worrying unnecessarily?

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User

Posted 28 Apr 2024 at 15:01

I'm now 10 weeks post my RARP surgery and in two weeks time I'll have my first PSA test followed a week later by a meeting with the surgeon that did my operation. My biopsy was gleeson 3 + 4 I was told at one hospital by the cancer nurse that the cancer was confined to one side of the prostate, but immediately before the operation the surgeon told me that it was actually throughout the gland. I'm concerned that after the biopsy and before my surgery, unlike many on this forum, I didn't have any kind of scan to see if the cancer had spread at all. I've also read of some having undetectable PSA post op but despite this the cancer had spread. Assuming, fingers crossed, that my PSA is "undetectable" should I ask the surgeon if I could have a scan to be absolutely sure (as far as it's possible) that it's gone?

User

Posted 28 Apr 2024 at 19:56

Surely you must have had an mpMRI scan before your biopsy. That's standard procedure. Unless you are paying private I doubt very much whether the NHS would provide a PSMA PET under those circumstances. Even if you did go down that route you still couldn't be absolutely sure you are cancer free. I've not heard of a case with an undetectable PSA and cancer being present but I could be wrong.

User

Posted 28 Apr 2024 at 20:15

Looking at your previous posts, you had both an MRI and several (?) detailed CT scans as part of your diagnostic path? Not everyone has a nuclear bone scan; the hospital where I was treated preferred to do an in-depth MRI scan instead. I'm sure that some sort of scan to check for bone mets will have been done. It's a standard part of the diagnostic process.

Best wishes,

Chris

Edited by member 28 Apr 2024 at 20:16 | Reason: Not specified

User

Posted 12 May 2024 at 11:46

Hi Chris

Thank you for your reply, I can see that I really wasn't very clear in my post describing what had happened so far. I did of course have an MRI before my biopsy, but after the biopsy confirmed cancer was present I didn't have another scan, bone or otherwise, to see if it had spread, like quite a few others on the forum have. I probably really am worrying unnecessarily, anyway I have a meeting with my surgeon tomorrow so I'll know more soon.

User

Posted 12 May 2024 at 11:55

Hi Chris

Thank you for your reply, you've may have seen my reply to the other Chris on the forum. I really made a bad job of explaining what had happened so far. I had an MRI and then a biopsy which confirmed I had cancer, my concern was that unlike some on the forum I haven't had any further kind of scan to see if it had spread. You're quite right I did have two CT scans, these were prior to my prostate cancer diagnosis, I wasn't told at the time but have since found out that these scans were of my urinary tract, as the consultant had suspected at that time I may have had kidney cancer which thankfully I didn't.

User

Posted 12 May 2024 at 11:57

Originally Posted by: Online Community Member

I have a meeting with my surgeon tomorrow so I'll know more.

Best of luck mate.

User

Posted 12 May 2024 at 12:02

It may depend on the MRI results. I was T2cN0 and went straight to RALP without any further scans. Am now 4 weeks post-op awaiting follow-up PSA and results 🤞

User

Posted 13 May 2024 at 10:14

I do think you may be worrying unnecessarily.

My understanding with the NHS is that for those with G3+4 ratings at diagnosis additional tests are NOT required because the like of any spread is HIGHLY unlikely. I was G4+3 and therefore THEY WERE. I was put on a medical trial where I had both PSMA PET CT and MRI scans to see if there was any spread. Blessedly there wasn't and post op the pathology proved this to be accurate. In fact the designated lesion was actually smaller than had been reported at the time of the biopsy. Happily all was well confined with the prostate capsule; there were no additional findings in terms of the cancer and all surgical margins were clear. I, too, am awaiting my first PSA - which I'm planning to have done either tomorrow or Wednesday.

All best wishes with your treatment.

Edited by member 13 May 2024 at 10:16 | Reason: Not specified

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