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User
Posted 15 Apr 2020 at 17:16

Hi all I’m a new member hope everybody is ok

im looking for advice please had a PSA Of 4.7 GP referred me for an mri with contrast saw consultant urologist who said that I had an enlarged prostate of 54 cc and PI RADS 4 with suspicious lesion on the prostate measuring 17 mm that really worried me.

She got me booked in for a template biopsy on the 25 March which got cancelled which I fully understand why considering what’s happening right now.

When I phoned the hospital to enquire when I would be rescheduled to have my biopsy they said when it is deemed safe to come in now that could be months away.

Iam absolutely scared stiff not knowing if it is cancer or not I just don’t know what to do.

Help anybody.

User
Posted 15 Apr 2020 at 18:28
Take a deep breath , unfortunately at this time with the virus everything is on hold or slow progress. You can’t get much info till after the biopsy then you will see the lay of the land , everyone approaches the thought of pca differently , me it helped considerably knowing a lot of guys who I knew had treatment and they gave me a lot of support . There are several different treatments as you more than likely investigated . Just use this site and NHS that’s all you need for advice , no need for dr google that’s in my opinion too much information . Just download info off this site . Chin up
User
Posted 15 Apr 2020 at 19:17

Nigel,

You might be able to be referred to a hospital that is still doing cancer diagnosis and treatment. In London, I've heard this is the Royal Marsden.

I suggest talking with the specialist nurses here (number at top of this page), and then maybe your GP if you identify a different hospital, so your GP can refer you.

User
Posted 15 Apr 2020 at 22:32

Hi Nigel,

No doubt you will have looked up the fact that a Pirads 4 score is likely, but not definitely, cancer: “PI-RADS 4: high (clinically significant cancer is likely to be present)”.

I have watched the Health Secretary and others in the NHS state repeatedly that the NHS has not closed down exclusively for the plague, and that other procedures are continuing to take place.

Their thinking, of course, is that prostate cancer is usually slow growing, and so it should not be a major problem to put you on the back boiler for a few months to await a biopsy.

I can see you are worried, so I would get in touch with your consultant and whoever else you can think of to get them to find you somewhere that is still doing this relatively minor template biopsy procedure. Be prepared to travel.

Best of luck.

Cheers, John.

Edited by member 16 Apr 2020 at 06:24  | Reason: Not specified

User
Posted 17 Apr 2020 at 11:54

Hi Nigel,  

A 55g prostate is quite big and it might not be anything significant.  A suspicious 17mm something could also be not significant.  Your psa isn't that high.  That's the good side.  The bad side is it could be significant so I can well imagine you're worried.

Without knowing a lot more it's hard to say but my thoughts would be to ring anyone I could find which might include the GP, Prostate Cancer Nurse, Urology, Macmillan until I got an answer I wanted.

I know it doesn't always work. 

Also I doubt you've seen a consultant yet.  I've seen a lot of doctors and some of them aren't that great so a second opinion might be useful if done tactfully.

The answer I'd want is where can I get a template biopsy in the next few weeks.  I know they're busy but they keep making calls about 'where are the patients'.    The number of people qualified to do template biopsies is more than those qualified to do prostatectomies.   Urologists won't be doing Covid, although the nurses might.

Also I don't know if you'd be willing to consider private treatment or if your hospital will accept a private diagnosis.  Private work can upset some hospitals so it might be worth asking your doctor. 

I don't think it's about safety.  The hospital should have areas that are safe or there should be hospitals that are safe areas.  Granted it can't be as safe as normal if people can have Covid without symptoms but life is meant to go on.

I'd get on that phone today as weekend is no good.

I have rambled on.  Hope it makes sense.

