Cancer or BPH concerns

User

Posted 17 Mar 2018 at 18:35

Hi I just joined the forum and would be grateful for any advice i can get please

I am 60 and have been having problems emptying my bladder, both at night and during the day. I have had a DRE but the doctor says my prostate was too large to examine properly so I am being sent for an MRI scan and possibly a biopsy.

Because my father had prostate cancer and two other family members also had it I have been checking my PSA since 2013. Then it was 1.6

In 2015 it was 2.1 and in January 2017 it was 2.0

Then in February 2017 I was quite ill with a bout of prostatitis when the feeling of not having peed properly started, but the fever I had subsided and I felt better. I had another PSA 6 months later in July 2017 because the problem of not feeling satisfied after a pee never went away and a nagging pain in my penis also started. I then had another bout of prostatitis in August 2017.

Now in March 2018 my PSA is 2.83 so it's edging up and I have developed lower back pain and also suffer from erectile dysfunction in addition to the unsatisfied peeing and penis pain. I didn't have ED 12 months ago.

I have read on here and on other sites that the PSA test, the DRE and indeed some MRI and biopsies are not entirely reliable so I obviously want to be making the right decisions and choices now as opposed to later.

Hopefully I just have BPH and possibly even chronic prostatitis having had it twice in the last 12 months but I am obviously concerned I have PC.

Thanks

User

Posted 17 Mar 2018 at 19:48

60% of men in their 60s have at least some cancer in their prostate although for most it will never cause any problems and will not need treatment. However, it is possible to have cancer even at your low PSA score so best that the tests are all done. There isn't a right way to do the tests; the biopsy is not perfect and an MRI does not always pick up the problem correctly which is why hopsitals vary in how they do the diagnostics. If you are offered a combination of MRI and biopsy with DRE and flow test, you should get a reliable result.

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

User

Posted 19 Mar 2018 at 17:25

Thanks Lynn for your quick reply to my posting.

I will certainly ask for those four tests to be done, although it could be taken from reading what you say that hospitals don't actually agree with each other as to the best practice methods when you say "There is no right way, which is why hospitals vary in how they do the diagnostics".

Hopefully you mean they all assess each case in the same way according to laid down pre agreed assessment criteria and apply the treatment that any of them under the circumstances would apply?
If not then it implies a certain amount of hit and miss in finding the right hospital to treat you and a variation in the quality of treatment one can expect to obtain.

If that is the case then it would reinforce my desire to be making the best decisions and choices. For example what hospital, what form of biopsy etc.

What in your opinion is the best form of biopsy and are the symptoms I have also to be found in BPH?

Thanks again

Steve

User

Posted 19 Mar 2018 at 17:34

No, I wasn’t saying that it is hit and miss - I was saying that there is no definitive answer to which tests should be done in which order ... the important thing is that the tests are done.

For example, until recently the TRUS biopsy was done first and if that was positive an MRI was arranged to see whether the cancer was contained. If the biopsy was clear, no MRI even though the PSA might suggest there was a problem. Now, more and more hospitals offer the MRI first and then do a biopsy if there are any grey areas. Seems sensible but in my husband’s case, the MRI was inexplicably clear even though he turned out to have cancer throughout the gland and into his bladder. There are some prostate cancers that simply do not show on an MRI. The best combination then is both MRI and biopsy where neither are dependent on the other being positive.

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

User

Posted 19 Mar 2018 at 17:56

OK Lynn and thanks for the clarification and advice.

I will certainly press the hospital for a biopsy after the MRI . From what you are saying it should be standard practice and the two tests should surely be part of the same routine but I guess costs dictate this doesn't happen unless patients press for them both.

Steve

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