PSA 33 but no apparent urgency for diagnosis - PSA33,Scans (CT / MRI / Bone scan),Biopsy

Thanks Bollinge for your detailed and helpful reply. I wish you the very best of treatment and outcome following you own diagnosis.

I will try to hold out for a template biopsy but that will mean getting referred on to North Bristol Trust - One Stop Clinic.

While trawling the internet I stumbled upon this Freedom of Information Request from PCUK to North Bristol Trust for information about available scanners and their use in prostate cancer diagnosis.

https://www.whatdotheyknow.com/request/multiparametric_mri_usage_data_f_139

It seems that they do have both 1.5T and 3T multi-parametric MRI scanners available but I don't know which if either they used for my scan. I'll try to update you when I get my results. The following is an extract from the response to the Freedom of Information Request:

2. How many scanners do you have available to use for mpMRI scans before prostate biopsy?
2 out of 4 scanners at Southmead hospital can be used for mpMRI prostate. Although the majority of prostate scans are carried out on the GE MR450
3. For each individual scanner used for mpMRI scans before prostate biopsy, please provide the following:
Scanner 1
• Make GE
• Model MR450
• Magnetic field strength 1.5T
• Age 6 YEARS
• When the scanner is due to be replaced APPROX AFTER 10 YEARS
Scanner 2
• Make PHILIPS
• Model INGENIA dSTREAM 3T
• Magnetic field strength 3T
• Age 2 YEARS
• When the scanner is due to be replaced APPROX AFTER 10YEARS

Even with a mpMRI there is no guarantee that the results are 100% reliable - just as with biopsies, you can get false negatives and false positives. The important thing is to make sure you get a scan and a biopsy, and that the scan is not done too soon after a biopsy (where bleeding / bruising can affect the scan result). If the guy told you that you didn't have an mpMRI then you probably didn't. You could ask for a second referral to the other Trust but it seems to me that the quickest way to get answers is to wait for the result of your MRI and then insist on a biopsy regardless of the scan result.

At this point, do you know that your trust will refuse to give you a template biopsy? The fact that they cancelled your TRUS and gave you a scan instead suggests that they may be catching up with the 21st century?

You say at the end of your post "I feel I could have been diagnosed much sooner" - with an enlarged prostate it is entirely possible that you have a benign condition and that there is indeed no cancer - we have had members with PSA 2 or 3 times higher than yours who do not have any apparent prostate cancer despite numerous and frequent tests.

It is a good predictor but we have men on here with much higher PSA and only a very large prostate! So yes, prepare yourself but don't assume it is nailed on. It goes the other way as well of course - we have men whose PSA was in normal range but still had extensive spread and my father-in-law had a PSA of 1.2 so no-one noticed the mets in his soft organs until the day before he died.

A mobile unit in a health centre sounds hellish :-( As you say, very unlikely to have the facilities for general anaesthetic. As for the mention of ultrasound, they may be one of the centres trialling mpMRI combined with ultrasound guided biopsy - everything is done at once. Nationally, there are very few mpMRI facilities and an awful lot of research going on to work out how best to use it.

Just a brief update. I called GP Care (NHS) Ltd today as it's two weeks since my MRI scan. They told me the report was not yet back from radiology. I called the North Bristol Trust radiology department and they advised that there is a backlog getting reports out but noted that my scan was marked urgent and they would chase it further to hopefully get a report out by Friday.

Edited by member 04 Apr 2018 at 20:11  | Reason: Not specified

Yesterday (Friday 6th April) I called North Bristol Trust radiology. It seems putting a chase on the report worked as they told me it had been sent to GP Care (NHS) Ltd on Thursday 5th April. I called GP Care (NHS) Ltd and they confirmed that they had received it. It would now go to a Urologist for 'triaging' and then on to my own GP who will give me the results of the MRI some time next week.

With the best will in the world I don't see how a GP can answer your questions or explain your results to you fully. Can you not insist you are seen by a Urologist/ Oncologist instead? They certainly deal with prostate cancer patients differently in your neck of the woods. I hope they don't roll out this system to the rest of the country.

Regards

Ann

Edited by member 07 Apr 2018 at 20:11  | Reason: Not specified

I think AC and Peggles have misunderstood the situation. GP care is a private company set up in that area by GPs to reduce the number of hospital referrals. GP Care Ltd won the contract for NHS urology services some years ago - the GP refers you, the private company does the scans and, if thought necessary, a biopsy and then sends the results back to the GP who is paying for those tests. If the results are concerning, the GP will refer you to the hospital. GP Care Ltd does not employ any specialists so you won’t be under a urologist at the moment.

Yes, it seems like a s*** system to me too but like all the paediatric services that have been privatised in the Swindon area (resulting in very disabled children not being seen by a paediatrician for 18 months or more) this is how our NHS is being broken bit by bit.

That's a useful bit of information LynEyre. GP Care (NHS) Ltd have told me over the phone that the results will go back to my GP. My GP insists that now that I have been referred to GP Care (NHS) Ltd, it is up to them to refer me on if I need further treatment. This is when he got quite cross with me for questioning the process. Let's see who turns out to be right.