My dad's journey so far - worried about biopsy - Being diagnosed with prostate cancer

User

Posted 05 Oct 2020 at 12:14

Hello All,

I have been reading many of the posts on here for the last few weeks and have found them to be very helpful, reassuring and emotional, so thank you to the community for sharing your stories, this forum seems to be such a valuable resource. I wanted to get a bit of feedback on my dad's condition so far, if possible.

My dad was admitted to hospital several weeks ago with chronic high pressure urine retention, a catheter was fitted and he was referred to the Urologist with a PSA of 18, he is 72 year old. He has an MRI scan on the prostrate pelvis area which showed a 'suspect area or a shadow' on the prostrate, he has now been referred for a biopsy. The idea of a biopsy, for him is dreadful and he is seriously considering not attending.

I think the lockdown has been very cruel for him, he is alone and I think it impacted his mood considerably, not that he would ever admit that. I think he is weighing up his quality of life and if it is worth finding out a diagnosis when he might not consider any treatment.

I understand that his PSA is not that high compared to many of the stories that I have read on here, his last test was over 6 weeks ago as the hospital messed up the blood test form so he is due to have another this week. I am just worried that with the urine retention and the need for a catheter, if he was to have any cancer it could be advanced. He has a lot of pain in his leg and back and of course, this is speculation but I would worry that could be caused by a spread to his bones. - However would that not have been picked up by an MRI Scan?

I was hoping someone could offer some reassurance that I could feed to my dad to encourage him to go for the biopsy.

Thanks in advance for any replies.

User

Posted 05 Oct 2020 at 13:46

Running

He obviously needs to get the retention issue sorted, have they offered a long term solution to that.

Do you know what sort of biopsy is being offered.

Trus biopsy involves a probe up the back passage.

""Transperineal template biopsy of the prostate involves using a grid (or template) to insert several fine needles through the skin in the area between the scrotum and the anus (the perineum) into the prostate gland in order to obtain several tissue samples for testing.""

Is the reluctance to have the biopsy a dislike of surgery or the indignity of having a trus biopsy. The transperineal biopsy is considered by many as the gold standard , I had a trus biopsy and described it as a walk in the park.

Having been prodded and probed numerous times for bladder and bowel issues over the last six years, I no longer get embarrassed by what happens.

Might be worth taking to the nurses on this site on the number at the top of the page.

Thanks Chris

Edited by member 05 Oct 2020 at 13:50 | Reason: Not specified

User

Posted 05 Oct 2020 at 19:44

I can see why he might be reluctant to have radical treatment - my father-in-law diagnosed at 79 refused any treatment that would affect his sex life and my dad - dealing with a recurrence in his 80s - has also decided that quality of life is the most important thing at this time.
However, quality of life may be your in-road with your dad - assuming he is diagnosed, they may offer him hormone treatment without anything too radical in the way of other treatments and you may be able to persuade him that the hormones might reduce his prostate size enough for urination to become comfortable again.

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

User

Posted 06 Oct 2020 at 07:49

A biopsy is really nothing to worry about - the anticipation is vastly worse than the actual experience. I had both an initial TRUS biopsy and a subsequent template biopsy. The TRUS, which you're awake for, certainly involved a loss of dignity but in terms of discomfort is on a par with having a filling at the dentist. A template biopsy is done under general anaesthetic and you know nothing about it. Discomfort subsequent to the biopsy is minimal for both.

Best wishes,

Chris

User

Posted 06 Oct 2020 at 14:04

The TRUS biopsy is not pleasant, but not too painful - more uncomfortable, and certainly not very dignified! After it is done, you have to wait for a while, until you prove you can pee. I had a shock when I went to do so, because what came out was a big blood clot, which is apparently quite normal. The blood in urine lasted for a few days.
Hermit.

User

Posted 08 Oct 2020 at 21:27

Hi All

Thanks so much for your replies, I passed this info on to my Dad and with some strong encouragement he went for his bopsy today, he actually said that it wasn't as bad as he had built it up to be and the nurses took really good care of him. Now it's just the waiting for the results. I imagine, this might take a while longer due to Covid.

Would anyone be able to tell me about the diagnostic process, is it usual to have a MRI and then a Biopsy? I was thinking that, the dr would be able to tell for certain if he had cancer from the MRI but that is obviously not the case, or there would be no need for the biopsy. If it does come back as cancer, what are the usual next steps, a bone scan?

Thank you.

User

Posted 09 Oct 2020 at 08:52

Glad the biopsy wasn't as bad as he feared.

Its very easy to get ahead of yourself with these things. The results from the biopsy should at at least let your dad know what he is dealing with. It may, or may not come back as PCa. IF it is PCa then he should know how extensive it is (number of cores, % in cores) and also the Gleason grade- 3+3, 3+4, 4+4 etc.

He can then think about options which could be far ranging.

User

Posted 09 Oct 2020 at 12:01

Best practice is to have an MpMRI first, and if it shows anything suspicious a biopsy and bone scan should follow in short order.

Let’s hope Dad is clear of cancer, but if not it’s a probably treatable level, which will see him die in his old age of something else, like most here expect to do.

Best of luck to him.

Cheers, John.

Edited by member 11 Oct 2020 at 02:57 | Reason: Not specified

User

Posted 09 Oct 2020 at 12:18

The MRI before biopsy is more common now than it was a few years ago. The MRI may show areas of interest or nothing and depending on the procedure can help target the biopsies to where the suspect areas may be. It may also show suspicious things outside the prostate. I got my biopsy result a week after the procedure,it may take longer at the moment.

After my diagnosis of PCa I had a bone scan and CT scan to check for spread. Again not all hospitals have the same protocol.

One thing this disease teaches you is patience.

Hope all goes well.

Thanks Chris

Edited by member 09 Oct 2020 at 12:19 | Reason: Word corrected

User

Posted 10 Oct 2020 at 10:48

Normal procedure these day is to have an MRI and then a biopsy. If the biopsy shows cancerous cells, then a bone scan to check for spread of the cancer, and only then will treatment options be discussed. Unfortunately it is a slow process - in my case it took about two months from initial diagnosis to discussions of treatment (although that was partially because my scans showed that I also had a kidney tumour 😁). The waiting is the hardest thing for many people. Just a case of getting through it a day at a time.

In my own case here I am two and a half years later, minus a kidney and with a thoroughly irradiated prostate, but leading a happy and healthy life!

Very best wishes,

Chris

User

Posted 10 Oct 2020 at 17:08

I think the responses above are correct for those people - in many areas of the country, a bone scan will be done if the biopsy is positive. However, that isn't the case in all parts of the country - NICE guidance says that a bone scan should only be offered if the biopsy & other diagnostics suggest a moderate to high risk cancer or there is reason to suspect that bone mets are present.

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

User

Posted 11 Oct 2020 at 03:11

Why are there these postcode lotteries?

It’s supposed the be the National Health Service not the Local Health Service whose services depend on the whim of a Chief Executive of the trust on 150 grand plus, as to how he (or she, see how PC I’ve become?) decides to spend OUR money.

When I read of the hassle some guys have to get a PSA test it makes my blood boil.

I’d contact the Health Secretary but he seems preoccupied with perpetuating the Pandemic Plague Paranoia at present.

Cheers, John.

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My dad's journey so far - worried about biopsy

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