Information needed please.

He says under his bio that he has been told he has cancer Lyn but if he hasn't had a scan and biopsy unless a DRE was very abnormal it is surprising he has been told this already. Generally, it's only when a PSA is much higher that a man is told he has PCa without other supporting tests.

Pete, at your age more men have PCa than don't have it. Many of them don't even know they have it and most die of something else.
Where considered appropriate men can have treatment(s) which where not curative does set the cancer back.

Where PCa is low grade and not looking like breaching the capsule men are sometimes offered Active Surveillance (AS) or initial radical treatment either using one of the methods of surgery or radiation. There are less frequently used treatments but these are not widely available.

It does seem likely that the next step will be to have a scan and biopsy, preferably in that order. It's really only after that that a complete diagnosis can be given and treatment options discussed. I would suggest that you obtain all the details of your diagnosis so that you and we have a better idea of where you are. Unfortunately, for patients this can be an anxious wait.

Meanwhile, I suggest you download or obtain a hard copy of the 'Toolkit' available from the publications section of this Charity. It provides a lot of useful information about PCa and various treatments.

Edited by member 23 Jul 2019 at 03:42  | Reason: Not specified

Thank you for your information.

Just had my mri scan this morning and now waiting for my next step. Recieved a copy of my dre sent back to my doctor this morning. Letter states possibly T2b right lobe of the prostrate . See what the mri scan shows !!!

Edited by member 09 Aug 2019 at 00:15  | Reason: Additional information

The next step will be driven by the MRI scan report. (I'm not sure the DRE carries much weight when you've gone this far past that point.)

The MRI will show where in the prostate any cancer might be, and via a PIRADS value, the radiologist predicts what the gleason score might be, although this is not an accurate prediction. However, the MRI can't normally diagnose PCa, only point to where to test for it. If the MRI report is PIRADS 4 or 5 (and in some cases 3), you will then have a biopsy of the suspect area, and the gleason score more accurately determined by histology.

I imagine that regardless of the MRI result, the urologist will recommend that you have a biopsy just because of the DRE.

Do you know what type of biopsy? Is it a theatre procedure, or an outpatients procedure? (Probably too short notice for an elective theatre procedure.)

One thing I would say, make sure they have the report of the MRI scan and are using it to guide the biopsy. You could try phoning to ask beforehand.

If they don't yet have the MRI scan result, defer the biopsy until they do. Biopsies are much more effective when they target suspicious areas identified by the MRI scan. About 80% of hospitals are getting this right now, but too many still aren't.

OK, it's probably a TRUS biopsy.

It's really important they look at the MRI scan report first, or they'll likely miss the cancer. (That happened to me.) Some parts of the prostate cannot be reached with a TRUS biopsy, and if the MRI report says the cancer is just there, then you would need a transperineal biopsy instead. That's normally a theatre procedure, but there is an outpatient version being done by a few leading hospitals now.

Dont know who I am seeing. Only seem to get phone calls from the clerical only advising me about appointments. Just told to log in when I arrive at pinderfields hospital tomorrow to see where I need to be. 

Biopsy results today. It will be much better when I know how I am and what treatment I require. It has been a very long month getting to this point with very mixed emotions, sadly, for my poor wife also. We had our 46th wedding anniversary on the 4th of this month. Hoping to see our 50th !   🤞

Edited by member 20 Aug 2019 at 08:50  | Reason: Additional information

Thank you.

With Gleason 7 treatment will be necessary. That’s what I was told when I was diagnosed.

But that was also due to the fact my cancer was bulging at the edge of the prostate.

Is your cancer completely contained?

The final decision on treatment is personal and reached from the information you are given from the different medical disciplines.

Never an easy choice. Each treatment choice will have side effects and pros and cons. 

I don’t think anyone will recommend one treatment over another.

I would always opt for surgery but your age may nudge you towards Radio therapy.

Best read up on everything and make an informed decision.

Right-1/2 random - 4/4 targeted - Gi 4+3 , left 0/6. Psa 17.5 psa density 0.7. Ipss 8/35. Not sure about most of this but told I have a Gleason score of 7+.

Was told possible T2b at dre only. Nothing on results page. Thank you for your input. Additionally, when I see the consultant and surgeon, will they guide me to a treatment or is that down to me ?

Edited by member 25 Aug 2019 at 15:28  | Reason: additional information

Thanks for your input. I am just getting my head around the latest information. 

Sorry to jump in here but my diagnosis was 3 + 4 T3B. My PSA had been 33. I had a bone scan before I was offered radiotherapy or surgery. I opted for surgery and on meeting the surgeon was put on hormone therapy (Triptorelin) for 3 months and then underwent radical prostatectomy. One year post op my PSA is <0.1 ng/ml.   

All the hormone therapies have broadly similar side effects, things like reduction in libido, loss of body hair acquired at puberty (although in case of beard, I think most people just get a slowing of growth unless you're on HT lifelong). You need to make sure you continue having erections, or you may find they don't work again after an extended period of not having any - this can be harder than you think if your libido goes very low. There are many side effects which are significantly reduced by exercise - exercise is really important when you're on HT. Many of the local support groups run weekly exercise classes for members, often free or cheap, but you need to fill in between these with exercise of your own. You might check with your GP if you can take calcium and Vitamin D supplements to try and maintain bone strength (although this only works with exercise too). There are also hot flushes which about 80% of men on HT get, but to varying degrees.

Is the bicalutamide 50mg for 3-4 weeks before starting injections, or is it 150mg for a longer time (typically 18-36 months)?

In the case of using bicalutamide for a longer time, it is more prone to generate man-boobs than the other treatments, but they can all do it. There are ways to avoid this, e.g. taking tamoxifen or getting a once-off radiotherapy blast to the breasts. If the bicalutamide is only for 3-4 weeks, it won't cause this side effect.

Put like this, it probably sounds rather uncomfortable, but no one gets all the side effects, and some people get none at all. We all handle it though.