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PSA 7.3 - referred to urologist

User
Posted 26 Nov 2018 at 11:55

Thanks Chris. So this suggests that the MRI scan is fallible. I have already been advised (on here) to ask for a biopsy if the scan reveals nothing. Of course, being a coward, I'd like to cut my losses and run at that point (if it is clear), but as I have also been advised, I'd never truly know until the biopsy was done. I thought one of the reasons for the MRI was to target the area for biopsy more clearly. How would they know what part to focus on without the MRI info? 

The wait time though seems immense. I am basically looking to be going in on 4th December and with the Xmas period, and from what you suggest, I may not fully know until the New Year. 

Anyway, thanks for all the info - I am building a picture of it all in my head now. 

Haig

 

User
Posted 26 Nov 2018 at 12:12
If it comes to a scan, the other point to make is ideally it should be an ‘mp’ MRI at 3 Tesla resolution if available where you live. Or if not maybe you could travel to where there is one? I realise now after a year that the NHS doesn’t have thousands of these million-pound machines dotted round in every cottage hospital and unlimited resources.

But If I was given the all-clear on such a hi-definition scanner, I would be quite content to eschew any biopsy - both kinds are invasive and carry potential risks...and pain......😉, and just check my PSA levels on a regular basis.

Of course, be advised by what your medical professionals say, but I have found that if you approach them with a modicum of knowledge about your medical situation, and suggest a particular course of action, they are often happy to go with you rather than what is cheapest for their hospital budgets.

Let’s hope you have good news as a nice Christmas present.

Cheers, John.

User
Posted 26 Nov 2018 at 12:50

Thanks John,

I will be sure to ask what machine they have (I'm in Thames Valley - Royal Berks Hospital, Reading). In general, how long after an MRI (which revealed bad news) would they pull you in for a biopsy?

H

User
Posted 26 Nov 2018 at 13:23
I had my blood test PSA 10th September, MRI 25 September, Biopsy 19th October, Diagnosis 13th November and started treatment on 23rd September
User
Posted 26 Nov 2018 at 13:43

H,

Well, if potential cancer is suspected, you are on an accelerated route, hence your ‘two week’ appointment, which in the case of prostate cancer is probably an over-reaction as it’s usually very slow-growing over many years, unlike some of the buggers!

So everything will happen tout-de-suite. It seems now that no one seems to know what resolution my mpMRI scan was as Tommy the Tumour (R.I.P.) was large and would have shown up anyway. It’s in marginal cases where hi-def is important, like watching football or Formula 1 on Sky HD or 4K.

If there is a mass on the MRI - if you ever have one - you will be invited in shortly for a biopsy, and then around two weeks later called back for the results.

I think all you should do now is try and keep as calm as you can and wait until your December appointment. If you want to read a ‘good news’ story, read mine.

I just updated it today, a year after my raised PSA reading.

Cheers, John.

Edited by member 26 Nov 2018 at 13:45  | Reason: Not specified

User
Posted 26 Nov 2018 at 13:47

Thanks John,

I hadn't realised that "cancer was suspected" - I just thought that it could be BPH and the GP knew nothing for sure with what he had to go on. Damn.

User
Posted 26 Nov 2018 at 14:23
Calm down dear. ‘Cancer suspected’ as a possibility is not cancer confirmed, and I would refer you back to the penultimate paragraph of my last post above.

Cheers, John.

User
Posted 26 Nov 2018 at 15:16

I like that "calm down dear"...sounds like my wife speaking to me these last few days, except I'm not afforded the "dear" anymore. I read your latest John and well done for coming through it all & hopefully any lack of 'function' will return in due course...

User
Posted 26 Nov 2018 at 15:41

Haig,

As regards waiting time etc...i had mri 6th august, biopsy 15th and diagnosed 24th.  Did take four months of faffing around prior to that. I got quite insitent in the end and asked for a template biopsy, after trus was mentioned. Surprising how fast things moved when i was proactive.

