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Waiting for TRUS

User
Posted 14 Mar 2019 at 13:55

Am 56 year old, had a TURP operation in February 2017. Since the Urologist has monitored my PSA. Was 18.1 prior to TURP. In May 2017 was 5.0, July 2017 4.1 and 4.7 in December 2017. Saw Urologist in February 2018 and he arranged for MRI which I had and came back as no clinically significant cancer. Have had PSA done again since and came back as 4.2 in November 2018 and 4.19 last week.

For past 4 months have had a pain above pubic bone area that comes and goes. Also getting pain in lower back, buttocks and legs. GP thinks some of the pain is stress related.

Saw Urologist at end of January, DRE was OK. He put me on Ciprofloxacin for 4 weeks for possible prostatitis. This has done no good, still getting the pain above pubic bone area and in left groin. My GP has referred me back to Urologist who has written to me suggesting I have a TRUS biopsy. Got an appointment in 3 weeks.

Thought the clear MRI was the end of this and am looking for any thoughts and support. 

 

 

User
Posted 15 Mar 2019 at 01:44
Bollinge, you really should desist from saying this as it simply isn't true. I have done some checking, and as far as I can see few private consultants offer template biopsy as the default, mainly because the general anaesthetic is rather expensive (anaesthetist, theatre time, bloods, recovery room charges, etc) and rather more risky. Men who are insured may have differing experiences of persuading their insurer to pay the additional costs, and men who are self financing because they are frightened may find the TRUS biopsy affordable and the template biopsy unattainable.

All you are doing is causing additional and unnecessary fear / anxiety. The material removed during the TURP will probably have been far more substantial than any biopsy, template or otherwise. So a clear TURP, a clear MRI (presumably mpMRI since it was done pre-consideration of biopsy), symptoms that are indicative of urine infection, prostatitis or anxiety rather than PCa, a PSA that fell significantly with the removal of some excess gland material and has held stable since plus what I assume is a large prostate (otherwise he wouldn't have needed the TURP) .... Unless the pathology from the TURP showed pre-cancerous changes, PIN or similar, what makes a template biopsy worth the risk?

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

User
Posted 08 Apr 2019 at 18:44

Just had phone call from specialist nurse to say my biopsy result shows all samples are clear.

Thanks to everyone for your comments and support, much appreciated.

User
Posted 08 Apr 2019 at 22:10
Great news!

User
Posted 08 Apr 2019 at 23:56
Brilliant - hopefully, the pain will now reduce and you are getting some help with stress management?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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User
Posted 14 Mar 2019 at 22:07
Having had a TURP, it seems a bit daft to keep on having biopsies - I assume no cancer was identified in the TURP? It seems then that your pain is probably not cancer related and the pains you describe are not classic signs of prostate cancer anyway. Why did you need a TURP in the first place?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Mar 2019 at 01:18
If you are going to have a biopsy at all I would recommend a template biopsy under general anaesthetic. It is far more precise and more samples are taken (42 in my case) as around 12 on average for TRUS.

Yours is just the kind of case where results from TRUS are often indeterminate, (no lesion visible on MRI, slightly raised PSA) and some men end up having to have a second template biopsy afterwards. Two for the price of one!

A template biopsy ought to put your mind at rest one way or the other. See what your consultant says. The NHS favours TRUS biopsies because they are quicker and cheaper. If you had private healthcare you would probably go straight for a template.

Best of luck.

Cheers, John.

User
Posted 15 Mar 2019 at 01:44
Bollinge, you really should desist from saying this as it simply isn't true. I have done some checking, and as far as I can see few private consultants offer template biopsy as the default, mainly because the general anaesthetic is rather expensive (anaesthetist, theatre time, bloods, recovery room charges, etc) and rather more risky. Men who are insured may have differing experiences of persuading their insurer to pay the additional costs, and men who are self financing because they are frightened may find the TRUS biopsy affordable and the template biopsy unattainable.

All you are doing is causing additional and unnecessary fear / anxiety. The material removed during the TURP will probably have been far more substantial than any biopsy, template or otherwise. So a clear TURP, a clear MRI (presumably mpMRI since it was done pre-consideration of biopsy), symptoms that are indicative of urine infection, prostatitis or anxiety rather than PCa, a PSA that fell significantly with the removal of some excess gland material and has held stable since plus what I assume is a large prostate (otherwise he wouldn't have needed the TURP) .... Unless the pathology from the TURP showed pre-cancerous changes, PIN or similar, what makes a template biopsy worth the risk?

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

User
Posted 15 Mar 2019 at 05:35
From the senior prostate oncologist at the Royal Marsden Hospital - “the trial has shown us that the TRUS biopsy is as bad as we thought it was”.
User
Posted 15 Mar 2019 at 07:55

Hi Lyn, had the TURP for enlarged prostate and urine retention. the samples taken at the time came back clear.

Edited by member 15 Mar 2019 at 10:13  | Reason: Not specified

User
Posted 15 Mar 2019 at 09:32

Originally Posted by: Online Community Member
From the senior prostate oncologist at the Royal Marsden Hospital - “the trial has shown us that the TRUS biopsy is as bad as we thought it was”.

John Lennon said "I am the walrus" but it doesn't make it true 😂

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

User
Posted 15 Mar 2019 at 16:02

Thanks Lyn for your messages much appreciated

User
Posted 02 Apr 2019 at 15:56

Had TRUS biopsy this morning, went ok, just a little sore.

Was told my prostate size was 48 grams, would this cause my slightly elevated PSA of 4.18?

Get results a week on Thursday.

User
Posted 08 Apr 2019 at 18:44

Just had phone call from specialist nurse to say my biopsy result shows all samples are clear.

Thanks to everyone for your comments and support, much appreciated.

User
Posted 08 Apr 2019 at 22:10
Great news!

User
Posted 08 Apr 2019 at 23:56
Brilliant - hopefully, the pain will now reduce and you are getting some help with stress management?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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