Negative Biopsy result - still worried - Worried about symptoms

User

Posted 11 Nov 2023 at 14:41

Hi All,

In 2017, following incontinence symptoms and raised PSA level, I had an MRI showing lesions at PIRADS 3. TRUSS biopsy found no cancer and I was discharged from urology with advice to have 4 monthly PSA checks (via GP surgery), and to refer back to urology should levels rise above 7.

Last month, after incontinence symptoms got much worse, and PSA rose to 7.5, I had an MRI which showed 9 mm growth with PIRADS score 4 and had a transperineal biopsy.

Good news is that yesterday I received a letter saying that the results were negative. I will be given another appointment at urology in three months time and have to take a further PSA test.

However, I’m still concerned, as the letter said; ‘no cancer found in any of the samples taken’, which I understand is something they have to say, but a comment by the doctor doing the biopsy, when he pointed out my prostate is huge and finding anything will be like searching for a needle in a haystack, makes me wonder if a cancer could have been missed.

I’m going to ring up the specialist nurse who sent me the letter next week to ask about it.

Has anybody got any suggestions as to what questions I might ask?

User

Posted 11 Nov 2023 at 20:54

The biopsy sampling will have been guided by the MRI image, so they will have taken samples from the area of suspicion shown on the scans. There are many possible causes for an increase in PSA; by the sound of it, it's unlikely to be cancer in your case. A repeat test in a few months sounds like a good plan.

All the best,

Chris

User

Posted 12 Nov 2023 at 00:31

The question is, did they manage to take cores from the suspicious area? When I was about to have a Template Biopsy prior to HIFU, I remember the urologist saying "it looks the size of a pea on the MRI and I will do well to hit it". He did on this occasion and I went on to have HIFU. At an estimated 9mm your possible cancer might be just as difficult to hit due to the size of your Prostate. More than one leading urologist has said the TRUS Biopsy is pretty useless so you have had one good biopsy. Do you know how many cores they took? We have had a member who had three biopsies before they got samples of his tumour but I can't remember which type(s) of biopsy was used. Hopefully you don't have a cancerous tumour but you might remember the forgoing and ensure you are carefully monitored.

Edited by member 12 Nov 2023 at 00:33 | Reason: repeated word

Barry

User

Posted 12 Nov 2023 at 08:38

Thanks Barry, I asked one of the nurses on here about it and she advised I should ask whether a ‘fusion’ biopsy was done, as apparently, they don’t do this at every hospital. If I understand it correctly what she said, this is where they superimpose the image of the MRI over the ultrasound imaging whilst doing the biopsy.

User

Posted 12 Nov 2023 at 14:45

This seems a great way forward. My second transperineal fusion biopsy was a fusion one but not done on my side, though done under local anesthesia, which seems better https://www.youtube.com/watch?v=4w48MlOj_a8

Edited by member 12 Nov 2023 at 14:55 | Reason: Not specified

Barry

User

Posted 12 Nov 2023 at 15:09

Thanks for the link - very interesting that and I’m more suspecting that the doctor’s comment that ‘it will be like finding a needle in a haystack’ indicates it was not a fusion biopsy.

The other thing that bothers me is that in 2017, when my PIRADS score was 3, the letter which included the MRI result contained the PIRADS score, whereas last month when they sent me the result of the MRI and the score was 4, they did not include it in the letter and I had to ring up the consultant’s PA to get it.

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Negative Biopsy result - still worried

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