Also,  if they offer you antibiotics without signs of infection, question their reasoning. Waisted 10 weeks taking pills in my case. Avoid ciprofloxacin...few cases of serious side effects - i can vouch for that.

Neil.

 

 

 

Edited by member 27 Nov 2018 at 01:17  | Reason: Not specified

User
Posted 26 Nov 2018 at 16:44
I had the multi-spectrum anti-biotic ciproflaxin for a week as a potential prophylactic in case of infection following my template biopsy, and fortunately I had no side-effects whatever.

As Neil says, anti-biotics are best avoided where possible. But having said that, I do keep a little stash of Cip and Amoxillin at home in case we need them, as it takes about three weeks to get a GP appointment here. Some are prescribed by the vet for our dogs, some I pick up over the counter on my world-wide travels.

We find the prescriptions interchangeable, as we are all mammals, so the species jump has no side effects whatever. Woof woof!

They say with partial nerve-sparing prostatectomy, it can take up to two years to recover from surgery, so I am looking forward to rampant sex around 2020, when I will be 65.😉

Cheers, John.

User
Posted 26 Nov 2018 at 16:45
I had the multi-spectrum anti-biotic ciproflaxin for a week as a potential prophylactic in case of infection following my template biopsy, and fortunately I had no side-effects whatever.

As Neil says, anti-biotics are best avoided where possible. But having said that, I do keep a little stash of Cip and Amoxillin at home in case we need them, as it takes about three weeks to get a GP appointment here. Some are prescribed by the vet for our dogs, some I pick up over the counter on my world-wide travels.

We find the prescriptions interchangeable, as we are all mammals, so the species jump has no side effects whatever. Woof woof!

They say with partial nerve-sparing prostatectomy, it can take up to two years to recover from surgery, so I am looking forward to rampant sex around 2020, when I will be 65.😉

Cheers, John.

User
Posted 26 Nov 2018 at 17:59
The main reason that most men should have biopsy and MRI rather than allowing the result of one to rule out the other is that each test is fallible. There are prostate cancers that don't show on a scan, even if the tumour is substantial.

My husband was fortunate that he had a positive biopsy first as the subsequent scan was clear, leading the doctors to believe they were dealing with a very small T1. When they operated they found that it was in every segment of his prostate and had spread to his bladder. Since his PSA was only 3.1, if he had had the scan first he may have decided not to go ahead with the biopsy and might not be here now.

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

User
Posted 26 Nov 2018 at 18:11

Thanks Lyn. PSA 3.1 - that's really low. I'm 7.3 and now getting very worried I have Pca. I thought being 50, I was low risk but the more I hear the less optimistic I am tbh. I am slowly resigning myself to having Pca and hopeful with a PSA of below 8 that it is fairly localised. After that, the various treatments confuse me and I think I'll need to sit down and talk these through if and when. 

In short though, it sounds like the MRI & the biopsy is the sensible way to go in order to eradicate any doubt. I also seem to get the impression that the Template biopsy is way better than TRUS.

Haig

User
Posted 26 Nov 2018 at 19:44
I am not of the opinion that template is always best - that is simply a view promoted by a small number of members who quote a well known but self-promoting consultant. Template biopsy and TRUS each have their benefits and risks - the very small risk of infection is slightly higher with TRUS but the template biopsy introduces additional risk from general anaesthetic or spinal block. In addition, there are recorded cases of needle tracking with template biopsy but not with TRUS. TRUS is more likely to miss the tumour and give a false negative (described by our urologist as akin to sticking a pin in a fruitcake and hoping to spear the cherry) but with MRI first they can target any suspect areas in TRUS biopsy. In many areas, the wait for template is much longer than for TRUS and many men probably prefer to just get on with it rather than waiting around for weeks or months. My personal view is that a wise patirnt talks to the specialist about which tests are being suggested in what order and why, rather than go in demanding something that we don't necessarily understand the implications of.

