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Green Laser, PSA levels and PI RADS score

User
Posted 12 Mar 2019 at 11:50

Hi everybody

This is my first post, so sorry if I’m asking stupid questions but I can’t seem to find answers by just searching.

I had green laser surgery for BPH which was causing weak flow and urine retention when I was 44 – at the time the urologist mentioned taking a PSA baseline after the surgery as the green laser surgery would affect any future PSA tests.

Fast forward seven years and I’ve had another PSA test which was slightly raised for my age (51 years old, PSA of 3.2) - the GP couldn’t find any baseline PSA results on my medical records and said the result was slightly raised but not worth worrying about yet. This of course worried me…. so I asked to be referred to the urologist that carried out the initial green laser surgery.

At the consultants, nothing felt on a DRE except for an enlarged prostate but he recommended a prostate MRI with contrast, the results of which were a lesion on the left side of the prostate with a PI RADS score of 4 (radiologist also reported a thickening of my colon wall that also needed investigation). I then had a Fusion Target Biopsy which took 17 cores that were all benign and a colonoscopy that was all clear.

My GP has discussed my case with the head of practice who has an interest in prostate cancer management and he has recommended that I get a second opinion as the PI RADS score was so high, so I’ve seen another consultant who has said that it is possible for the biopsy to miss cancer cells but it’s unlikely but has recommended a 3T MRI as it generates sharper images than the 1.5 MRI that I had in October 18 but to wait until October 19 as the biopsy would have caused scarring and to give this a chance to heal.

Just before seeing the second consultant I had a second PSA test that is a little lower at 2.8.

So I’m looking for some advice on the following:-

Would the green laser surgery seven years ago have a significant effect on my current PSA level?

Is it possible for lesion with a PI RADS score of 4 to be completely benign?

Would it be advisable to leave the next MRI until October 2019?

The last question is a little random – is it ok to ride a bike with a lesion i.e. could it cause it to grow or change etc.

Thanks for reading this and I really do appreciate that I’m lucky at the moment with the results that I’ve had so far but I’d really value people’s advice, opinions and experiences.

Thanks

Mike

User
Posted 12 Mar 2019 at 12:02
Hi Mike,

Good news that your PSA has dropped. I don’t think your BPH surgery yonks ago would affect your PSA today. It seems you are in good hands and going for a 3T mpMRI later this year.

Did you have a template biopsy under general anaesthetic, or a TRUS biopsy under a local? The former is far more precise. For example, I had 42 cores sampled with the latter. Still confirmed cancer though :-(

Many such lesions can be completely benign, so best of luck with yours.

Cheers, John.

User
Posted 12 Mar 2019 at 12:09

Hi John -  the biopsy was with a local - I know they took 20 cores as i counted every one, but 3 "broke up" so had the results on 17.

Thanks

Mike

 
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