Prostate harder on one side.

User

Posted 01 Jul 2018 at 03:19

I'm 72 with an enlarged prostate, which I believe is normal for my age, but I'm told it feels harder on one side. Latest PSA three months ago was 6.3 which seems to be Ok for 72. Just. I'm to have another PSA this coming week and of course am getting paranoid. I'm approaching 5 years since emergency surgery for bowel cancer and can't face a new problem. But I'll have to if necessary. Any thoughts?

User

Posted 20 Jul 2018 at 23:04

Originally Posted by: Online Community Member

Also latest research supports the view that if it's not visible on MpMRI it is not clinically significant disease so you can do without any biopsy.

That might be a good generalisation but a) my OH had a completely clear scan even though the cancer was in every section of his prostate and had also moved to the bladder b) CJ has a post op PSA of about 50 so obviously has mets but his scans come back clear. There are just some types that don’t show up.

Biopsy is not fool-proof but neither is a scan, regardless of whether it is mpMRI or old-style. Put the two together and we are starting to get somewhere near reliable.

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

User

Posted 14 Oct 2018 at 23:46

And he will refer me to an Oncolgy radiographer I think it is, for a discussion about what to do next, if anything. There is a 12 week wait here with about 130 men on the list, but as mine is just a consultation I shouldn't have to wait that long. So I was told last week. We shall see! Trying to put it at the back of my mind. The good news is that the 5 year all clear for my bowel cancer is now under a month away, with no concerning colonoscopies, blood tests or checks so far. Best wishes to all. John.

User

Posted 14 May 2019 at 11:04

I've just had my 6-week follow-up after my RT. My PSA immediately before treatment was 13; last week it was 4.6. Your PSA a few weeks or months after RT doesn't really matter (as long as it hasn't risen!); what matters is the PSA at the nadir which typically occurs around 18 months after the end of RT. You carry on "cooking" for a long time after RT stops!

Best wishes,

Chris

Show Most Thanked Posts

User

Posted 01 Jul 2018 at 18:15

Dennis, as you know perfectly well, you are a worrier but so far you have nothing to worry about. Nobody has diagnosed PCa and your PSA is not unusual for one with an enlarged prostate. So relax and put ifs and maybes to the back of your mind until you have some facts on which to base your feelings. There may be more diagnostic tests before you have the facts. Relax.

User

Posted 05 Jul 2018 at 03:25

I'm now on 7.4 PSA, which is a rise of 1.1 from 3 months ago. Dr will refer me to a specialist who will no doubt do a DRE and whatever else he thinks necessary. I will have another PSA in a months to look for a trend. He said 7.4 is not a major worry aged 72, it's any upward trend that is interesting. Not the news I wanted, but could have been worse I guess.

User

Posted 18 Jul 2018 at 21:56

Saw a specialist who agreed there was a nodule so now need a biopsy. Possibly in about two weeks. Looking up various sites and getting contradictions, but he said no it doesnt hurt and I believe there will be blood for a while in stools, semen and urine for a while. I'm not going to Google any more. Funny really, I advise others not to but I still do. Hmmm...

User

Posted 20 Jul 2018 at 08:26

The best practice is to have a multi-parametric MRI scan PRIOR to any biopsy, as the result might render one unnecessary.

User

Posted 20 Jul 2018 at 10:00

Originally Posted by: Online Community Member

The best practice is to have a multi-parametric MRI scan PRIOR to any biopsy, as the result might render one unnecessary.

I wish you were more precise with your assertions. mpMRI should not rule out a biopsy as there are some prostate cancers that do not show on even the most advanced of scans. Template biopsy is not 'best practice' ... it is the best first step for some men in an increasing number of (but not all) regions.

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

User

Posted 20 Jul 2018 at 10:50

Originally Posted by: Online Community Member

The best practice is to have a multi-parametric MRI scan PRIOR to any biopsy, as the result might render one unnecessary.

I said an mpMRI “might” render a biopsy unnecessary and moreover would give the surgeon an idea of where to sample during the biopsy. I didn’t mention template biopsy on this occasion, but two friends, one with BUPA insurance and the other with loads of money went privately and had the MRI first and then a template biopsy. That is “best practice” if the NHS is not involved.

