No MRI scan

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User

Posted 05 Apr 2026 at 20:40

Hi,

I just wrote a long explanation, but my topic wasn’t posted - grrr!

I have a pacemaker and so can’t have an MRI. To cut a long story short, I was identified with a high PSA (18) four years ago. Following, I had a biopsy under local anaesthetic and had clear results. Four years of monitoring have followed and results have fluctuated between 14 and 19. Last autumn I had a result of 20 and in February my PSA result was 24.

I recently had a biopsy under general anaesthetic which returned a positive result of mostly Gleason 6 on the left side with some 7’s (3/4s) and, on the right side 8’s (4/4’s).

I seem to have jumped to a possible Stage 3 or Stage 4 spread (I am waiting for Nuclear test and CTC scan.

I wondered:

a) has anyone else with a pacemaker had a similar experience and

b) Can anyone give some ‘reassurance’ about the levels / staging?

I am now taking Bicaluticide (?) and with start hormone injections in a couple of weeks.

I look forward (I think) to responses.

Thanks,

Rich16

User

Posted 05 Apr 2026 at 23:09

Without some kind of scan it is impossible to know if it has spread. The two scans you have mentioned should answer that question.

PSA on its own is not too useful for diagnosis, but a series of tests, like you have, is a lot more useful. Though the PSA is moderately high, and once above 20 is considered high risk, the rate of increase has been quite slow, so it is probably not too aggressive, and that means on balance it has probably not spread, though as said earlier the scan results will tell you more.

I don't know if the pacemaker will rule out surgery? If you have radiotherapy, I don't know how they will do a planning scan.

I guess you have many questions for the oncologist.

Dave

User

Posted 07 Apr 2026 at 18:59

As said above they can't know if its spread without a scan. Probably they put you on hormones just in case.

The MRI magnetic field is very powerful and can suck metal out of your body. I read there is an MRI compatible pacemaker and I read that you can have CT scans with a pacemaker if it's controlled. Sometimes you can have PET scans if its done with extra controls. The best scan is a psma PET scan.

It sounds like you're a stage T2c/possibly T3. I was a T2a/possibly T3 and had surgery. After the surgery they will know with a psa test 8 weeks after the op. The NHS doesn't like to do surgery without evidence that it will probably be successful but there are theories that removing the main lesions can slow down any tendency to spread or develop.

On the other hand they've no evidence its spread so you could argue they should do the surgery because the slow increase suggests it hasn't spread.

I don't know if you can argue to have a CT Scan first or just to have surgery based on the lack of evidence its spread and any benefit of having surgery even if it has spread. You can only ask these things or perhaps pay to have it done if you have the money and think it worthwhile. Just a few thoughts. Peter

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