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Does the Consultant phone or ask you to come in?

User
Posted 30 Jun 2020 at 11:05

Hi there...


Was referred about 10 days ago after a random 4.7 PSA came up when having a general test done for something else.  Had an MRI on Sunday eve.  Just got a call from the hospital booking me in to talk to a Doctor tomorrow. Do they normally dish out the bad news over the phone or ask you to come in?


Thanks in advance...

User
Posted 30 Jun 2020 at 15:12

JPM


You can't change what is , so stay positive. How old are you. 


Thanks Chris

User
Posted 30 Jun 2020 at 17:25
Hi Chris...I'm 54. Had a mild flair up when I was 42, saw a specialist then (blood in urine), but PSA was only 1.3 and Prostate slightly enlarged. Consultant said I was fine and no need to worry about anything. My aged Dad joked he had a Prostate the size of a Medicine Ball (he was 82 at that point and went on another 11 yrs without any knowledge of PC). So, I'm hoping I'm following on his footsteps...and just have a whopper of a Prostate!
User
Posted 30 Jun 2020 at 17:49
There wouldn't be any diagnosis at this stage anyway as you haven't had a biopsy, as far as I can see.

The MRI can predict likelihood of cancer but not with certainty - we have had men on here recently who were given a 5 (certain and significant cancer) who subsequently got the all clear, men with a 2 (unlikely to be cancer) whose biopsy pulled out quite high grade cancer and men whose MRI was clear although it turned out there was quite a lot of cancer in their prostate.

So I guess the 'bad news' tomorrow would be if the doc says "there is a suspicious area(s) on the MRI so I am going to recommend that you have a biopsy." But to be honest, many urologists would be just as likely to say "the MRI was clear but I am going to recommend you have a biopsy just to confirm everything is okay."

Good luck!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 30 Jun 2020 at 18:22
Thanks Lyn...much appreciated, and very pragmatic.

I'm preparing for the worst, but hoping for the best. If it's bad news, I'm hoping my age and PSA level will indicate something that is treatable. Fingers are crossed!
User
Posted 30 Jun 2020 at 20:58

I think the best approach is to:-


- remember that whatever the MRI saw is not God-given truth but is usually a good indicator
- don't be fobbed off with a quick 'we will look again in 6 or 12 months' unless the MRI was totally clear
- understand before you go tomorrow what the different biopsies are so that you can make a reasoned judgment about whether that biopsy is the right one for you


BIOPSIES - 3 types
- TRUS - unless they know where they are aiming (e.g. because of the MRI), this is the equivalent of sticking a needle in a fruit cake & hoping to spear the cherry. If they know where the suspect area is, TRUS biopsy is quicker & cheaper than the others, doesn't need a general anaesthetic, isn't done in an operating theatre and therefore may be more available during COVID. Biopsies are taken through the bowel wall.
- image guided transperineal - uses a live scan to help aim the needles at the suspect areas - can be done with local anaesthetic so possibly more available than template biopsy during COVID. Biopsies are taken through the skin between your scrotum & anus.
- template biopsy - until recently, always done under general anaesthetic although some NHS trusts have started doing it under local or spinal block instead and this may be becoming more common now that so many operating theatres / recovery rooms have been converted to COVID ICU rooms. Many samples are taken, so a better option than TRUS if the MRI was clear (no suspicious areas) or they aren't absolutely sure where to target. Like the image guided, biopsies are taken between your scrotum & anus.


https://prostatecanceruk.org/prostate-information/prostate-tests/prostate-biopsy


 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 01 Jul 2020 at 08:46
Thanks again Lyn for your solid advice. I'll report back later after I've had the conversation later this morning...
User
Posted 01 Jul 2020 at 11:36
Just had the call from the Consultant at the Churchill in Oxford. Before I could even really say hello, he opened with 'well, your MRI has come back as completely clear' - I almost passed out! He did say my Prostate is slightly enlarged but not more so than you'd expect from a slightly raised PSA (4.7).

He did add that 1 in 7 cases that come back as clear are hiding something nasty so he's suggested another PSA test in 3 months and then meeting him at a clinic to discuss. But his main/probably diagnosis is BPH.
User
Posted 01 Jul 2020 at 11:41
Great result.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 01 Jul 2020 at 12:54
In the meantime, thank you for your time and expertise - and I wish all those reading this the best of times and strength to deal with what's thrown their way. I will remind all I meet to keep a close watch on all things down below...and sites like this only help with that message.
User
Posted 01 Jul 2020 at 12:58

JPM


Great news .


Thanks Chris

User
Posted 02 Jul 2020 at 00:31

Great to read! Thanks for sharing

User
Posted 02 Jul 2020 at 09:02
Good luck, keep an eye on your PSA and if you see it increasing over the next three to six months, request a biopsy, avoiding if possible the now outmoded TRUS (up the bum) variety.

Cheers, John.
 
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