I got exactly the same on the NHS by asking nicely.

Cheers, John

User

Posted 20 Jul 2018 at 12:59

Template biopsy carries a higher risk because of the anesthetic and all those punctures. If there is a clear target from an MRI a TRUS will normally suffice.

Also latest research supports the view that if it's not visible on MpMRI it is not clinically significant disease so you can do without any biopsy.

User

Posted 20 Jul 2018 at 13:02

Here is an example https://www.practiceupdate.com/content/men-with-negative-prostate-mri-may-not-need-standard-biopsy/70603/62

User

Posted 20 Jul 2018 at 13:45

I logged in to the hyper-link to this learned paper eventually, and after reading a load of medical jargon (lucky I studied Latin 50 years ago), the last paragraph contained the most salient point:

“In some countries, such as the UK and Australia, there is widespread use of prebiopsy MRI across different settings. In light of the work by Panebianco et al on intermediate-term outcomes for men with a negative regarding the significance of a negative MRI, in conjunction with PROMIS and PRECISION, the time has come for urologists to strive to make prebiopsy MRI available to all men being assessed for prostate cancer.”

Edited by member 20 Jul 2018 at 13:46 | Reason: Not specified

User

Posted 20 Jul 2018 at 23:04

Originally Posted by: Online Community Member

Also latest research supports the view that if it's not visible on MpMRI it is not clinically significant disease so you can do without any biopsy.

Biopsy is not fool-proof but neither is a scan, regardless of whether it is mpMRI or old-style. Put the two together and we are starting to get somewhere near reliable.

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

User

Posted 29 Jul 2018 at 10:12

Dr phoned me! And said no MRI but a biopsy on 3 September. Have to go to public hospital as private is $NZ900. It would have been done by now privately, but now I'll try and enjoy August.

User

Posted 29 Jul 2018 at 11:21

Put it to the back of your mind while you can :-)

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

User

Posted 02 Sep 2018 at 00:38

Well, biopsy is only 27 hours away now! Nervous, of course. But it must be done then the waiting begins for the results. Thousands must be done every year, so it's just a routine procedure. I've been through emergency bowel cancer, a large mesh repaired hernia and gall bladder removal in the last 5 years, so this is nothing. Hmmm. Post surgery infections and cellulitus for extras too. Right, have I convinced myself not to worry?

Sorry, nothing really bothered me health wise until the bowel cancer scare, now I get paranoid over every little twinge.

User

Posted 03 Sep 2018 at 05:30

And all over and not too bad really. The worst bit was a vigorous DRE to begin. Results in 2/3 weeks or so. Thanks all.

User

Posted 05 Sep 2018 at 10:49

Good luck with the results Dunniz

We can't control the winds - but we can adjust our sails

User

Posted 20 Sep 2018 at 00:32

Thanks all. He took 13 samples. 6 on the left were benign, but 2 of the 7 on the right were cancerous. Gleason score 7 (3+4) which could be worse. Grade Group 2, intermediate favourable. It is contained and no perineural invasion or extraprostatic tissue identified. I'm trying to make sense of the terminology but it doesn't sound too threatening. I have to wait for the Urologist to discuss treatment, if any. Maybe watchful waiting or active surveillance? Radiology? We shall see ...

User

Posted 20 Sep 2018 at 00:38

That must be some relief, which seems an odd thing to say to someone that has just had a cancer diagnosis! As you say, an intermediate cancer and from the sound of it, quite small - it will be interesting to know what % of the cores were cancerous; you could ask the urologist when you see him / her.

AS might not be first option with a G7 - some hospitals would only advise it for a G6. They may suggest a bone scan before you decide on treatment, just to ensure they have a full picture.

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

User

Posted 20 Sep 2018 at 01:20

I think tissue involved 20% must mean 20% of the two ardenocarcinoma cores? I like the word favourable for the G 7 (3+4) compared with unfavourable for G 7 (4+3.) Latching on to all the positive words I can find! Thanks for your reply.

User

Posted 20 Sep 2018 at 02:31

I would think so - and seems it is well inside the gland rather than being the 20% near the surface :-) - brachytherapy might be a possibility?

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

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.

Notification

Join the online community now.