help PSA 9.7

If you have PCa, very big "if" at the moment, the treatment will likely involve a period in which to prevent the disease spreading, you will be advised to take pills or have injections to reduce your testosterone. This will reduce your libido. Nothing to be afraid of, if the alternstive is to let PCa rule your shortened life....

AC

It seems you have looked at some rubbish websites - biopsies do not cause ED or urinary issues (although I guess there will be some men who get ED simply because they are frightened of having cancer). It is the treatments that may cause ED / incontinence. Better to know whether a) you actually have PCa b) it needs treatment or could be manged through close monitoring. A slight firmness is a concern so I can see why the urologist wants to start diagnostic tests. 

You could ignore all of this and not get a diagnosis if you wish but it is important to understand that if indeed you do have PCa which goes untreated and becomes advanced, you will end up with ED and incontinence anyway plus you will die much sooner. And a PCa death is not usually an easy pain-free affair. Basically, avoiding diagnosis does not avoid the side effects you fear whereas treatment does not automatically lead to those side effects. 

If you get the all-clear, you will have a baseline for future monitoring. 

O

It was nearly five years ago, but I remember describing my Trus biopsy as a walk in the park.

Thanks Chris

That's really helping Chris thank you.

Does anyone know why we are offered the Trus type more frequently than the template type. Would my Uro think I'm being awkward if I requested the template type?

As to why is a TRUS biopsy more common, I think the simple answer is that it's a much cheaper and more straightforward procedure. In my case I was subsequently referred for a template biopsy because the findings of the TRUS weren't really consistent with my relatively high PSA of 32, so my urologist wants to find out if there's something more aggressive lurking in the part of the prostate that a TRUS can't get at.

Biopsies are honestly nothing to be scared of. Please have one - it's the only certain way to find out whether or not you have prostate cancer.

Chris

Chris

So yes, as the article says, if an mpMRI shows something suspicious, it can then be used to guide a biopsy. The problem is that "false negatives" are common. A clear MRI does not mean no cancer.

Chris

Absolutely. My Multi Parametric MRI showed only one significant lesion. The scanner was a t1.5 and I commented to the technician why it wasn’t a t3 (latest tech) he told me that they were being used in research. I said they give better definition he had no answer. Injections are a die and relaxant. Slight sensation of sickness due to drugs.

Professor contrasted my saturation biopsy vs image and was surprised that significant tumours did not show on the MRI. He assumed biopsy pot error.

You can elect to do biopsyunder general anaesthetic if you want. I think my surgeon preferred it because he was more able to manover the body into different positions. My biopsy stopped a partial prostectomy call. They may have left significant tumour behind if I only had an mri guided biopsy targeting the single lesion. Your large prostate works in your favour. Mine was measured at 19ml so your PSA would be higher naturally. My DRE negative, yours positive. Welcome to the lottery

Post biopsy symptoms - soreness, bruising, blood in pee slightly uncomfortable to pass, burning sensation in coccyx. Nothing to worry about

The weird thing about transitioning from the world of complete ignorance to knowing you have an elevated PSA comes home fast when you lay on that scanner bed it suddenly becomes very real and quite emotional. You are quite likely to say your first prayer at that point.

Fresh

Edited by member 24 Jul 2018 at 22:00  | Reason: because auto correct was invented by Satan

Thanks Fresh. Just read your profile.

Can I ask what your treatment is going to be?

Also seems like your saying no alternative to getting my Prostate turned into a pin cushion.

My treatment was RALP (Robot Assisted Laparascopic Prostectomy). You May take an alternate route- don’t rush to take that decision. You need a lot of info before you make that or any call. My choice was influenced mostly by a belt and braces approach. Surgery left Radiotherapy on the shelf if needed. 

I interviewd a surgeon who does operate (selectively) on Radiotherapy patients with reoccurrence. He described how it was like cutting through concrete (his words) and risky plus the natural surgical planes are broken down as the prostate is radiated. Etc .... lots to discuss. 

The biggest point here though is that you owe it to everyone else in your life to take it seriously and the guys in this forum who are fighting major late stage disease. plus coutless other lives that have qued up in hope for trials, and sat in control arms of trials and died to get us this far.

The alternate is I can take you BASE jumping which I guarantee will cause incontinence and erectile function loss and probably poopy nickers as well.

