Advice, please

Thanks Dave, I had an MRI a year and a half ago,  and ut was fine but would that show up cancer? Can an enlarged prostate turn to cancer? Thanks again. 

An enlarged prostate, and prostate cancer, are almost nothing to do with each other. You can get both conditions. An enlarged prostate sometimes (but not always) generates side effects, but prostate cancer rarely causes side effects (at least not while in the prostate). I said they're "almost" nothing to do with each other, but actually you seem to be very slightly less likely to get prostate cancer if you have an enlarged prostate, but this is a minor effect, and plenty of men with enlarged prostates do also get prostate cancer.

I was assuming you are under your GP, but if you're already having Active Surveillance, then the followup would be by Urology.

A DRE (Digital Rectal Exam) is where a doctor's finger (digit) is inserted into your rectum to feel your prostate.

Why did you have the MRI scan? A standard MRI scan doesn't show prostate cancer very clearly, but if the scan was specifically to check for prostate cancer, a multi-parametric MRI scan would have been done which shows up suspicious areas of the prostate. MRI can't diagnose prostate cancer, just identify suspicious areas which might need more investigation.

A DRE is only a rough guide. An MRI will probably give more information but still not be definitive. Biopsies are where samples are taken from the prostate either using the TRUS system, where up to a dozen samples are taken from the prostate with probe that is inserted through the rectum. Template sampling takes around 30 samples from between the anus and the perineum, using fine needles. Anasthesia varies but a general is sometimes used for template biopsies.

A biopsy will be definitive in terms of any cancer in your prostate. There are other types of scan, like a PET PSMA scan which use markers injected into the bloodstream, which can be very helpful where cancer has spread beyond the prostate.

All the best for your next steps. It's impossible to know before you've had all the tests, where you stand but it's also excruciating waiting to find out, so don't jump to conclusions but do persist with your tests and follow up

Jules

Concentrate on that.

If you get a definite diagnosis the staging and Gleason grade will guide the most effective treatment options.