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Biopsy is on the cards!

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User
Posted 08 Nov 2020 at 20:17

Hello,


Iv'e been having the usual investigative procedures for Prostate Problems from feb2020  after having the classic 


urinating more probs with frequency/flow etc.  2 DRE both normal flow test 


Diagnoses   Rising PSA.  MRI  No high grade or large volume disease ,35cc prostate (PiRADs 1)


PSA Test levels 7.0 FEB.      8.4 August.      9.7 september 


I had another PSA Test in October and will be discussing this on tuesday via telephone call with consultant


and the recommendation  is if PSA Remains elevated at PSA 9.7 Or has increased then they will send me 


for an urgent LATP  Biopsy,although the MRI Scan came back satisfactory .


First of all What does the LA stand for in the LATP? I know that the TP Is transperineal


And secondly what can i expect from this procedure in terms of risk/benefits etc


worried about the procedure because of infection risk!


thankyou

User
Posted 08 Nov 2020 at 23:09

Hi sorry you are here. 


I hadn't heard the initials latp before, but a Google search through up, local anaesthetic trans perennial biopsy. 


The benefit is that you will have a far better idea of what is going on. The risks are not too great, the older Trus biopsy involved shoving needles through bowel in to prostate, which had a moderate infection risk, latp is a lot safer as it is not going near the rather dirty bowel. Latp is also more accurate as they take more samples. 


You will find a few posts from people who have had Latp biopsy, they mention bruising, blood in urine semen etc. Not too pleasant but not unbearable. 


I hope all turns out well for you keep us informed. 


 

Dave

User
Posted 08 Nov 2020 at 23:10

John,


LA = Local Anesthetic.


LATP has replaced TRUS biopsies, and has at least a 30x lower infection risk, and can access the whole prostate (which TRUS can't). Many places which have switched to LATP have had no infection cases at all, so I think you don't need to worry about infection risk. It has also replaced some transperineal template biopsies (although it's not a template biopsy).


A biopsy is the only way to diagnose prostate cancer (unless it's spread so widely it's unmistakable in MRI or bone scans). If cancer is found, the biopsy will give the Gleason score (or Gleason Grade) which is a measure of the aggressiveness of the cancer, and also where it's located in the prostate, so it's the key diagnosis procedure.


It typically takes about 3 weeks to get the results, and that's usually an anxious time.


You may also be asked to have a nuclear bone scan to check for any spread. This doesn't mean they suspect any spread, it's routine in many hospitals.


The biopsy will cause blood in semen and urine. The semen in particular can look just like tomato ketchup - that's normal, don't worry. However, it's very alarming if you haven't been warned to expect it beforehand. Blood in urine is usually very minor.

User
Posted 10 Nov 2020 at 13:33

According to the PCUK interactive map, Maidstone does have mpMRI facility but is not meeting the PROMIS standard:-


https://prostatecanceruk.org/about-us/projects-and-policies/mpmri


Medway NHS Trust is next door and apparently rather better :-/ 


 


 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Nov 2020 at 17:08
Perhaps Maidstone hospital is in Medway trust ... Maidstone & Tunbridge NHS Trust is the one that is not working to PROMIS standard, according to PCUK
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 18 Nov 2020 at 21:01

Oh what a shame but good that your new appointment is just around the corner. Good luck.

User
Posted 01 Dec 2020 at 15:36
That's great to hear. Yes, the anticipation of the biopsy generally is much worse than the actual event. You'll be black and blue for the next few days, but that'll probably be the worst it gets.

Best wishes,

Chris
User
Posted 02 Dec 2020 at 07:29
Hi Van 64,
In the last 4.5 years I have had 3 biospies whilst being under active surveillance and these were Ultra sound guided transrectal.
The first was 10 samples and the following two were 20. Both under local aneasthetic and to be honest I think I have had worse at the dentist (although I was in a different postion hahaha).
When I had the second one done I told the nurse not to tell me when she was going to take another sample as you automatically tense yourself whereas if they just get on with it before you know where you are at its all been done.
As previously explained there is not a great deal of pain afterwards more for me more of a dull ache as if I had been kicked in the nether regions. I found the after effects ie blood in your pee more disturbing so to counter this just sit when you need a pee, you dont need to luck. In the semen it starts bright red, changes to brown and eventually clears.
Try not to worry as the procedure is not as bad as it sounds and its the only way to get acurate results which is what you want

all the best
User
Posted 09 Dec 2020 at 23:40
The cramps and churning are almost certainly anxiety - these are not symptoms associated with PCa or mets.

Bit concerned that you have decided on the op so quickly - you have only just been diagnosed so have you had chance to talk to an oncologist as well before making such a big decision?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Dec 2020 at 00:22
Yes, as Matron says, do discuss the matter with an oncologist as to the pros and cons of surgery versus hormone and radiotherapy treatments.

Most prostate cancers are very slow growing, so there’s no rush. I waited seven months between diagnosis and surgery, and saw two surgeons and two oncologists for second opinions.

Best of luck.