PSA is a good example of this. You are getting het up about your PSA but need to understand that all it indicates is that further checks are needed. We have men here who had a PSA of 6 with mets all over their body, and men with PSA of 70 or 80 with no cancer to be seen. The PSA number can't be relied upon to indicate whether there is cancer or how advanced it might be (unless it is in the thousands in which case they don't even bother doing the biopsy sometimes.)

Waiting is tough but you will cope because you have no choice but to cope. And if you eventually get the all clear you will become very good at ensuring you have regular monitoring because now you have seen a hint of why it matters!

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

User
Posted 26 Nov 2018 at 19:59

Thanks Lyn - you call a spade a spade, which is good - no frills. Right now though, hearing that blokes with PSA 6 having Mets all over, only heightens my anxiety and plunges me further down the drain. 

 

User
Posted 26 Nov 2018 at 20:40

Yes, Lyn is right about people promoting treatment that they favour.   Also about psa not being a test for prostate cancer.  I had a psa of 9.9 and according to stats I had a strong chance of it not being PCa.  Also I found this forum very worrying while I was being diagnosed as certain well meaning comments can be frightening at the stage of uncertainty and ignorance,  I only came on here regularly after my op. My preference was to look at stats of probability and investigate the fastest treatment options.    Although I once freaked out about a big pain in my hip being related and rang a Prostate Cancer nurse who pacified me with some simple advice about not getting ahead of myself.

Edited by member 26 Nov 2018 at 20:49  | Reason: Not specified

User
Posted 26 Nov 2018 at 20:43
Just a word regarding Matron’s comments regarding the TRUS vs template biopsy. The only reason I declined the offered TRUS biopsy was that two friends had TRUS and then had to have subsequent template operations for greater accuracy, and they told me to avoid it.

Indeed, in the recovery ward after my template, there was another guy who was on his second biopsy as the TRUS was inconclusive.

We read here weekly of others who have the same quandary.

Possibly the the number one prostate cancer specialist oncologist in Britain - not a self-promoter with a PR department, as far as I know, although he does charge £400 a consultation - said: “The TRUS biopsy is as bad as we thought it was”.

Keep calm and carry on, H.

Cheers, John.

User
Posted 26 Nov 2018 at 21:19

John,  It's a statistically poor result to have 2 friends who needed template biopsies for greater accuracy assuming you don't know many more who had biopsies.   There are probably about 45,000 biopsies a year and presumably the vast majority are TRUS biopsies or the NHS would be swamped. 

I was offered a template biopsy for greater accuracy after my TRUS biopsy but declined it as it seemed conclusive enough to find one pin with 5% cells predominantly Gleason 4 and the MRI result.  If I'd had the MRI first they'd probably have found a lot more as I was told by the surgeon it was 13mm diameter.

Regards Peter

User
Posted 26 Nov 2018 at 22:33
Hi Peter,

You are probably quite correct, but as I have said here before, I am not Her Majesty’s Principal Secretary of State for Health, and I couldn’t be bothered about the NHS being swamped, they get billions, so sort it out!

It’s about self-preservation, and diagnosis with one bite of the cherry rather than a second attempt months later.

It is pertinent that yet another friend who had BUPA cover went straight to a template biopsy with no mention of the inferior TRUS.

I seem to be accumulating friends with PCa on a regular basis now - maybe I was contagious!

All clear now. So far so good, fingers crossed.

BTW, mine was bigger than yours at 15mm, but with what’s left of mine post-op, you are likely to be the overall winner. 😉

Cheers, John.

User
Posted 26 Nov 2018 at 23:26

Originally Posted by: Online Community Member

 There are probably about 45,000 biopsies a year.

Regards Peter

There are over 100,000 prostate biopsies each year on the NHS and who knows how many more done privately. It isn't just cost; there would have to be a strategic approach to build new theatres and recovery rooms, employ additional anaesthetists, theatre nurses, porters etc OR men would have to wait much longer for their biopsy and the 31 day target would have to be abandoned. 