All the best, Peter

 

User
Posted 17 Apr 2020 at 15:57

Hi Nigel sorry that you’ve joined the club that none of us want be in. Try not to worry to much because from my experience it can make you quite poorly. Check out some of the posts on the site to see that your not alone. You will have good and bad days I found it’s how you manage the bad ones makes all the difference.Im a bit further ahead of your situation, I had my template biopsy in November 19 and then the diagnosis mid December, it was an awful time over Xmas worrying myself sick day after day but it does you no good at all. 

It’s a trying time for all of us guys and our families who have to put up with our mood swings and frustrations but I found a lot of support from the guys on here and also from Maggie’s cancer centers who were very supportive not only to me but my wife also.

Im currently waiting for my Da Vinci surgery, I had my pre op assessment 5 weeks ago so now I do feel like a ticking time bomb just waiting but do you know what at this time in all our lives there is a lot to be thankful for. Our NHS are doing the best they can and I’m sure when it’s safe for all of us to have the various treatments then we will be called for.

Try your best to keep your mind focused and stimulated and take good care. 

Carl.

User
Posted 17 Apr 2020 at 16:06
In our city (Leeds), one of the four hospitals is now a COVID provision and the other three hospitals are doing everything else. The same has happened in Newcastle where the RVI has been cleared of all non-COVID patients to become the infection hub for the region - the other hospitals are presumably hosting all other departments.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Apr 2020 at 17:02

I had TRUS biopsy carried out on 21/03/2020. Hospital had COVID restrictions in place. I have also had a CT scan first week in April.

2 different hospitals in Glasgow so although there are many restricted services some clinics open with social distancing and PPE etc in place

User
Posted 17 Apr 2020 at 17:32
I suspect it is the template biopsy that is the problem - TRUS can be done under local anaesthetic but many areas use general anaesthetic for template biopsy and there simply won't be enough staff, theatre slots, ventilators or recovery rooms for unnecessary GAs right now. You could ask whether there is a consultant in your area that does template biopsy under local anaesthetic or image guided TRUS, or ask for a referral to another hospital that does these - or just have a normal TRUS biopsy since they already know from the scans where the suspect areas are.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Apr 2020 at 23:29

I would guess that they have asked for a template biopsy because a TRUS can't reach the area they want (such as the anterior, and the apex is not easy to get at with TRUS either).

Finding a hospital which does LATP (local anesthetic transperineal) biopsies might avoid the need for a template biopsy under GA. LATP biopsies are replacing TRUS and many template biopsies, and can access the whole prostate.

 

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User
Posted 15 Apr 2020 at 18:28
Take a deep breath , unfortunately at this time with the virus everything is on hold or slow progress. You can’t get much info till after the biopsy then you will see the lay of the land , everyone approaches the thought of pca differently , me it helped considerably knowing a lot of guys who I knew had treatment and they gave me a lot of support . There are several different treatments as you more than likely investigated . Just use this site and NHS that’s all you need for advice , no need for dr google that’s in my opinion too much information . Just download info off this site . Chin up
User
Posted 15 Apr 2020 at 19:17

Nigel,

You might be able to be referred to a hospital that is still doing cancer diagnosis and treatment. In London, I've heard this is the Royal Marsden.

I suggest talking with the specialist nurses here (number at top of this page), and then maybe your GP if you identify a different hospital, so your GP can refer you.

User
Posted 15 Apr 2020 at 22:32

Hi Nigel,

No doubt you will have looked up the fact that a Pirads 4 score is likely, but not definitely, cancer: “PI-RADS 4: high (clinically significant cancer is likely to be present)”.

I have watched the Health Secretary and others in the NHS state repeatedly that the NHS has not closed down exclusively for the plague, and that other procedures are continuing to take place.

Their thinking, of course, is that prostate cancer is usually slow growing, and so it should not be a major problem to put you on the back boiler for a few months to await a biopsy.

I can see you are worried, so I would get in touch with your consultant and whoever else you can think of to get them to find you somewhere that is still doing this relatively minor template biopsy procedure. Be prepared to travel.

Best of luck.

Cheers, John.

