Has anyone had an MRI Scan before a Biopsy

User

Posted 25 Nov 2014 at 16:16

Thanks for the replies.

I now have my PSA result and it's 6.3 with my first visit to a Urologist scheduled for Friday.

User

Posted 26 Nov 2014 at 10:50

Hi All,

We had good news today, there was no obvious cancer on the MRI. Protate is enlarged and some small abnormalities on outer lobes but he feels it is inflammation. He has decided to put Stuart on a 2 month course of alpha blockers before checking his PSA again and if still raised he will then do a biopsy. He is concerned that his Kidney function is low so also referred to a Kidney specialist so hopefully that will be OK.

Thanks,

Trish

User

Posted 26 Nov 2014 at 23:13

Not sure I would be thrilled with this outcome Trish - what was the consultant's view about the symptoms such as pain and ED?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 27 Nov 2014 at 07:25

Hi Lyn,

He said these symptoms could be caused by enlarged prostate, he didn't say it wasn't cancer but feels it's more likely to be BPH hence going down the Alpha Blockers route first and then doing next PSA at end of January.He then said if still raised he would do a Biopsy possibly a Template one.

Hopefully this is not delaying the inevitable.

Thanks

User

Posted 28 Nov 2014 at 01:15

I hope the tablets work - my husband was on them from the age of 35. I just think that your OH is too young for ED to be considered a side issue.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 05 Feb 2015 at 19:39

Hi All, It's been a while but as usual I have been lurking on the forum every day!nAfter 2 months on Alpha Blockers (which didn't really help with symptoms) Stuart had his latest PSA results which were 3.5 (1st 3.33 and 2nd 3.82), his consultant was hoping it would have gone down to 1.5 if it was BPH so today he suggested the Template Biopsy as the next step. He is still having the back pain and toilet problems as well as the ED so I am relieved if a little scared that they are doing a Template Biopsy, at least hopefully we get an answer one way or another. Stuart is gone very quiet and has just gone for a pint to be on his own for a while not sure how he is going to deal with it if he is diagnosed with PCA, I have already lost a stone with worry as it's been such a long few months. Has anyone on here had a Template Biopsy, what were your experiences of it?

Thanks,

Trish

User

Posted 05 Feb 2015 at 21:16

Hi I'm just new.
Interesting treat as going now just through this. I must agree with all I read since 2011, TRUS Biopsies bring so many unknowns, so I support the 3T MRI. This whole PSA thing is a nightmare as even high readings bring no certainty. Had PSA, PSA Free, PCA3 tests, DRE's, MRI's with all in "equivocal" grey area, neither one nor the other. Even current MRI is score 8 and yet again can be inflammation or potential cancer. The one advantage I see is at least with MRI Guided Biopsy they can target exact area and know with more certainty. What happens with this information then is unknown, either to live with and do nothing as like most people live with....stress over many treatments or wait for improvements or risk and have some closure, this is the more worry. The only benefit I see from all these years is identifying any fast growing tumours and to mitigate this risk versus the low risk and then making decisions.
I pray and hope that the biopsy is the 80% benign and inflamed version.
Dean

My journey started in 2007, then PSA was 1.40
2009 Dec, had 4 hernias repaired which is only main change.
In 2010 during regular checks it was 3.30 which was somewhat high for my age. PSAFree not taken.
2011 it was higher 5.30 and Free was 27%
3T MRI in 2011 no timor but transition zone was low 2. MRI Volume 27
2011/12 was in the 3.0's range No PSAFree taken
2013 was 5 tests in 4.0's as high as 5.19 but PSA Free in 13-15% range which was worry.
2014 was low 4.0's and also 3.64 but PSA Free in 12% area
ALL DRE's Normal. PCA3 in 2011 was 27 which was told is good. 3T MRI no timor.
ALL within GREY ZONE which is very hard to have clear outcome.

Jan 2015 PSA was 4.04 and Free Ratio 13%
Dr concerned ONLY by low PSA Free
Redid 3T MRI in Jan 2015
Results of 3T was "equivocal" PI-RADS score of 8 which implies 19% chance of timor. Score was due to change compare from 2011 benchmark.
MRI Targeted Biopsy planned March 2015

User

Posted 05 Feb 2015 at 21:33

Hi Dean,

You are on such a long journey since 2007, I take my hat off to you coping with this uncertainty for such a long time. I am not sure we would and I can speak for my husband too as he just read your post. Good luck with your Biopsy in March and I hope it is the inflamed version too. Can I ask your age? My husband turned 46 in January so this is why I'm so worried about his PSA level.