Fresh

Latest research would say MPMRI is diagnostic on its own for significant (ie needs treating) prostate cancer. It is definitely better to have the MRI before biopsy, MRI after biopsy is clouded by the damage from the biopsy needles, it also provides a target for a susequent biopsy..

But if you either don't have cancer / have a low grade cancer that does not need any treatment / have a contained cancer and choose surgery, your libido will be unaffected AND you will most likely still have erections. If you have a contained cancer and choose radiotherapy or brachytherapy you may be advised to have hormones for a period of time and you may lose your libido but it comes back when you stop the hormones. 

Read Lynns profile... 3 men in her life affected by it 

I did read that  it can be usual for a man's PSA to be as high as 10 percent of his prostate weight  in cases of BPH.That  in your case could account  for your PSA of 6.

However it's not as simple as that as I have seen only too well on here that men can have PCa with very low PSA's. Some prostate cancers just do not produce much PSA.

We don't know how much of my husband's PSA could be attributed to his existing  BPH and how much to the cancer. His pre-op PSA was 9.2 and his prostate on removal weighed 70cc but we cannot assume the cancer just produced 2.2

Best Regards

Ann

As several people have now told you, a biopsy involves minor discomfort at worst. Is it really worth putting your life at risk in order to avoid that?

It's now 9 days since I had my template biopsy and all side effects have entirely vanished. No more blood when I pee, and no discomfort when I sit down.

Chris

It’s purely down to cost, as the TRUS is much cheaper for the NHS, not involving a general anaesthetic. My friend who had BUPA cover had a template biopsy right away, TRUS was never mentioned.

I imagine your your urologist would respect your request for a template, as he knows it is the most accurate biopsy. You may have to wait a while - I did, just a few weeks.

The incidence of needle tracking following either a TRUS or TPM biopsy is considered to be extemely rare.  I researched this prior to having my own TPM biopsy and the below link was the latest information that I could find on this.

https://www.google.co.uk/url?sa=t&source=web&rct=j&url=https://sperlingprostatecenter.com/truth-biopsy-track-seeding/&ved=2ahUKEwibsbvup9XcAhXBK8AKHS8nAEAQFjAAegQICBAB&usg=AOvVaw3ciQrvAr8fC-GwCy-4OjBo

Also the risk of sepsis (although still low) is much greater in a TRUS biopsy vs a TPM biopsy.

While discussing my options with the surgeon he made the point, twice! that if RT doesn't work surgery is, seldom, a successful later course of treatment.

Luckily I had researched the 2 types of biopsy and even a “low risk of sepsis” was too much, sepsis can be a killer.

 When I went in to see my oncologist I asked her if I could have the template biopsy as I did not want the trus biopsy and she said we don’t do the trus biopsy anymore only template biopsy as there is a risk of sepsis and it’s not as accurate.

that is Weston area health trust,  there probably thousands of patients that had trus biopsies without any issues  and every patient is different but I’m just glad I had the template biopsy as it found I was Gleason 4:5 T2c

that rea seems strange way of doing it? I had DRE on 7th Feb, MRI 8th Feb, Template Biopsy 1st March, results 15th March

Despite enemas, and post-operative anti-biotics, s*** happens! With the inevitable risks of infections.

The template perineal biopsy avoids all of that.

All I know is that when I was diagnosed, two friends told me independently not to have a TRUS, as they had had one and then were recalled for a more accurate template biopsy. And this forum is littered with stories from men who endured the exactly the same.

I don’t think either of the biopsies carry much of a risk for the conditions you mention.

My elder brother had a TRUS biopsy and he told me he would never do it again. Purely in my opinion, I must say it seems a wholly risky, painful and relatively inaccurate method.

when I was put forward to biopsy my Oncologist told me straight away I would be getting TPT biopsy, I was so relieved.

re. Sex life on hormone therapy, I do have a lack of interest, and do not now initiate intercourse, but my experience and yes, everyone’s will be differenot, on Triptorelin is with a little concentration and effort, dry ejaculations are obtainable. I persevere and always will, for my wife’s benefit, after 43 years of marriage I owe her the effort.

Triptorelin 11.25mg is an IM Injection into the thigh I get every three months

Edited by member 20 Aug 2018 at 20:03  | Reason: Spelling

Chris