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New M4 lesion diagnosis

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User
Posted 26 Jul 2022 at 23:08

Hi


I’m a 62 year old male. I was diagnosed 7 years ago with Benign prostatic hyperplasia. Ever since I’ve been having a ix monthly PSA tests, all regularly below 1.


In the last year have had two bad bouts of UTI’s requiring multiple courses of antibiotics and my PSA spiked to 4. It’s ow settled back into the upper 2’s.


I’ve had an Ultrasound and my bladder function is normal.


I’ve had a contrast MRI which found a 15x12mm M4 lesion in the lower left of the prostate. I was given the news yesterday afternoon.


I’ve just had a Cystoscopy which showed nothing but some minor misshaping of the prostate. Everything else was good.


I’m now waiting for an appointment for a biopsy. 


I’m a little frightened but trying not to get ahead of myself or worry too much - but I have no-one to talk to. My partner has gone into denial mode, refusing to acknowledge the lesion is more likely to be cancerous than not, hasn’t mentioned the results or even asked me how I am (after the Cystoscopy) in the last 24 hours. I’m being treated at Addenbrookes.


Anyone got any advice or know what form the biopsy is likely to take?

User
Posted 27 Jul 2022 at 00:17
Your biopsy is likely to be either a template biopsy taken through your perineum (under general anaesthetic or local) or an image guided TRUS biopsy taken through the bowel wall and using a scanner to guide the needles to the suspicious area.

I think you are right not to panic yet - the misshape is a little bit concerning but an M4 lesion could be the remains of the inflammation ... a scan cannot always tell the difference between cancer, bruising and infection.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 27 Jul 2022 at 07:37

Both TRUS and Template biopsies are on the way out.


It's most likely to be an LATP (local anesthetic transperineal biopsy).

User
Posted 27 Jul 2022 at 11:43
Re tailbone highly unlikely with that PSA.

You need to get the investigation concluded, save your worry until you know what to worry about.
User
Posted 27 Jul 2022 at 11:56

I worried about every little thing before my husband was properly diagnosed….I still do to be honest. I think it’s very normal to feel like that. I’m sure everything will be ok and not nearly as bad as you fear….this was definitely the case for us. Although I would have preferred for him not to have PCa I am so grateful that a year on he’s doing and feeling pretty good.


Best of luck to you 

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User
Posted 27 Jul 2022 at 00:17
Your biopsy is likely to be either a template biopsy taken through your perineum (under general anaesthetic or local) or an image guided TRUS biopsy taken through the bowel wall and using a scanner to guide the needles to the suspicious area.

I think you are right not to panic yet - the misshape is a little bit concerning but an M4 lesion could be the remains of the inflammation ... a scan cannot always tell the difference between cancer, bruising and infection.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 27 Jul 2022 at 07:37

Both TRUS and Template biopsies are on the way out.


It's most likely to be an LATP (local anesthetic transperineal biopsy).

User
Posted 27 Jul 2022 at 09:36

Thx.


The result was “Prostate: normal but slightly occlusive”. Why might this be a cause for concern?


I’ve also been complaining of a pain at the very base of my tailbone for six months plus. Everyone says I’ve probably just bruised it but with this diagnosis my mind is going into overdrive and I’m wondering/worrying if it could be indicative of any cancer spreading. Any thoughts?

User
Posted 27 Jul 2022 at 11:43
Re tailbone highly unlikely with that PSA.

You need to get the investigation concluded, save your worry until you know what to worry about.
User
Posted 27 Jul 2022 at 11:56

I worried about every little thing before my husband was properly diagnosed….I still do to be honest. I think it’s very normal to feel like that. I’m sure everything will be ok and not nearly as bad as you fear….this was definitely the case for us. Although I would have preferred for him not to have PCa I am so grateful that a year on he’s doing and feeling pretty good.


Best of luck to you 

 
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