Awaiting biopsy. Rapid PSA rise.

User

Posted 14 Jun 2019 at 14:31

Hello everyone,

I have been following the posts on this forum for over a year and find everyone to be so helpful, honest and extremely courageous given yoursituations.

Over a year ago I was referred to the urologist with a psa of 22.4, dre was enlarged but smooth. Had MRI, bone scan and 18 core biopsy all were clear (apart from a suspicious area showing on scan). This was followed with a CT scan and a second targetted, 13 core biopsy. Again no positive cores and no pin.

The urologist then removed me from the cancer pathway, so we assumed all was ok. However moving forward a few months to the next psa test and result was 37.4. Had another Mri. Prostate is large at 90cc No change in suspicious area. Suspicious area is peripheral zone possibly PI-RADS 4.

MDT meeting now want a template biopsy and a second bone scan.

Worried that rapid increase in psa over a short time is indicative of spread. Have seen here on this blog and others where psa levels can be high due to other causes but such a rapid rise is causing some concern.

Just totally confused at present and more than a little concerned.

Thanks in advance for any comments

Edited by moderator 14 Jun 2019 at 14:39 | Reason: Not specified

User

Posted 14 Jun 2019 at 23:26

In your shoes I would also be concerned considering the increase in PSA. Unfortunately, MRI does not always show cancer even when you do in fact have it. In your case it seems logical to have a template biopsy now. With a large prostate this could involve a lot of needles but at least you won't feel them! You will be tender for a week or so after the procedure, particularly after the first 24 hours. I found it more comfortable to stand or lie down. When you sit remember to sit back. If you sit up straight (correct posture normally), it puts a lot of pressure on the tender parts and causes considerable discomfort.

Do let us know how you get on.

Barry

User

Posted 15 Jun 2019 at 03:07

What a shame you didn’t have a template biopsy in the first place. Something is clearly going on so it might be third time unlucky!

I turned down a TRUS biopsy on the advice of two friends who had had one, only like you, to have to undergo a transperineal biopsy in the end. I read yesterday that three hospitals in Britain have abandoned TRUS altogether in favour of template biopsies.

As to the procedure, I had 42 samples taken and, apart from pissing razor blades for my first two or three post-op micturitions and a massive yellow/blue/purple bruise on my perineum, I had no problems and virtually no pain at all.

I hope you get it sorted and the best of luck.

Cheers, John.

User

Posted 22 Jun 2019 at 20:35

Thanks for responding.

Had template biopsy yesterday. Urologist took 24 cores. A bit surprised as prostate is 90cc. Expected more! No pain and only a little blood in pee.

Bone scan on Tuesday results in about a fortnight.

Rabjohn

User

Posted 22 Jun 2019 at 22:54

Let’s hope they can work out what’s going on here John. Good luck

love Devonmaid

User

Posted 15 Jul 2019 at 17:56

Hi everyone,

Quick update. Still waiting for results of template biopsy. Had appointment with specialist 2 weeks after biopsy. Waste of time as no results through. Decided to go on booked holiday for 2 weeks anyway. Best news is bone scan clear!

Rabjohn.

User

Posted 26 Jul 2019 at 11:34

Hi all

Just had results of template biopsy. All clear no PCa. Must be one of the lucky ones even with PSA of 37.

Many thanks to all of you for your kind words of support.

Rabjohn.

User

Posted 26 Jul 2019 at 12:15

Happy days mate. Enjoy your holiday and then come back and get sorted what is really the matter with you!

Cheers, John.

User

Posted 26 Jul 2019 at 13:30

They're now saying BPH and chronic prostatitis.

Rabjohn.

User

Posted 26 Jul 2019 at 15:16

What a relief that it isn’t PC.

Ido4

User

Posted 28 Jul 2019 at 12:38

Jul 2019 11:15 in response to Rabjohn

HI ALL,

Just to clarify my situation re "all clear", with PSA of 37.4.

I have had 3 MRI scans, 1CT scan, 2 bone scans, 1 x 18 core TRUS biopsy, 1 x 13 core targetted biopsy and 1 x 24 core Template biopsy. All were negative for PCa. Apart from a "suspicious" area on MRI's possibly PIRADs 4. Despite that no cancer.

For the sake of clarity, both TRUS biopsies (totalling 31 cores) are taken horizontally through the prostate and the template biopsy (24 cores), vertically. Hence a thorough sampling of the whole prostate. A total of 55 cores. My pathology report shows all cores clear of PCa. Prostate is very large at 90cc. Some evidence of inflammation in 2 cores.

Hope this clarifies my situation and experience of my journey so far!!

User

Posted 28 Jul 2019 at 14:57

Unfortunate you had to go through all these tests to show you don't have PCa but sometimes it's not easy to find and as in your case there can be other causes that raise doubt. Hopefully, your Prostatitis will be resolved. I would nevertheless ask for a PSA test in 6 months time unless one is arranged earlier.

Barry

User

Posted 28 Jul 2019 at 15:06

Hi Barry ,

Totally agree Barry. Waiting now for hospital to get in touch. Fully expecting further PSA tests in the future. Realise there could be problems elsewhere e.g. seminal vesicles etc. Just play the waiting game again.

Cheers

Rabjohn.

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