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PIRAD4 awaiting biopsy

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User

Posted 03 Aug 2023 at 08:01

Hi I have just been told by my consultant that following a recent MRI that I have a 47mm prostate PIRADS 4 with lesions in bilateral peripheral zones? I have a transperineal biopsy booked for the 12th September under GA with my pre op on the 22nd August. Does the wait for the biopsy seem reasonable? I am naturally worried sick as my dad had PC. Any advice or steer would be great fully received.

Edited by member 03 Aug 2023 at 14:58 | Reason: Update

User

Posted 03 Aug 2023 at 19:44

Hi Conrad,

Sorry that you find yourself here.

It does seem strange that your pre-op. assessment is booked before your biopsy, but that might be because you are having the biopsy under General Anaesthetic, which may require more advance planning.

I know that it's easier said than done, but try to distract yourself from worry with pleasant activities between now and then.

Take good care of yourself.

JedSee.

User

Posted 03 Aug 2023 at 20:54

PCa is generally a slow growing cancer so apart from the mental worry of the waiting, the timeframe seems reasonable. Do you know why they chose to do transperinal rather than through the rectum?

User

Posted 03 Aug 2023 at 22:01

Hi I believe the risk of infection is lessened?

User

Posted 03 Aug 2023 at 23:11

Hi Conrad, sorry you’re here (in the nicest possible way!). My husband is just a bit ahead of you, only just diagnosed after biopsy on 4/7. His was TP too but under local. There is definitely a move towards TP biopsies rather than rectal for that exact reason, less infections.

Distraction is the best way to help the waiting worries! Good luck!

Debbie

User

Posted 04 Aug 2023 at 04:08

Originally Posted by: Online Community Member

Hi I believe the risk of infection is lessened?

Yes, good option for that reason and usually it will give a number of samples eg 40 in a grid pattern. Usually a local anaesthetic, sometimes a general, which is what I had and what you're about to get.

I had a rather alarming amount of blood in my urine and semen for some time afterwards but that's "normal" and nothing to worry about.

You will probably be given a bone scan, if you haven't had one already. It's precautionary only, so don't let it get to you.

More information needed to give a full picture and I'm wondering if you've been given a choice between radiotherapy and a prostatectomy?

Jules

User

Posted 04 Aug 2023 at 07:15

Hi jules

not got that far yet. I had two raised PSA scores of 5.7 and 6 which led to the MRI. The MRI results indicate somethings amiss with a PIRAD score of 4. Next step is the biopsy the date of which is the 12th Sept. My consultant urologist is conducting the transperineal biopsy under GA (I have gone private through my work insurance scheme) the consultant mentioned that this biopsy is normally done under local with the NHS. My concerns are is a 6 week wait for a biopsy the norm? Not sure on next steps until I have had the biopsy and received results.

User

Posted 06 Aug 2023 at 22:37

So that you're prepared for your "pre-op" there's a couple of possibilities that you can be ready to ask questions about. With PIRADS 4 there's a high chance of cancer. If that's the case ...

There's a chance that your cancer might have broken out of the prostate capsule, in which case you would most probably be limited to radiotherapy because a prostatectomy might not remove everything. This would also mean that you'd be put on hormone therapy before radiotherapy.

Alternately, if the cancer is contained, you could have a choice between a prostatectomy and RT.

Since you are covered by private health insurance you could ask if they would give you a PSMA PET scan. This can give clarity as to whether there's been any spread to nearby lymph nodes. You would need to have this scan before going on to HT because HT reduces the size of cancer bodies and hence makes small mets harder to pick up with a scan.

Jules

Edited by member 07 Aug 2023 at 00:36 | Reason: Not specified

User

Posted 07 Aug 2023 at 01:12

Hi Conrad,

I would think with you going private that seems quite a long time to wait for your biopsy. It may have something to do with having to have a pre op because of the GA? My husband on the NHS had his biopsy and bone scan 2 weeks after MRI confirmed PIrads 5. He didn’t have any anaesthetic though. We then waited 3 weeks for the results of biopsy and bone scan.

Wishing you the best of luck with your biopsy and hope it comes back negative 🤞🏼

User

Posted 07 Aug 2023 at 07:02

Thank you

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