Very worried about referral for high PSA

Firstly, this lunchtime I had a more detailed CT scan of the splenic artery, where the aneurysm is, to see if it'll need anything doing before they can go ahead with the kidney surgery. The last CT scan I had, for the kidney, I was fine with, but apparently when they scan a blood vessel they need to pump in a much more intense dose of the iodine "marker" that goes in through a cannula in the arm, and that's had me throwing up all afternoon. Not nice at all. Seeing the vascular surgeon on Thursday morning to get the results.

This evening (still feeling somewhat queasy!) I've seen the oncologist who attended the regional MDT. He said basically what I was expecting, which is that the Gleason 3+3 from the TRUS isn't consistent with a PSA of 31, so they want to do a template biopsy to see if more active cancer is lurking around the front of the prostate. He's referring me to yet another consultant (number five!) for that, and it'll probably be done next week. That'll be under general anaesthetic (thank God!).

One thing he did say is that with a PSA of 30+ they're very unlikely to offer surgery, because that level of PSA probably means active cancer cells that could be missed by the surgery, so the offered treatment will most likely be HT followed by RT.

So things move on, but unfortunately no treatment plan as yet.

Cheers,

Chris

Not too concerned about the template biopsy. Peed blood for a week and a half after the TRUS, so hoping this time I'll avoid that!

Cheers,

Chris

I had the iodine marker on two MRI scans as I had suspect areas that were not clear.  I had no adverse reactions I think you were just unlucky 

 I think the strangest thing was going for the bone scan and following the signs for nuclear medicine and going down in a lift as it was in the basement 

 Then watching the technician get the injection out of a shielded metal box nearly freaked me out 

Edited by member 11 Jun 2018 at 21:48  | Reason: Not specified

They move quickly, anyway. Just got a phone call from the hospital to arrange an appointment for Saturday morning with the chap who’ll be doing the template biopsy. He will be the 5th different consultant I’ll have seen in the last month! This isn’t an appointment for the procedure itself, just for a consultation. I’m hoping the procedure will follow soon after that. I believe that since this will be done under a general anaesthetic there’ll be a “pre-op” examination (ECG, etc).

Starting to worry a bit about tomorrow’s appointment to get the results of the aneurysm scan, in case they say that it’ll make the kidney surgery too risky. The vascular surgeon did say that there was a very small chance they’d need to remove my spleen and tie off the splenic artery, but that would only be done if it were a case of saving my life, but I need the kidney surgery to save my life. Eek! Must try not to over-analyse these things, but still worrying about it. Oh well, I’ll know tomorrow. I really want to get the kidney surgery over with so at least the renal cancer is sorted out.

Chris

Edited by member 13 Jun 2018 at 09:53  | Reason: Not specified

I'm not worrying about the template biopsy particularly, more about what it might show. The oncologist whom I saw on Monday said that in his experience a PSA level as high as mine is more consistent with locally advanced PCa than localised PCa, and that obviously has implications for the chance of a long-term cure. Unfortunately I've always been a worrier - can't help it!

I'm hopeful that this will be the last test I need to have. They seem to have been going on for an eternity, although I'm well aware that I've been fortunate in getting all this done a lot more quickly than many people do, and that it's actually only been 41 days since I got the results of my initial PSA test.

Once the results of the template biopsy come back they should give me a definite staging for my PCa and then a treatment plan can be put in place.

Chris

Cheers,

Chris

I suppose the good news is that these appointments don’t have weeks in between Chris. Keep your chin up pal.

Chris

I started my journey on 26th January and started treatment 8th April, so I think that’s 41 days, just about 6 weeks?

i had 5 scans in total, Bone, MRI and CT were routine to eliminate possible mets, then 2 more detailed area MRI scans where the radiographer was unsure about results, 1 was a spot on my spine that thankfully turned out to be nothing and 1 on my pelvis, that has turned out to be Paget’s disease,  a bone growth abnormality, something that is nearly always discovered by scans looking for something else.  Once I am through the cancer treatment I will look into what can be done about the Pagets disease

My detailed timeline;

PSA blood test 26th January

result of 38 PSA 30th January 

DRE with consultant 8th February 

MRI Scan 9th February (got last minute cancellation as I live 2 miles from hospital)

Trans perineal biopsy day case 1st March

Oncologist review of biopsies 15th March

Gleason 4:5 = 9 in 11 cores on left, greatest core was 100% total cores 60%

Gleason 4:4 = 8 in 5 of 12 cores on the right, greatest core was 80% total cores 20%

So as I had 32 biopsies, 9 were clear.

Bone scan 23rd March mets

CT scan 26th March mets 

Consultant review 29th March 

Detailed spinal MRI scan 3rd April mets

start Bicalutamide 8th April

Decapeptyl hormone injection 23rd April 

End  Bicalutamide 6th May

MRI scan 11th May mets

Blood test PSA Testosterone check 15th June

Full Oncologist review and RT planning 21st June 

 The last two are Imminent 

 I have put this whole list as it might be of use to other members of the website to give them an idea of what occurs 

Edited by member 14 Jun 2018 at 14:16  | Reason: Add information

Consultant appointment at 10 o'clock in the morning. Perhaps he'll be able to give me a little reassurance. Hope so. Worst day emotionally that I've had in a couple of weeks today.

Chris