Thanks,

Trish

User

Posted 06 Feb 2015 at 08:17

Trish, 53 now, 54 this year, born 1961. Yes the road is so long, the problem is do we need to know when the PSA testing is so uncertain. Biopsies also hit and miss. The only true benefit I see is to identify fast growing, but other than this, the rest is a nightmare. Even my Urologist told me he tested some years ago because he should but then he has not since, maybe this is explaining the dilmer. The AS wait and see, is also worry as then with so many developments there could find cure....its like trying to guess which way the currency exchange will go when sending money....not been very good at this either. In part I agree with many, have it removed....then less stress of all these tests not knowing. I read about one guy that had 5 biopsies, no cancer, then he told come back in 1-2 years, which he did and just forgot about. Then PSA rasied so much, not he is Stage 2 and stuggling, so both the Biospies and PSA gave false negatives, so this is my main worry. The good thing I see at this stage is maybe not multiple biopsies or thinking it cleared but it not, at least they have MRI to guide and with 81% probability that its inflamation, which is what we hope. The other issue, is information overload and for each bad there is good, however, just like another site called Yana....the people on are all PCa, so you have more of the outcome stories rather than the good news stories so people presume more the negative, so I try to use information for what it is knowing there are millions of men without any issues v ones with issues......although this is sometimes also hard when your that person and you make the decision. Lets hope for a breakthough and stay positive. Ciao Dean

User

Posted 06 Feb 2015 at 09:32

Dean, very few men on here have had the benefit of 3T MRI and apart from you and Devonlad I can only think of two others who have ever referred to their IPSS.

You are right that PSA is not always a reliable indicator, and our urologist refers to biopsy as being like sticking a needle into a fruit cake and hoping to spear a cherry. At least with guided biopsy, you know whether the cherries are around the edges or in the middle. However, scans are not perfect either - my husband's scan was clear so if he hadn't had a positive biopsy first he would have assumed all was okay - as it turned out, the cancer had already spread to his bladder neck.

Active surveillance is a good choice for some men for all sorts of reasons as is close monitoring for men with indicators but frequent negative tests. You could perhaps read Rogcal's profile as he has been in your situation for many, many years now.

Your interpretation that guided MRI in some way reduces or minimises side effects is I think a misunderstanding. The risk of infection is the same, plus you may have the additional risk of general anaesthetic to contend with.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 07 Feb 2015 at 14:32

Thanks for your pm Skyfox - it seems that the MRI concludes that you are likely to have prostatitis or some other infection but has identified some specific areas to target during the biopsy, including the TZ, just to be sure. Timor isn't a word, I don't think so if it was included on your results report I imagine it was a typo for tumour.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 07 Feb 2015 at 16:54

Hi Lyn,

I have six monthly check-ups at the Royal Marsden and I always complete an IPSS form. I'm not sure what they do with the data. Must ask the next time I'm there.

User

Posted 08 Feb 2015 at 18:57

Hi all. I've just started to get involved with the converstations. My PSA was 8 last summer and urologist suggested TRUS biopsy. I had done a bit of research on the subject and I have to say I was NOT convinced. The science seemed too flakey. So I declined. Instead I did some more research and discovered the PROMIS clinical trial (http://www.ctu.mrc.ac.uk/our_research/research_areas/cancer/studies/promis/ ) . This is collecting data to determine if MRI is a reliable diagnostic tool for prostate cancer. It involves having an MRI first, followed by both TRUS and Template biopsies. I asked my GP to ask if I could be accepted onto the trial, which I was and had MRI in October last year and biopsies in November. My results in January indicated that MRI had identified two areas of possible cancer. The TRUS biopsies were all clear. Template biopsies indicated cancer 3+4. While the Template biopsies were not guided or targeted by the MRI results (the trial required the results from the three procedures to be kept independant of each other) I'm glad I got onto this trial and obtained an accurate diagnosis, which I don't think I would have got from a TRUS biopsy alone. I think the PROMIS trial finishes later this year with the results some time later. After my experience, I hope MRI is the first diagnostic tool rather than TRUS biopsy. But like all things NHS I guess it comes down to cost.

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