Originally Posted by: Online Community MemberThanks Lyn. There certainly seems to be a strong body of knowledge amongst the community members.
I'm interested as to why you think the DRE result is concerning. I guess it would help if I knew what "T2 disease" refers to !!
The MRI can see an area of suspicion and provide a likelihood that it is cancer but it can be wrong - the grey area could be cancer but it could be infection or bruising / bleeding. However, at DRE your doctor could feel something - either the right side of the prostate was hard or knobbly - and that indicates that cancer is present.
T2 means that from what the doctor could feel, he believes at the moment that the cancer has not broken out of the prostate wall into surrounding tissues (sometimes, the doctor can feel the cancer on the outside). The MRI also indicates that if it is cancer, it is still contained. Once you have a full set of diagnostics, the T levels are:
T1 - the cancer is too small to feel or see on an MRI
T2a - the cancer is only in one side of the prostate and is quite small
T2b - the cancer is in one side of the prostate but takes up more than 50% of that side of the prostate
T2c - the cancer is in both sides of the prostate
T3 - the cancer has broken through the prostate wall
T4 - the cancer has invaded other tissues nearby
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
It means that the MRI scan shows pretty strong evidence of a tumour that's confined within the right lobe of your prostate. Only a biopsy can confirm the definite presence of cancer and determine how aggressive it is, though.
Best wishes,
Chris
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Hi Alec, you are definitely in the right place. There are people on this forum with a lot of experience. Just wondering whether they have talked about giving you a bone scan. As Chris says the indications from the MRI is that the tumour is well within your prostate capsule, which is good news. The grading from MRI is not always entirely accurate so usually a precautionary bone scan is carried out. I expect your mind is all over the place at the moment (although you wouldn't think it from your post). Going through diagnosis is the worst period. Once you are through that and you have decided on your preferred course of treatment then you start to see a pathway through this. Chris
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No one is going to suggest a bone scan before the biopsy has been completed and cancer has been found. At this stage, it is still only suspected cancer although the DRE findings are concerning.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi,
T refers to the tumor size and location and T2 means in only one side of the prostate.
Lots of people here to provide advice and support. Welcome aboard.
Regards
John
User
My OH had his MRI and before they had given us any results we had a call to book a bone scan, after this we got a letter to say a biopsy had been booked aswell. So the biopsy and bone scan were done on consecutive days. His PSA was 8.3 and never had a DRE.
Alec, not sure if anyone else has mentioned but downloading the PCUK toolkit (or you can get it sent in the post) will help you make sense of your diagnosis and different treatment options.
All the very best to you x
Edited by member 28 Mar 2022 at 22:31
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User
Hi Alec. When you are being treated for PCa, exposing your bits and pieces to all and sundry becomes the new norm 😄 but that's good news on your results. It does seem your consultant is being very thorough. If things are not quite adding up it is good to be on the cautious side. You can rest easy for 12 months. Chris
User
Really good news, Alec. Delighted for you!
All the best,
Chris
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It means that the MRI scan shows pretty strong evidence of a tumour that's confined within the right lobe of your prostate. Only a biopsy can confirm the definite presence of cancer and determine how aggressive it is, though.
Best wishes,
Chris
User
Hi Alec, you are definitely in the right place. There are people on this forum with a lot of experience. Just wondering whether they have talked about giving you a bone scan. As Chris says the indications from the MRI is that the tumour is well within your prostate capsule, which is good news. The grading from MRI is not always entirely accurate so usually a precautionary bone scan is carried out. I expect your mind is all over the place at the moment (although you wouldn't think it from your post). Going through diagnosis is the worst period. Once you are through that and you have decided on your preferred course of treatment then you start to see a pathway through this. Chris
User
No one is going to suggest a bone scan before the biopsy has been completed and cancer has been found. At this stage, it is still only suspected cancer although the DRE findings are concerning.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
Just to say I had MRI, Bone scan, Biopsy & then PET- Scan!
User
It seems a different policy in my NHS Trust Lyn. My bone scan was booked in three days after the MRI, before any MRI results came through. I think this approach was based on the initial DRE (evidence of enlargement) and the PSA (36 with GP followed by 34 urology clinic). Chris
User
Originally Posted by: Online Community MemberNo one is going to suggest a bone scan before the biopsy has been completed and cancer has been found. At this stage, it is still only suspected cancer although the DRE findings are concerning.
Thanks Lyn. There certainly seems to be a strong body of knowledge amongst the community members.
I'm interested as to why you think the DRE result is concerning. I guess it would help if I knew what "T2 disease" refers to !!
Edited by member 28 Mar 2022 at 20:10
| Reason: Not specified
User
Hi,
T refers to the tumor size and location and T2 means in only one side of the prostate.
Lots of people here to provide advice and support. Welcome aboard.