Personally, I am always frightened that I might die under GA so would avoid it at all costs but I realise that not everyone feels the same. Spinal block ... well that's a completely different kettle of fish; the experts say that it doesn't cause back problems but find me someone that has had an epidural and not been left with back problems! 

 

Haig, rather than focus on the person with PSA of 6 with mets; think of all the people with a PSA 10 times higher than yours who were given the all clear. 

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

User
Posted 27 Nov 2018 at 00:59

Edited by member 27 Nov 2018 at 01:00  | Reason: Not specified

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

User
Posted 27 Nov 2018 at 06:26

Thanks Lyn. I will try to focus on the positive side (nigh on impossible for people of my disposition); I shall be going for a template biopsy because whether I wake-up or not on the block feels pretty irrelevant to me right now. Morbid, I know, but hey, that's the way it is.

User
Posted 27 Nov 2018 at 09:55

Hi Haig,

 

I can completely sympathise with how you are feeling at the moment.  The waiting and not knowing is the worst thing, but then I suppose the knowing is pretty crap too. Hopefully you just have an enlarged prostate, which is causing your raised PSA.

My husband had a uti, his first PSA was 9.5, thought this was raised due to the infection, but then after the antibiotics his PSA was 7.3. Still too high!  We then found ourselves on this path of MRI, then template biopsy, now told we have PCa.  Gleason 6, grade 1, but because the MRI showed the tumour up against the prostate capsule, they have staged it at T3a.  I'm devastated and worried about my husband.  He is due to have the robotic surgery on the 10th Dec.  The surgeon said/hoped this procedure would be enough to cure him of cancer.  I'm praying it is.

This disease has just snook up on us, no real symptoms, husband is fit and well otherwise.

I know it's so hard not to worry, this is all I've thought about for the past few weeks.

Good luck, thinking of you.

 

Michaela

User
Posted 27 Nov 2018 at 10:30

Thanks Michaela; I empathise with and your hubby. I truly hope all goes well for him and although there will be tough times ahead, you are there for him and that is such a huge asset. I have not been great with any of this (as people on here are all too aware) - some have told me it is unlikely given my facts and figures, others are just rightly sitting on the fence because you just don't know. I just hope I can hold it all together, as much for my wife and boy, as for me. 

Haig x

User
Posted 28 Nov 2018 at 16:05

Hi all. I rang the specialist nurse today. They are such lovely people. It helped to talk to someone. Thanks for steering me their way. 

User
Posted 28 Nov 2018 at 16:33
The specialist nurses are fantastic. They help to put things into some sort of perspective.

Glad you’ve made the call.

Ian

Ido4

User
Posted 28 Nov 2018 at 16:41

I couldn’t agree more! They stopped me getting ahead of myself last week and calmed me down, when I was having a wobble.

Hope you’re ok Haig? X

User
Posted 28 Nov 2018 at 17:18

Originally Posted by: Online Community Member

Hi all. I rang the specialist nurse today. They are such lovely people. It helped to talk to someone. Thanks for steering me their way. 

Good. I hope you take note of what they told you and put all thought of localised PCa being a "death sentence" out of your head!

Chris

 

User
Posted 28 Nov 2018 at 17:22

Not really okay. I am just about surviving - I have eaten nothing but a few bits of fruit since last Wednesday. My PCa or BPH symptoms have been hard at it today with that "not emptying feeling" & basically Tuesday's uro appt. feels miles off, let alone the eventual mri and biopsy. Can't even imagine the diagnosis day. Have to keep going for my wife and son, otherwise I wouldn't.

User
Posted 28 Nov 2018 at 17:23

Hi Chris. Nice to hear from you old bean.

User
Posted 28 Nov 2018 at 17:25

Oh, & my dog had his anal glands emptied for the 3rd time in a month and needs them "flushed". It's all ass round my joint, I tell you.

User
Posted 28 Nov 2018 at 17:42
Glad to see you have listened to everyone’s advice and spoken to a professional.

Hang on in there

Bob

User
Posted 28 Nov 2018 at 17:58

Evening Bob - hope all is well with you.

