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Advice sought please

User
Posted 05 Mar 2019 at 05:51

Good morning from Cape Town, South Africa!

Really pleased to have come across this forum in my extensive research over the past few days. I am in awe at the compassion displayed and patience shown, especially to Newbies, well done and thank you!

My story ...

57 years old, married to a wonderful woman, semi-retired, very fit (we are both keen mountain bikers). 

I have been battling with the urination for 5 years unconsciously believing it to be normal. Text book prostate related problems, frequency, reduced flow, half emptying etc etc. Easier to ignore than face up to, ignorantly! In that time my libido has also waned to the point that currently I have zero interest whatsoever. I had a PSA done 3 years ago by my GP and was told at 4.1 it was on the edge of acceptable and that it should be monitored. He emigrated shortly after and I neglected follow ups until February 2019. I had some bloods analyzed for insurance purposes including a PSA. It came back 8.9 (free PSA 7) and my GP immediately set up a session with the Urologist.

I buried my Dad 2 years ago. He was killed by liver cancer 2 years after finding out that he had been living with PCa for a fair amount of time. 

After the initial interview, the PSA result and then the news of my family history, I knew immediately that in his mind the odds changed from possible to probable. It was actually visible. He performed a DRE and indicated a lump on the right hand peripheral posterior of the prostate. I was booked immediately for an MRI and received the result yesterday 4th March. PIRADS 5 lesion!

I am now booked for a biopsy for 14th March.

The advice Im looking for... Please understand that in SA we do not have NHS, All this is expensive!

- Is it worth the risk and cost of having a biopsy considering what seems to be overwhelming evidence of fairly aggressive PCa? or am I overreacting?

- As a total layman, what options do I have in the best treatment should I decide to not have the biopsy? or is it imperative to have it to discover the best way forward?

- Further, Is there anyone who has similar evidence (circumstances) in whom cancer was not found?

I think thats a good start, hoping someone may find time to reply and help a young guy make some good decisions.

  

User
Posted 05 Mar 2019 at 06:50
I think you need the biopsy, otherwise you risk the massive expense of treatment only to find out out when your prostate is on the slab that it was fine..
User
Posted 05 Mar 2019 at 08:00
Unfortunately, looking at the cells of your prostate under a microscope is the only way to know whether or not you have cancer and, if so, how widespread and aggressive it is. A biopsy really is vital.

Chris

User
Posted 05 Mar 2019 at 10:33

Many thanks to the 3 gentlemen who replied. Looks like I have an appointment for my biopsy. Will be back!

User
Posted 05 Mar 2019 at 10:33

Hi and welcome to the club that nobody wants to join.

I think the only way you will find the level of the problem is to have a biopsy to find the staging and your Gleason score and the read up as much as you can on this site as many members have been through just about every level of PC.If you click on the avatars of the members you can see their journey.

Good luck John.

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User
Posted 05 Mar 2019 at 06:50
I think you need the biopsy, otherwise you risk the massive expense of treatment only to find out out when your prostate is on the slab that it was fine..
User
Posted 05 Mar 2019 at 08:00
Unfortunately, looking at the cells of your prostate under a microscope is the only way to know whether or not you have cancer and, if so, how widespread and aggressive it is. A biopsy really is vital.

Chris

User
Posted 05 Mar 2019 at 10:33

Many thanks to the 3 gentlemen who replied. Looks like I have an appointment for my biopsy. Will be back!

User
Posted 05 Mar 2019 at 10:33

Hi and welcome to the club that nobody wants to join.

I think the only way you will find the level of the problem is to have a biopsy to find the staging and your Gleason score and the read up as much as you can on this site as many members have been through just about every level of PC.If you click on the avatars of the members you can see their journey.

Good luck John.

User
Posted 10 Feb 2020 at 16:47
I would agree that a biopsy is needed.

I would opt of a transperineal biopsy rather than a trans-rectal one, as the risk of infection is much lower.

User
Posted 10 Feb 2020 at 21:44
Amnon,

The OP said he would get back to us nigh on a year ago, so your thoughts are perhaps rather late!

Barry
 
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