Active monitoring MRI results waiting time

"Thank you for attending for multi parametric surveillance MRI of your prostate. This shows changes, which suggest a more significant cancer than your known grade group 1 (Gleason 3+3) cancer. In light of this I recommend transperineal biopsy, which I have booked for you. [Next Monday]."

So, on we go.

I continue to be concerned about the fact that urologists and cardiolgists can't definitively agree on how to handle atrial fibrilation patients like me who are on Apixaban or other anticoagulants.

My first biopsy led to the worst medical trauma I have ever experienced. Who knew that not being able to pee because there were blood clots in your bladder could be so painful. My wife had to rush me to A&E and I spent four extremely distressing days lying in a pool of my own blood in a hospital bed sporting the thickest of catheters (a 'three-way' used for pumping out the bladder, which is as horrible as it sounds.

So I will ask "what's the alternative?" but also "could the biopsy lead to anything other than a decision to remove my prostate?" Frankly, I have lived with the possibility of a prostatectomy for more than four years (my brother had his five years ago). I'm now 73 and somewhat resigned to this anyway.

Thanks again for your help and encouragement.

Stephen

Hi again, Stephen.

Like you, I've got a family history of prostate cancer. My dad, had it, and both me and my younger brother were diagnosed with the disease. My brother opted for radiotherapy and hormone treatment. Six years later he's fine, and has had no recurrence. 

I went on active surveillance. After a couple of years they discovered significant disease progression. I ended up having robotic surgery. Three years after the operation, I'm doing fine and have, touchwood, had no recurrence

If you read my profile and this link, you'll see my PCa history.

https://community.prostatecanceruk.org/posts/t30214-Almost-a-year-on-after-RARP

I must emphasis that I'm not medically trained, mate. The advice I give is purely based on my own experiences and what I've learned over the past few years, from reputable sources.

Your family history of the disease may increase your risk. In the grand scheme of things your PSA level is elevated, but not drastically so. For a man of your age, anything above about 6.5 is deemed abnormal. Elevated PSA can, and often is, due to other non-cancerous prostate conditions, like an enlarged prostate (BPH) prostatitis, and urinary infections.

Did your clinicians, rule out non-cancerous conditions for your PSA rise. If so, was that the reason they sent you for an MRI scan or was the scan a routine follow up as part of your active surveillance monitoring?

This MRI has shown ' more significant cancer than your Grade 1, Gleason 6 (3+3)'. This comment mystifies me. As far as I'm aware, an MRI scan can show apparent visible disease growth, but it can't show any difference to your the Grade or Gleason score. Only a biopsy can show histological changes. 

I'd have the biopsy, mate and wait for the results, before worrying about the need for any radical treatment.

The experience of your first biopsy is bound to make you anxious about another. If I were you, I'd ask to have one under general anaesthetic. It's how they did my second biopsy. I didn't feel a thing.

The biopsy will dictate whether you need further treatment, it may also conclude that you are safe to remain on active surveillance.

IF you need further treatment here is an excellent link to treatment options and possible side effects.

https://youtu.be/zYTU94-8pTc?si=1Z29_l8rbTwF6DHl

Good luck, mate, and please keep us updated. 👍

Edited by member 14 Nov 2025 at 11:25  | Reason: Add link