Cheers, John.
User
Posted 10 Dec 2020 at 07:36

Hi


 


I totally agree with the comments you seem to have made a decision very quickly on what course of action to take.    My consultant that I have been under while under surveillance also suggested surgery but then he is a surgeon, there was no pressure at all and he also referred me to an an oncologist and that is the route that seems a better option for me, (we are all different and its hard a decision but now that I have made that decision I feel a lot better to be honest).    The logic in me kept saying "Get it out" then its all gone but then the oncologist pointed out that it's always possible for tissue to be left behind during surgery.  Nothing can be guranteed I guess but radiotherapy can also be the solution.     Stereotactic Radiotherapy has been recommended for me based on my results which do not seem dissimilar to yours 


All the very best mate


 

User
Posted 10 Dec 2020 at 12:57

Hi John


See my profile, as others state, please don't rush.  Have you discussed with partner and fully understand implications. 


I've just read your profile, Biopsy ? 30/11 ?  How are you feeling in general ?


Any temperature ?


I assume you are fit and well previously. Eating as normal ?


 


Hope this helps..


Gordon


 


 


 


 

User
Posted 10 Dec 2020 at 19:52
Surgeons are always keen to wield the knife, because that’s what they do. I’d add to the recommendations that you ask for an appointment with an oncologist to discuss non-surgical options. There’s no hurry to make a decision here, and your choice will have lifelong consequences. Don’t rush it.

Best wishes,

Chris
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User
Posted 08 Nov 2020 at 23:09

Hi sorry you are here. 


I hadn't heard the initials latp before, but a Google search through up, local anaesthetic trans perennial biopsy. 


The benefit is that you will have a far better idea of what is going on. The risks are not too great, the older Trus biopsy involved shoving needles through bowel in to prostate, which had a moderate infection risk, latp is a lot safer as it is not going near the rather dirty bowel. Latp is also more accurate as they take more samples. 


You will find a few posts from people who have had Latp biopsy, they mention bruising, blood in urine semen etc. Not too pleasant but not unbearable. 


I hope all turns out well for you keep us informed. 


 

Dave

User
Posted 08 Nov 2020 at 23:10

John,


LA = Local Anesthetic.


LATP has replaced TRUS biopsies, and has at least a 30x lower infection risk, and can access the whole prostate (which TRUS can't). Many places which have switched to LATP have had no infection cases at all, so I think you don't need to worry about infection risk. It has also replaced some transperineal template biopsies (although it's not a template biopsy).


A biopsy is the only way to diagnose prostate cancer (unless it's spread so widely it's unmistakable in MRI or bone scans). If cancer is found, the biopsy will give the Gleason score (or Gleason Grade) which is a measure of the aggressiveness of the cancer, and also where it's located in the prostate, so it's the key diagnosis procedure.


It typically takes about 3 weeks to get the results, and that's usually an anxious time.


You may also be asked to have a nuclear bone scan to check for any spread. This doesn't mean they suspect any spread, it's routine in many hospitals.


The biopsy will cause blood in semen and urine. The semen in particular can look just like tomato ketchup - that's normal, don't worry. However, it's very alarming if you haven't been warned to expect it beforehand. Blood in urine is usually very minor.

User
Posted 10 Nov 2020 at 12:06

Hello,


I had my Telephone appointment this morning with My urology Consultant  who informed me that my Last PSA


Test has remained the same with 9.7 so the next course of action is to go ahead with the LATP Biopsy at the 


Maidstone Hospital sometime in December.


I am not sure how good they are at Maidstone for these types of procedure, anyone who has personal 


experience at this Hospital?


many Thanks

User
Posted 10 Nov 2020 at 13:33

According to the PCUK interactive map, Maidstone does have mpMRI facility but is not meeting the PROMIS standard:-


https://prostatecanceruk.org/about-us/projects-and-policies/mpmri


Medway NHS Trust is next door and apparently rather better :-/ 


 


 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Nov 2020 at 16:21

Hello Lyn,


Thanks for this info. I did Have my MRI Scan in Pembury Hospital ,Tunbridge wells back in February


Part of the same NHS Health Trust as Maidstone Hospital ,not sure what type of MRI Scan it was though!


many thanks

User
Posted 10 Nov 2020 at 17:08
Perhaps Maidstone hospital is in Medway trust ... Maidstone & Tunbridge NHS Trust is the one that is not working to PROMIS standard, according to PCUK
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 18 Nov 2020 at 16:38

Hello,


A quick update , i was sent home from work yesterday due to me working with a student who tested


positive with covid so i now have to self isolate, And the NHS Track and trace app does work because it


flashed.  up an alert to tell me i need to self isolate for 10 days!


Then this morning my  wife answered the phone to a Urologist Specialist nurse from the Maidstone hospital


to offer me My prostate Biopsy Tomorrow!  that would have been perfect 😆


I told him i was self isolating , so he booked me for the 30th😀


Wiil update you 


 


 

User
Posted 18 Nov 2020 at 21:01

Oh what a shame but good that your new appointment is just around the corner. Good luck.

