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Elderly dad with prostate symptons

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User
Posted 21 Sep 2022 at 05:33
Hi, I am posting here for the first time so please take time to read and offer any suggestions.

Dad is 69 years old. He has had problem urinating for past 6 to 12 months. He was not aware of enlarged prostate until a cardiologist did routine PSA test and result was 33.2. He was referred to Urologist. An ultrasound report has suggested Moderatly Enlarged Prostate and a stone in the right kidney.

He has number of issues but does not complain.

1- has had heart attack back in 2009 and a stent

2- Diabetic

3- has had arm surgery and metal object in his arm due to which Dr thinks MRI could not be done.

A DRE was done and doctor says he did not get any nasty feeling don't know what this means and suggested for a TURP guided biopsy.

Any suggestions would be highly appreciated. Unfortunately he lives on his own in Pakistan and is quite scared as to what happens next.

User
Posted 22 Sep 2022 at 09:22

On a point of fact, Dave, I had an MRI even though I have 2 metal pins in a finger due to a spiral fracture that I incurred falling down an escalator in London some 20 years ago. Now, the pins are not that large and when I mentioned them to the consultant he said they would not stop me having the MRI scan.

 

Ivan

User
Posted 22 Sep 2022 at 10:01

Metal implants in bone are usually titanium because bone fuses very well with the thin oxide layer on it, whereas it won't fuse with most metals.

Titanium won't prevent MRI scans, but it will cause artifacts in the images which lower the quality of the images in tissues nearby. If the titanium is in an arm and they're imaging the abdomen, they might request he holds the arm above his head rather than having it alongside the body.

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User
Posted 21 Sep 2022 at 20:44

The DRE being ok is possibly good news the PSA being quite high possibly bad news. I assume you meant TRUS guided biopsy (trans rectal ultra sound). TURP is an operation to open out the prostate and make peeing easier, though I think they then test what they have removed so I guess either is possible.

MRI with metal in the body is almost certainly not possible. I guess a nuclear bone scan could be done to see if it has spread to the bones, but this should be post biopsy.

Until the biopsy results come back it is not worth making predictions. At his age he almost certainly has cancer most men do, the question is will it kill him before something else does? In the UK if his life expectancy were less than ten years they are reluctant to treat aggressively. I suspect the heart and diabetes are sufficiently under control that they won't kill him soon. So await the biopsy results and see what they say.

Dave

User
Posted 21 Sep 2022 at 21:32
In view of peeing problem, a TURP might well be a possibility.
Barry
User
Posted 21 Sep 2022 at 21:47
Roughly 70% of men your Dad’s age do have prostate cancer, and almost every man has it by his 80s, but that doesn’t mean that treatment is required or beneficial. A biopsy would be a sensible next step: looking at cells under a microscope is the only way to know if cancer is present and, if so, how aggressive it is. I note that you say an MRI can’t be done because of metal in his body; an alternative would be a CAT scan if that’s available where he lives?

Best wishes,

Chris

User
Posted 22 Sep 2022 at 09:22

On a point of fact, Dave, I had an MRI even though I have 2 metal pins in a finger due to a spiral fracture that I incurred falling down an escalator in London some 20 years ago. Now, the pins are not that large and when I mentioned them to the consultant he said they would not stop me having the MRI scan.

 

Ivan

User
Posted 22 Sep 2022 at 10:01

Metal implants in bone are usually titanium because bone fuses very well with the thin oxide layer on it, whereas it won't fuse with most metals.

Titanium won't prevent MRI scans, but it will cause artifacts in the images which lower the quality of the images in tissues nearby. If the titanium is in an arm and they're imaging the abdomen, they might request he holds the arm above his head rather than having it alongside the body.

User
Posted 22 Sep 2022 at 11:42

Thanks Ivan, Andy, always good to add to my knowledge.

Dave

 
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