How to get an mpMRI scan?

User

Posted 11 Apr 2018 at 18:23

Hello Community

I have recently been experiencing symptoms that whilst shared with numerous other medical conditions, are also commonly found with PCa.

Most recently I had a day when I was doubled over in pain just trying to pee. This was a lot worse than the slight leaking after going to the toilet and I decided to get checked out.

The subject is an emotional one for me having watched my father die from this curse approx 10yrs ago.

I had a DRE from the GP with no obvious signs of anything bad and I also had a PSA because of my family background. My PSA came back at 9 and I have been referred to a Urologist at Southampton hospital.

Whilst I know I shouldn’t panic, having witnessed the worst I’m already convinced myself I’ve got PCa and I’m going to die. Apologies to those already diagnosed and suffering thinking that I’m the lucky one who still has other possible explanations, I’m just being honest!

Inbetween the panic attacks and uncontrollable episodes of crying, usually after putting my two baby girls down to bed for the night, I have been doing the usual panic research on the net. I raised £2k+ for Prostate Cancer Uk following my dads death and the effort has already proven more than worth it, what a great web site!!

The long and short of it is I have quite easily established that the overwhelming opinion is that an mpMRI is a much better way to start the diagnosis process if you can find one. I’ve tried to find out in advance if Southampton hospital has the appropriate scanner but not been able to find this on the internet.

Please does anybody know if this is available at Southampton and if not how can I find out where they are available and how I can get one?

It is probably worth mentioning that I also have private medical insurance so not sure if private hospitals are more likely to offer me joy?

Apologies for the novel,

Jon

User

Posted 11 Apr 2018 at 21:26

Private hospitals will not have mpMRI facilities but private health cover might buy you a scan from the local NHS hospital if you are not offered it automatically. As it happens, both Southampton trusts and Portsmouth trust say that they provide mpMRI before biopsy so you shouldn't have any problems (if your urologist agrees that a scan is necessary) - see here https://public.tableau.com/profile/ali.cooper#!/vizhome/mpMRIFOIpublicdashboard-ProstateCancerUK_0/FullresultsStory

Don't overthink the family background though - it is a myth that your dad having PCa automatically increases your risk. Less than 5% of prostate cancers are believed to be genetic, where it appears in families it is more likely to be down to shared environmental factors. The main risk you face is simply being born male - 60% of men in their 60s have some cancer in their prostate although most would never know or be affected by it. If your dad was young at diagnosis (in his 40s or 50s) and / or you have close female relatives that have had breast or ovarian cancer, that increases your risk significantly, as does being black African / African Caribbean.

I think for now, the important thing is to wait and see what the urologist says before you start looking for alternative providers.

Edited by member 11 Apr 2018 at 21:27 | Reason: Not specified

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

User

Posted 11 Apr 2018 at 23:00

Thank you for taking the time to write such a considered response.

Just for completeness my dad had turned 60 and his dad died of cancer (not prostate). On my mums side of the family my nan died of bowel cancer, so we are big fans of Ca in this family!!

The environmental element is interesting and I didn’t know that, offers a little more hope as we lived apart from when I was 8yrs old.

Thanks again, fingers crossed.

Jon

User

Posted 11 Apr 2018 at 23:18

From my research on this site and other places, I couldn’t find out the following;

Is there an expected range for a PSA reading if it is due to a urine infection?

Should prostatitis show up on the urine sample/test for a UTI? If it should and it doesn’t does that rule out prostatitis or can it be hard to detect?

My urine sample for UTI came back all clear. How long would a UTI once cleared up be expected to affect your PSA level for before returning to normal? I was ill about 10days before my PSA and had a DRE 2 days before it.

Is there a certain level of PSA whereby it’s almost unquestionable that you have PCa? Most sites say over 4 is a concern but don’t give any more info than that. E.g 4-15 is a concern, 16-30 urgent concern but still could be other causes 31+ You are likely to have PCa.

If anyone could throw any light on the above this would be interesting to know thanks. These are all questions I will be bombarding the urologist with but that’s still another 6 days away and each day feels like an eternity!

User

Posted 11 Apr 2018 at 23:32

Jon,

Lyn has answered your initial question.

