Rather confused

User

Posted 09 Feb 2018 at 20:36

Hi everyone. I am a new member and have been reading a lot of the conversations. If anyone can give me some advice I would appreciate it. In October 2016 I went for a routine blood test on the recommendation of my doctor for something unrelated as he discovered I had never had a psa test. I am 66 years old.The result came back 4.6 he then sent me for another one two weeks later and it showed an increase to 4.7. He then sent me to the consultant oncologist and he carried out the feel test and suggested and mri scan and biopsy. Following the biopsy I was advised of the 10 samples. 6 showed pins and Ames. I was told to repeat blood test for psa very 6 months. In October 2017 I had another blood test for psa and it showed 6.5 so the doctor referred me back to the consultant for further investigation. Another mri scan and biiopssy and just come back from the consultant who advised me their appears to be something showing on the outside of the prostrate on the mri which the biopsy could not reach. Their are cancerous cells within the prostrate but not the ones that concerns him. He told we should proceed with cautious optimism.He suggested further refferal if psa gets to 10. My concern is, if there is an abnormality showing on the mri and the trans rectal biopsy can’t reach it as it is at the front of the prostrate, are they missing something important. He hasn’t mentioned a gleeson score that many contributors mention on this site.if anyone can advise I would really appreciate advice.

User

Posted 10 Feb 2018 at 00:26

Hi Mike, the consultant will send a letter to the GP explaining what s/he found. If you don’t receive a copy in the post, ask your GP practice to give you a copy. That should clarify things.

If the consultant thought he had seen cancer on the outside of your prostate he wouldn’t be allowed to send you away with no further examination - it would be totally against the NICE guidelines. The fact that he is happy for you to wait with identified cancer cells inside the prostate suggests that you are a Gleason 6 or maybe even a Gleason 5 and have been put on active surveillance.

You are right to be concerned - this doesn’t sound like a consultant following the usual routes - but hopefully the letter will make sense of it all and once you understand exactly what your situation is you can ask for a second opinion.

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

User

Posted 10 Feb 2018 at 12:26

Hi Mike.

I agree with Lynn.If you were my husband I wouldn't be happy to leave things as they are based on what your consultant has said.Are you sure it was a consultant oncologist you saw and not a Urologist?
I think it odd that he is happy to leave it until your PSA reaches 10. As you will see on here many men have significant Prostate Cancer at levels way below that.
If you have an enlarged prostate however that could maybe account for some of the PSA.
I am certainly no expert but I would have thought a Template biopsy could reach the suspect area your consultant seemed concerned with but as Lynn says wait to see what is on the letter to your GP ( our hospital always sends a copy of any letters to us as well so you could maybe ask them to do that for you)

Keep in touch and let us know how you get on Mike and we can offer you further advice.You could also speak to one of the specialist nurses on this site who would give you expert advice.

Best Wishes
Ann

User

Posted 11 Feb 2018 at 10:27

Hi Lynn and Ann. Thanks for you replies and yes I will keep you updated after I see the written report. I called the doctors surgery to see if the report had been re I ever but not yet. It’s been a couple of weeks so hopefully not too long. I will be hopefully have my concerns addressed when report has been read. Again much appreciation. Mike

User

Posted 11 Feb 2018 at 12:11

Hi Mike. Just another thought. Did you test results go in front of a multi disciplinary team? It is now routine for all cancer cases that recommendations for treatment options or Surveillance be discussed between a group of experts and not just the one Urologist or Oncologist.

Regards
Ann

User

Posted 11 Feb 2018 at 17:45

Hi Ann. When I went for my first biopsy 18 months agp the consultant said they had discussed my results and they decided that I should wait and watch. This time he never mentioned anything about this other than when psa reaches 10 further examinations should be taken. This is why I am a little confused. I will wait for his report then have a clearer idea of what is to happen next. Thanks and regards.
Mike

User

Posted 12 Feb 2018 at 00:56

There is a type of prostate cancer that grows on the outside of the gland rather than inside and a template biopsy wouldn’t necessarily pick it up. However, I think it is unlikely that a consultant would leave someone on AS if this was what he suspected. Once you have the facts, it will be easier to decide what to do.

If you have a very low Gleason and a very large prostate, waiting until the PSA reaches 10 wouldn’t be a crazy thing to do.

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

User

Posted 12 Feb 2018 at 00:58

PS results going to a multi-disciplinary team is not routine. It is becoming more and more common but not all hospitals do it.

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

User

Posted 12 Feb 2018 at 20:30

Hi Lynn
Thanks for your info all very helpful. Just to confirm I have not been told I have an enlarged prostrate and have no symptoms other than an extra visit to the loo through the night occasionally. I have arranged an appointment with the GP on Saturday to see if he can shed any light on the reason it it has been delayed to wait until psa 10 until further investigationtions will be carried out. Thanks and regards. Mike

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