H

User
Posted 28 Nov 2018 at 18:32

Originally Posted by: Online Community Member
Glad to see you have listened to everyone’s advice and spoken to a professional.
Bob

His Dog’s vet? 😉

Cheers, John.

User
Posted 28 Nov 2018 at 18:44

Originally Posted by: Online Community Member

Oh, & my dog had his anal glands emptied for the 3rd time in a month and needs them "flushed". It's all ass round my joint, I tell you.



...That must be a relief for yer dog........and you think you got problems!!   

Cheers 
Luther 






User
Posted 28 Nov 2018 at 18:45

Nice one John - I liked that.

User
Posted 28 Nov 2018 at 18:46

He didn't look particularly enamoured to be fair.

User
Posted 28 Nov 2018 at 19:48
Herman the German (shepherd) had his drained a few weeks ago.

I mentioned to the pretty young vet at his arse end, whilst I was holding his head and his mouth shut: ‘Some people think vetinary surgery is quite a glamorous profession, when they watch “The Supervet”.........’

Cheers, John.

User
Posted 28 Nov 2018 at 19:51

Mine's a 44kg labradoodle (black) crossed with a standard poodle. Unsociable as hell - takes after his owner. He wasn't keen having them emptied first time, but he had that resigned look on his face today about it all. You know sort of "bloody get on with it so I can get into the woods" look.

User
Posted 28 Nov 2018 at 19:52

His name is "Jango"

User
Posted 28 Nov 2018 at 20:09

Listen, wave a half a sausage at mine and you got a friend for life. Jango was my son's idea - some dodgy guy in a suit from Star Wars, if memory serves.

H

User
Posted 28 Nov 2018 at 20:44
Did you ask your GP for something to help you get through the emotional stuff, Haig? If you’ve not done so, I really would. My GP put me on a medication called Sertraline, which helped me tremendously.

Cheers,

Chris

User
Posted 28 Nov 2018 at 20:59

I ought to, I know. I want something that works though - and fast. 

User
Posted 28 Nov 2018 at 21:05
Do. I went through a hell of a time when I was waiting for treatment to begin. My diagnosis was complex (they kept finding new things wrong with me at every scan), so it took me three months (May to August) from diagnosis to the start of treatment. I wouldn’t have got through that without the Sertraline. It really works.

Chris

User
Posted 29 Nov 2018 at 06:47

I'll make an appt. today for tomorrow. How long does it take to kick-in, so to speak?

H

User
Posted 29 Nov 2018 at 08:41
A week or so, from memory. My GP also gave me Diazepam, which works instantly, as a "stopgap" while the Sertraline was building up in my system. I was on Sertraline for about 4 months in total, and it really helped me. I stopped taking it about 6 weeks ago when my major surgery (I had to have a kidney removed) was all done and I was feeling a lot happier about things. Now I have no concerns at all about the future.

Chris

User
Posted 29 Nov 2018 at 08:52

Thanks Chris - I'll be sure to ask for both. 

User
Posted 30 Nov 2018 at 19:18

Got Diazepam today. Feel calmer. Thanks, Chris.

User
Posted 30 Nov 2018 at 23:56
Hi. It's Summer down under today. I've posted on this site but have just read through all these posts. I'm trying to keep calm as well, my first radiotherapy was to begin on Wednesday next week but I asked to postpone it until January as I developed shingles. He eventually agreed and said I won't come to any harm. So a quietish December. I am G 7 3+4 which is Intermediate favourable. Two of thirteen cores positive both on one side. Localised. So, could be worse I suppose. Last PSA in July 7.4. Urologist not bothered about that. Best wishes to you all. P.S. I am a health wimp as well and unfortunately stopped drinking almost 12 years ago. Maybe get a new hobby to keep myself calm...
User
Posted 01 Dec 2018 at 00:03

I would recommend chain smoking but it isn't a very popular suggestion for some reason 🤷🏼‍♀️

Edited by member 01 Dec 2018 at 00:44  | Reason: Not specified

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

 
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