Can we take it that urine tests have been done which show you don't have a UTI which can be a reason for raised PSA? There are also other reasons for an above normal range for age PSA, an enlarged Prostate being one of them.

Do ask for all ongoing details of your case. These may help you and us better understand your situation and treatment if appropriate.

Barry

User

Posted 11 Apr 2018 at 23:41

Hi Barry

Yes my UTI urine sample came back all clear, what I was trying to establish was, if I had a UTI would that cleared up before the PSA test, does the affect of the UTI mean the PSA could be raised for a while after even if the infection is now gone. Does that make sense?

So I didn’t know how they test for prostatitis whether this would have been picked up by the urine test for UTI I.e is Prostatitis a form of UTI?

I’m hoping it’s BPE or Prostatitis, anything but PCa to be honest. The GP said his DRE didn’t reveal anything unusual or an enlarged prostate. I also had an ultrasound today to check for stones, my GP said good to rule this out. The radiologer said she’s not an expert but to her size and shape looks normal but she obviously couldn’t comment on the make up of the cells etc.

My understanding is when I meet the urologist they will probably do another DRE not sure if they will do another PSA or not, I hope so.

I’ve also been cycling loads recently, every day. I had an Achilles operation 2 months ago, so as I can’t run I’m cycling.

Cheers

User

Posted 12 Apr 2018 at 00:10

There isn't a definite range for PSA - it can't even be used as a predictor of anything other than 'this needs further investigation'. My husband had a PSA of 3.1 but the cancer had already moved to his bladder - Si-ness had a PSA of about 3.6 I think and it had spread throughout his skeleton. On the other hand, we have had men with PSA as high as 70 / 80 who were given the all clear and just had very large prostates or high levels of infection / inflammation. The highest PSA reading at diagnosis on here has been 13,000 but our urologist once had a patient with a reading of 160,000

Cycling and orgasm can raise your PSA temporarily (24 - 48 hours) but only by a very small margin - unless you are a pro cyclist with Sky your raised level is not going to be explained by that. Prostatitis is diagnosed by blood tests rather than urine. Conversely, there are some very sneaky UTIs that are extremely hard to detect - often missed by GPs and only picked up when the urine sample is sent to the hospital lab.

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

User

Posted 12 Apr 2018 at 07:24

Thank you once again, time to wait to see the urologist now I think.

Jon

User

Posted 17 Apr 2018 at 08:32

I have my initial consultation today with the urologist cancer clinic and I phoned through to see how long the appointment would last, I was told about 20mins!

I’m very disappointed to learn this as I was hoping this meeting might involve some more tests and at least another PSA check.

It sounds like I’m going to be left waiting longer and more appointments at a later date, meaning more anxiety. At the moment every day is a battle not to break down.

Can anybody give me an idea of what to expect today and anything I should be asking or making sure happens?

Thanks all.

User

Posted 17 Apr 2018 at 22:39

I hope today went well. From reading the many informative posts on here in the last 15 months since my husband was diagnosed I have learnt there is no standard approach to diagnosing PCa.

My husband was referred privately and had a consult at the local spire hospital under BUPA. After an initial consult with a urologist ( who was a surgeon) my husband was given a DRE, a urine test and a MoMRI scan with a 1.5 Tesla magnet. An appointment was booked in for a template biopsy under general anaesthetic.

The scan showed a leasion which the urologist.said ‘ gave him something to aim at and he also commentated that he didn’t do TRUS biopsies if a man was fit enough to have the general. He had 46 cores taken.

Luckily he was a3+3 this risk diagnosis though a large amount.

As I say the experiences on here show a variety of experiences and approaches taken with a lot of controversy too.

Good luck

Clare

User

Posted 18 Apr 2018 at 14:13

Hello

So yesterday was informative if nothing else. I am going to be booked in for an mpMRI and I’ve managed to get my priv med insurers to allow me to see the same consultant/surgeon at the Spire Southampton.

This didn’t happen without a fight though as originally they were going to send me elsewhere, I am so thankful they have allowed to follow this pathway and taken my personal circumstances into consideration, thank you Aviva!

I was also told that the TRUS biopsy would occur on nhs even after a mpMRI unless there was a reason not to. I am hoping that now as a private patient I might get the biopsy through the pereneum or even better not need one at all!!

On we go....

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