User
Posted 30 Nov 2020 at 16:05
Had my Prostate Biopsy today all went well, a liitle bit sore and procedure wasnt as bad as i expected

Very quick proffessional turnaround at maidstone hospital staff were fantastic, i am back home with at least another

2 days off work yipee! Have my follow up with results next monday , so again very quick.

will update. best wishes to all
User
Posted 01 Dec 2020 at 15:36
That's great to hear. Yes, the anticipation of the biopsy generally is much worse than the actual event. You'll be black and blue for the next few days, but that'll probably be the worst it gets.

Best wishes,

Chris
User
Posted 02 Dec 2020 at 07:29
Hi Van 64,
In the last 4.5 years I have had 3 biospies whilst being under active surveillance and these were Ultra sound guided transrectal.
The first was 10 samples and the following two were 20. Both under local aneasthetic and to be honest I think I have had worse at the dentist (although I was in a different postion hahaha).
When I had the second one done I told the nurse not to tell me when she was going to take another sample as you automatically tense yourself whereas if they just get on with it before you know where you are at its all been done.
As previously explained there is not a great deal of pain afterwards more for me more of a dull ache as if I had been kicked in the nether regions. I found the after effects ie blood in your pee more disturbing so to counter this just sit when you need a pee, you dont need to luck. In the semen it starts bright red, changes to brown and eventually clears.
Try not to worry as the procedure is not as bad as it sounds and its the only way to get acurate results which is what you want

all the best
User
Posted 09 Dec 2020 at 21:29

update Biopsy follow up


Have just been diagnosed with early localised PC  Gleason 3+4 


Still in a state of shock!


Plan is to have a RALP Radical prostatectomy can be as soon as end of this month 


at the Eastbourne hospital, my wife will be staying at a hotel, so not ideal but the consultant only


runs this procedure in Eastbourne and not the Maidstone hospital where he heads the Urology team.


I am having very bad lower stomach cramps wind and constipation and churning not been to the loo for 4 days now


lost my appetite today and have a GP visit about these symptoms tomorrow , very worried about these additional symptoms  to deal with.


Would really be grateful  for any advice  / info on personal experiences  etc


 


many thanks

User
Posted 09 Dec 2020 at 23:40
The cramps and churning are almost certainly anxiety - these are not symptoms associated with PCa or mets.

Bit concerned that you have decided on the op so quickly - you have only just been diagnosed so have you had chance to talk to an oncologist as well before making such a big decision?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Dec 2020 at 00:22
Yes, as Matron says, do discuss the matter with an oncologist as to the pros and cons of surgery versus hormone and radiotherapy treatments.

Most prostate cancers are very slow growing, so there’s no rush. I waited seven months between diagnosis and surgery, and saw two surgeons and two oncologists for second opinions.

Best of luck.

Cheers, John.
User
Posted 10 Dec 2020 at 07:36

Hi


 


I totally agree with the comments you seem to have made a decision very quickly on what course of action to take.    My consultant that I have been under while under surveillance also suggested surgery but then he is a surgeon, there was no pressure at all and he also referred me to an an oncologist and that is the route that seems a better option for me, (we are all different and its hard a decision but now that I have made that decision I feel a lot better to be honest).    The logic in me kept saying "Get it out" then its all gone but then the oncologist pointed out that it's always possible for tissue to be left behind during surgery.  Nothing can be guranteed I guess but radiotherapy can also be the solution.     Stereotactic Radiotherapy has been recommended for me based on my results which do not seem dissimilar to yours 


All the very best mate


 

User
Posted 10 Dec 2020 at 12:57

Hi John


See my profile, as others state, please don't rush.  Have you discussed with partner and fully understand implications. 


I've just read your profile, Biopsy ? 30/11 ?  How are you feeling in general ?


Any temperature ?


I assume you are fit and well previously. Eating as normal ?


 


Hope this helps..


Gordon


 


 


 


 

User
Posted 10 Dec 2020 at 19:52
Surgeons are always keen to wield the knife, because that’s what they do. I’d add to the recommendations that you ask for an appointment with an oncologist to discuss non-surgical options. There’s no hurry to make a decision here, and your choice will have lifelong consequences. Don’t rush it.

Best wishes,

Chris
User
Posted 10 Dec 2020 at 22:01

Hi there Gordon


Thanks for taking the time to reply to me. When I posted on here yesterday I was very overwhelmed and shocked and was being too hasty in retrospect. Thanks for advising me to take a breath and think it over more. So yes, my wife and I have discussed it at length and we both initially felt that the operation is probably the way to go but I do need to consider the other options and so can talk to an oncologist soon, which I will do.


My general health is good and I eat a healthy and well balanced diet, and no I don't have a temperature, why do you ask? What I'd like to know is what are the implications of having surgery long term, this is what would help me because I'm worried about the leakage potential, how was and is this for you? I am 56 years of age and have been married for 30 years, my wife is aware of the implications (we think) it would help me to know how having the surgery has changed things for you in terms of having to wear pads etc, which I have to say really concerns me?


Thanks in advance for your reply.


 


 

 
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