably have a consultation with a urologist who will most likely want to repeat the digital rectal examination.

With a PSA of 11 I expect he will want to err on the side of caution and want book you in for a biopsy and / or a MRI scan. 

re. the biopsy itself, others have described the process pretty well. I decided in the end to take the whole day off (morning appointment) but looking back, could have gone back to work in the afternoon, a little sore.

re. the PSA result, again as others have said it could be due to a number of reasons, but best to get it checked out all the same.

Flexi

User
Posted 26 May 2016 at 15:18

I would have thought that a patient would have been previously advised if his initial appointment was to include a biopsy but should it do so it will be the Trus one where normally 8-12 cores are taken. (A transperineal template biopsy is much more involved, usually done under anesthetic and involves preliminary checks to ensure the patient is suitable). There is a growing tendency to give an MRI scan before biopsy but this is not the usual order. A patient due to have an MRI should be notified and prepared for this in advance anyway, as certain things can be a problem, metal implants or embedded metal, (though not dental implants) for example. So I would not expect you will have an MRI on this first appointment.

It would have helped if you had been told what your appointment involved and how long it would be for. I would take this as a pointer that the hospital are not very forthcoming and for you to be proactive in asking questions about any further follow ups and treatment.

Barry
User
Posted 26 May 2016 at 15:53

Are you NHS or Private? 

My first consultation was a 10-15 minute chat with the Consultant on history... followed by an ultrasound rectal scan.

Although he found nothing abnormal except that my prostate was enlarged - he arranged an MRI Scan next. (As others have said some Consultants do this first).

Biopsy only came later after the MRI revealed an area of concern and as others have said (for TRUS) this is uncomfortable but didn't need time off work next day.

For your first consultation I would think you don't need any more time off work.

Hope all goes well.

KRO...

User
Posted 26 May 2016 at 17:01

Hi Rect..... When you go to the appointment take a notebook and pen to write down things that you are told or record it on your mobile or go with someone so that two pairs of ears are better than one.

It will all be routine until you are told what or if there is anything to be concerned about but staying on top of the waiting game by phoning consultants secretaries to find out what is happening and maybe push things along a bit.

As the others have said be proactive and ask questions. You can post anything on this site and there will be somebody that can help you, we are all in the same boat being either the patient or other half or relatives and we will give the benefit of our experiences.

If there is a particular question that you want answers to there is also a specialist nurse on this site that you can call and get one on one help.

I had a PSA score of 63 and was sent for a MRI scan and a bone scan before having twelve template biopsies taken, this was not painful for me or particularly unpleasant but totally necessary.

Best of luck with your consultations

Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 26 May 2016 at 17:05
Rec

My PSA was 7.7 and my first appointment at the hospital was a chat with a junior doctor or registrar (not the consultant)followed by the biopsy, but my letter, which I did not fully read until the night before said consultation and possible biopsy.

Some hospitals do a MRI scan before a biopsy.

I went to work the next day and describe it as a walk in the park, I had taken a couple of pain killers on the day for another issue.

From my PSA blood test to that first appointment was just under two weeks.

Thanks Chris

Show Most Thanked Posts
User
Posted 26 May 2016 at 11:33

Hi David
My first referral was with a PSA of 15. At my first hospital visit I was finger examined again and then had an ultrasound scan which is a probe that goes in your anus. Not horrific but not pleasant either if you get the drift. I was 47 yrs old and so was referred for an MRI and then a biopsy same day. The biopsy is very similar to the u/s scan, with the biopsy staple gun device being passed through the probe. Normally 10 needle pricks which wasn't awful either. They would put you on antibiotics a week before then finish the course. Not really painful and straight back to work. Some small blood in poo. Lots of blood in semen for about 6 weeks which was yucky.
The PSA figure if high is usually worrying but NOT always an indicator of cancer ok. What is worrying is a constant change in your PSA level. My cancer was very hard to find but they kept looking as my PSA eventually hit 43 before they found it. Others will be along to help. Good luck and ask anything
Chris

User
Posted 26 May 2016 at 11:39

Hello David and welcome to our site.

A PSA of 11 is pretty high but does not of itself guarantee that you have prostate cancer as a high PSA can also be caused by infection, Benign Hyperplasia, or even cycling and sex (not together of course!) just before the PSA test.

The consultation will probably consist of another rectal examination and questions from the consultant. IF a biopsy is required then an appointment will be sent to you.

As for booking a day off if you have a biopsy you may prefer to. Some men have no problems during/following a biopsy. It can be either a little uncomfortable or very uncomfortable!! It also depends on what kind of biopsy.