Regards
John
User
Originally Posted by: Online Community MemberThanks Lyn. There certainly seems to be a strong body of knowledge amongst the community members.
I'm interested as to why you think the DRE result is concerning. I guess it would help if I knew what "T2 disease" refers to !!
The MRI can see an area of suspicion and provide a likelihood that it is cancer but it can be wrong - the grey area could be cancer but it could be infection or bruising / bleeding. However, at DRE your doctor could feel something - either the right side of the prostate was hard or knobbly - and that indicates that cancer is present.
T2 means that from what the doctor could feel, he believes at the moment that the cancer has not broken out of the prostate wall into surrounding tissues (sometimes, the doctor can feel the cancer on the outside). The MRI also indicates that if it is cancer, it is still contained. Once you have a full set of diagnostics, the T levels are:
T1 - the cancer is too small to feel or see on an MRI
T2a - the cancer is only in one side of the prostate and is quite small
T2b - the cancer is in one side of the prostate but takes up more than 50% of that side of the prostate
T2c - the cancer is in both sides of the prostate
T3 - the cancer has broken through the prostate wall
T4 - the cancer has invaded other tissues nearby
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
My OH had his MRI and before they had given us any results we had a call to book a bone scan, after this we got a letter to say a biopsy had been booked aswell. So the biopsy and bone scan were done on consecutive days. His PSA was 8.3 and never had a DRE.
Alec, not sure if anyone else has mentioned but downloading the PCUK toolkit (or you can get it sent in the post) will help you make sense of your diagnosis and different treatment options.
All the very best to you x
Edited by member 28 Mar 2022 at 22:31
| Reason: Error
User
Thank you for all your replies. Much appreciated.
Things are moving apace for me. I have heard from the hospital today. They have kindly arranged a transperineal biopsy for me next Wednesday (6th April). I cant really say its something on my bucket list but I guess I am looking forward to getting it done ..albeit with some apprehension.
User
Hope all goes well next week. Whilst it’s not on your bucket list, needs must and all of that. Once you have all the results of scans and tests you will be in a better position to get your head around it all. Lots of help and support on here x
User
@Alec_xx
I think it's generally accepted that the transperineal biopsy is a much better option than the usual TRUS biopsy. The pain/discomfort will be about the same but the chances of post-procedure infection are much lower.
User
Just a few steps ahead of you.
PSA 70, DRE hard on one side, MRI PIRADS 4.
Also did a CT scan and bone scan with both clear (prior to biopsy)
12 core TRUS biopsy confirmed cancer throughout prostate (mainly Grade Group 3) and waiting for open surgery in 3-4 weeks time.
I am still getting my head around it all. Wishing you the very best on your journey.
User
An update on what has proved to be quite a trying time.
I'm actually quite a laid back character and there isn't much that stresses me out. However, I was more than a little apprehensive about the transperineal biopsy and expected it to be painful.
I needn't have worried on that score as the procedure wasn't too painful but was quite uncomfortable.
However,I wasn't prepared to find, along with the urologist doing the procedure, two youngish looking nurses in the room.
I guess any ideas I had about preserving my modesty disappeared in seconds. Very embarrassing and I was cringing when one of the nurses applied some sticky tape in order to keep my bits and pieces out of the way. (patient modesty seems to be an oxymoron when it comes to prostate biopsies!!) Anyhow, embarrassment aside, a very pleasant nurse phoned me just over week later. She wasn't able to pass on results at that time but asked me to meet with the consultant.
Turns out my biopsy results were negative but the Consultant thought they shouldn't have been! I was invited to agree to further investigations once another few weeks had passed.
This turned out to be another transperineal biopsy and this one to be carried out under general anaesthetic.
The after effects of that second procedure were painful, definitely painful ... I felt as if Id been repeatedly kicked in the private parts. Everything is still a bit sore down there but there was good news.
No Cancer!! I
I haven't been discharged yet as there is much muttering about my still elevated PSA level and,apparently, I have significant inflammation of the prostate ... cause unknown ..and will receive ongoing treatment for that.
So it's not always bad news ...even if the Consultant thinks it should be. Take Care
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Forgot to say my Consultant thinks it would be a good idea, because of elevated PSA, to have a further repeat biopsy in about 12 months. I haven't decided yet but will probably agree .
User
Hi Alec. When you are being treated for PCa, exposing your bits and pieces to all and sundry becomes the new norm 😄 but that's good news on your results. It does seem your consultant is being very thorough. If things are not quite adding up it is good to be on the cautious side. You can rest easy for 12 months. Chris
User
You might ask for a PSMA PET scan. A bit unorthodox to do that with no diagnosis of PCa, but given they are clearly concerned, they might say yes.
User
Really good news, Alec. Delighted for you!
All the best,
Chris
User
Really good news Alec 👍 x