Edited by member 16 Apr 2020 at 06:24  | Reason: Not specified

User
Posted 17 Apr 2020 at 11:54

Hi Nigel,  

A 55g prostate is quite big and it might not be anything significant.  A suspicious 17mm something could also be not significant.  Your psa isn't that high.  That's the good side.  The bad side is it could be significant so I can well imagine you're worried.

Without knowing a lot more it's hard to say but my thoughts would be to ring anyone I could find which might include the GP, Prostate Cancer Nurse, Urology, Macmillan until I got an answer I wanted.

I know it doesn't always work. 

Also I doubt you've seen a consultant yet.  I've seen a lot of doctors and some of them aren't that great so a second opinion might be useful if done tactfully.

The answer I'd want is where can I get a template biopsy in the next few weeks.  I know they're busy but they keep making calls about 'where are the patients'.    The number of people qualified to do template biopsies is more than those qualified to do prostatectomies.   Urologists won't be doing Covid, although the nurses might.

Also I don't know if you'd be willing to consider private treatment or if your hospital will accept a private diagnosis.  Private work can upset some hospitals so it might be worth asking your doctor. 

I don't think it's about safety.  The hospital should have areas that are safe or there should be hospitals that are safe areas.  Granted it can't be as safe as normal if people can have Covid without symptoms but life is meant to go on.

I'd get on that phone today as weekend is no good.

I have rambled on.  Hope it makes sense.

All the best, Peter

 

User
Posted 17 Apr 2020 at 15:57

Hi Nigel sorry that you’ve joined the club that none of us want be in. Try not to worry to much because from my experience it can make you quite poorly. Check out some of the posts on the site to see that your not alone. You will have good and bad days I found it’s how you manage the bad ones makes all the difference.Im a bit further ahead of your situation, I had my template biopsy in November 19 and then the diagnosis mid December, it was an awful time over Xmas worrying myself sick day after day but it does you no good at all. 

It’s a trying time for all of us guys and our families who have to put up with our mood swings and frustrations but I found a lot of support from the guys on here and also from Maggie’s cancer centers who were very supportive not only to me but my wife also.

Im currently waiting for my Da Vinci surgery, I had my pre op assessment 5 weeks ago so now I do feel like a ticking time bomb just waiting but do you know what at this time in all our lives there is a lot to be thankful for. Our NHS are doing the best they can and I’m sure when it’s safe for all of us to have the various treatments then we will be called for.

Try your best to keep your mind focused and stimulated and take good care. 

Carl.

User
Posted 17 Apr 2020 at 16:06
In our city (Leeds), one of the four hospitals is now a COVID provision and the other three hospitals are doing everything else. The same has happened in Newcastle where the RVI has been cleared of all non-COVID patients to become the infection hub for the region - the other hospitals are presumably hosting all other departments.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Apr 2020 at 17:02

I had TRUS biopsy carried out on 21/03/2020. Hospital had COVID restrictions in place. I have also had a CT scan first week in April.

2 different hospitals in Glasgow so although there are many restricted services some clinics open with social distancing and PPE etc in place

User
Posted 17 Apr 2020 at 17:32
I suspect it is the template biopsy that is the problem - TRUS can be done under local anaesthetic but many areas use general anaesthetic for template biopsy and there simply won't be enough staff, theatre slots, ventilators or recovery rooms for unnecessary GAs right now. You could ask whether there is a consultant in your area that does template biopsy under local anaesthetic or image guided TRUS, or ask for a referral to another hospital that does these - or just have a normal TRUS biopsy since they already know from the scans where the suspect areas are.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Apr 2020 at 23:29

I would guess that they have asked for a template biopsy because a TRUS can't reach the area they want (such as the anterior, and the apex is not easy to get at with TRUS either).

Finding a hospital which does LATP (local anesthetic transperineal) biopsies might avoid the need for a template biopsy under GA. LATP biopsies are replacing TRUS and many template biopsies, and can access the whole prostate.

 

 
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