I wouldn't stress too much at this stage about booking time off because you don't know how long it will be before an appointment is sent to you.

If a biopsy is done (and depending on what is found) an MRI may be required. Something called a Gleason score is recorded for you based on what information is discovered. This denotes the staging of the cancer.

If you go to Publications on this website you can either order or download The Toolkit which gives lots of information regarding Prostate Cancer.

There will also be other members along at some stage to reassure you but for now try not to look on the bleak side. IF it's cancer and you have been having problems for a while then how much worse would it have been had you not taken advantage of the Wellman appointment.

Best Wishes
Sandra

Edited by member 26 May 2016 at 12:23  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 26 May 2016 at 12:05

Hi David, some as one of my local hospitals have if need be a fast track system. However noting your comments it's more likely to be a routine exam which might include another rectal exam, PSA test and a flow test on the day with a biopsy at a later date.

Ray

User
Posted 26 May 2016 at 15:16

Hi David,

You will probably have a consultation with a urologist who will most likely want to repeat the digital rectal examination.

With a PSA of 11 I expect he will want to err on the side of caution and want book you in for a biopsy and / or a MRI scan. 

re. the biopsy itself, others have described the process pretty well. I decided in the end to take the whole day off (morning appointment) but looking back, could have gone back to work in the afternoon, a little sore.

re. the PSA result, again as others have said it could be due to a number of reasons, but best to get it checked out all the same.

Flexi

User
Posted 26 May 2016 at 15:18

I would have thought that a patient would have been previously advised if his initial appointment was to include a biopsy but should it do so it will be the Trus one where normally 8-12 cores are taken. (A transperineal template biopsy is much more involved, usually done under anesthetic and involves preliminary checks to ensure the patient is suitable). There is a growing tendency to give an MRI scan before biopsy but this is not the usual order. A patient due to have an MRI should be notified and prepared for this in advance anyway, as certain things can be a problem, metal implants or embedded metal, (though not dental implants) for example. So I would not expect you will have an MRI on this first appointment.

It would have helped if you had been told what your appointment involved and how long it would be for. I would take this as a pointer that the hospital are not very forthcoming and for you to be proactive in asking questions about any further follow ups and treatment.

Barry
User
Posted 26 May 2016 at 15:46

Thank you for all your replies, very much appreciated.

I will just roll with it at the appointment next week. But as you said I will be more proactive in my questions about follow up appointments and procedures.

 

User
Posted 26 May 2016 at 15:53

Are you NHS or Private? 

My first consultation was a 10-15 minute chat with the Consultant on history... followed by an ultrasound rectal scan.

Although he found nothing abnormal except that my prostate was enlarged - he arranged an MRI Scan next. (As others have said some Consultants do this first).

Biopsy only came later after the MRI revealed an area of concern and as others have said (for TRUS) this is uncomfortable but didn't need time off work next day.

For your first consultation I would think you don't need any more time off work.

Hope all goes well.

KRO...

User
Posted 26 May 2016 at 17:01

Hi Rect..... When you go to the appointment take a notebook and pen to write down things that you are told or record it on your mobile or go with someone so that two pairs of ears are better than one.

It will all be routine until you are told what or if there is anything to be concerned about but staying on top of the waiting game by phoning consultants secretaries to find out what is happening and maybe push things along a bit.

As the others have said be proactive and ask questions. You can post anything on this site and there will be somebody that can help you, we are all in the same boat being either the patient or other half or relatives and we will give the benefit of our experiences.

If there is a particular question that you want answers to there is also a specialist nurse on this site that you can call and get one on one help.

I had a PSA score of 63 and was sent for a MRI scan and a bone scan before having twelve template biopsies taken, this was not painful for me or particularly unpleasant but totally necessary.

Best of luck with your consultations

Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 26 May 2016 at 17:05
Rec

My PSA was 7.7 and my first appointment at the hospital was a chat with a junior doctor or registrar (not the consultant)followed by the biopsy, but my letter, which I did not fully read until the night before said consultation and possible biopsy.

Some hospitals do a MRI scan before a biopsy.

I went to work the next day and describe it as a walk in the park, I had taken a couple of pain killers on the day for another issue.

From my PSA blood test to that first appointment was just under two weeks.

Thanks Chris

User
Posted 07 Jun 2016 at 12:10

Update
I saw the urologist, he performed a DRE. He said the prostate felt perfectly normal to him. I was then sent for a urine test.

This came back as having blood in the urine, so I was sent for an ultrasound scan of the prostate and kidneys.

This also came back as normal, so I'm back to see the urologist again soon I imagine.

Thanks for all your input. I will keep you informed of any developments.

 
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