help PSA 9.7

User

Posted 24 Jul 2018 at 22:51

Originally Posted by: Online Community Member

Latest research would say MPMRI is diagnostic on its own for significant (ie needs treating) prostate cancer. It is definitely better to have the MRI before biopsy, MRI after biopsy is clouded by the damage from the biopsy needles, it also provides a target for a subsequent biopsy..

For many yes, but not all cases. Those prostate cancers that do not show up on scans would be left unchecked if mpMRI was used to rule out biopsy. I am particularly thankful that John had it the other way round - the wait of two weeks after biopsy to ensure MRI is not skewed is not such a long time in the bigger scheme.

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

User

Posted 24 Jul 2018 at 22:54

Originally Posted by: Online Community Member

Thanks lynEyre

You are helping but what's the point of an erection with no Libido should I take up pole vaulting. No offence intended just trying to keep a sense of humour whilst drowning my sorrows in alcohol.

But if you either don't have cancer / have a low grade cancer that does not need any treatment / have a contained cancer and choose surgery, your libido will be unaffected AND you will most likely still have erections. If you have a contained cancer and choose radiotherapy or brachytherapy you may be advised to have hormones for a period of time and you may lose your libido but it comes back when you stop the hormones.

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

User

Posted 24 Jul 2018 at 23:19

lynEyre

you are sounding like my saviour. how come you know so much about prostate issues?

thank you so much for this post. I'm truly helped.

User

Posted 25 Jul 2018 at 07:17

Originally Posted by: Online Community Member

lynEyre

you are sounding like my saviour. how come you know so much about prostate issues?

thank you so much for this post. I'm truly helped.

Read Lynns profile... 3 men in her life affected by it

User

Posted 01 Aug 2018 at 15:27

Hi all I saw my GP to discuss the fact that I can't face a biopsy and I can't get hold of my Urologist to discuss with him.

GP had my PSA result and it's come down to 6.2 he says he would not refer me to a Uro if the original test had been at that level and that he will write to him requesting an app to discuss this and my MRI which I had 2 days ago.

I read recently that PSA level is related to prostate size, since mine is 60cc about twice normal size then PSA of 6 is expected, anyone agree?

Any comments?

User

Posted 01 Aug 2018 at 17:23

I did read that it can be usual for a man's PSA to be as high as 10 percent of his prostate weight in cases of BPH.That in your case could account for your PSA of 6.

However it's not as simple as that as I have seen only too well on here that men can have PCa with very low PSA's. Some prostate cancers just do not produce much PSA.

We don't know how much of my husband's PSA could be attributed to his existing BPH and how much to the cancer. His pre-op PSA was 9.2 and his prostate on removal weighed 70cc but we cannot assume the cancer just produced 2.2

Best Regards

Ann

User

Posted 01 Aug 2018 at 20:58

Bit shocking that your GP wouldn’t refer a man with a PSA of 6 ... pity any other men who go to him / her for advice. My husband’s PSA was 3.1 and it had already spread to his bladder.

I can see the sense of waiting to hear the specialist’s interpretation of your MRI results. However, if there is any concern, believe me that having uncontrolled prostate cancer is far worse than having a biopsy.

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

User

Posted 01 Aug 2018 at 21:15

You really need to ask yourself which is the more serious issue: your (very understandable) nervousness about having a biopsy, or finding out for sure whether or not you have prostate cancer.

As several people have now told you, a biopsy involves minor discomfort at worst. Is it really worth putting your life at risk in order to avoid that?

It's now 9 days since I had my template biopsy and all side effects have entirely vanished. No more blood when I pee, and no discomfort when I sit down.

Chris

User

Posted 02 Aug 2018 at 09:04

Originally Posted by: Online Community Member

Hi all I saw my GP to discuss the fact that I can't face a biopsy and I can't get hold of my Urologist to discuss with him.

I read recently that PSA level is related to prostate size, since mine is 60cc about twice normal size then PSA of 6 is expected, anyone agree?

Any comments?

The problem is it might be twice the size because it's stuffed full of cancer, my GP palmed me off for a year with the "large prostate" excuse - guess what it was large because it was full of cancer! !

If it was an MPMRI and it doesn't show any areas of concern there is some evidence that you can take this as being clear of clinically sibnificant cancer.

User

Posted 02 Aug 2018 at 10:30

Originally Posted by: Online Community Member

Does anyone know why we are offered the Trus type more frequently than the template type. Would my Uro think I'm being awkward if I requested the template type?

It’s purely down to cost, as the TRUS is much cheaper for the NHS, not involving a general anaesthetic. My friend who had BUPA cover had a template biopsy right away, TRUS was never mentioned.

I imagine your your urologist would respect your request for a template, as he knows it is the most accurate biopsy. You may have to wait a while - I did, just a few weeks.

User

Posted 04 Aug 2018 at 22:08

Thanks to all for your comments. I was feeling quite positive about things until I read them.

I know you are all trying to give me the best advice and I am grateful for it, but doesn't anyone think it's good that my PSA has come down quite a bit?

Surely if I have cancer then it would stay the same or go upwards?

User

Posted 04 Aug 2018 at 23:33

It is good that it has fallen but it is still twice as high as it should be. You might just have a big prostate, and the 9.7 could have been down to a bit of infection but until you have discussed the MRI results with the specialist you can’t know for sure what needs doing next.

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

User

Posted 04 Aug 2018 at 23:42

Originally Posted by: Online Community Member

Does anyone know why we are offered the Trus type more frequently than the template type. Would my Uro think I'm being awkward if I requested the template type?

It’s purely down to cost, as the TRUS is much cheaper for the NHS, not involving a general anaesthetic. My friend who had BUPA cover had a template biopsy right away, TRUS was never mentioned.

That’s not the full story though, is it. The main reasons that men are offered a TRUS more often than a template biopsy are because

a) there is less risk, particularly where a general anaesthetic is concerned

b) research indicates that spread via needle tracking is more likely with template than TRUS

c) for the high number of men diagnosed with a significant tumour, the TRUS is efficient at finding it, particularly if there is a target to aim for based on the scan results

d) the current guidelines / cancer pathway focus on speed of referral and diagnosis - not all regions can offer template biopsy and there are long waits at some of the hospitals that offer it which cause too much delay to diagnosis.

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

User

Posted 05 Aug 2018 at 07:11

The incidence of needle tracking following either a TRUS or TPM biopsy is considered to be extemely rare. I researched this prior to having my own TPM biopsy and the below link was the latest information that I could find on this.

https://www.google.co.uk/url?sa=t&source=web&rct=j&url=https://sperlingprostatecenter.com/truth-biopsy-track-seeding/&ved=2ahUKEwibsbvup9XcAhXBK8AKHS8nAEAQFjAAegQICBAB&usg=AOvVaw3ciQrvAr8fC-GwCy-4OjBo

Also the risk of sepsis (although still low) is much greater in a TRUS biopsy vs a TPM biopsy.

User

Posted 05 Aug 2018 at 14:27

I had the biopsy before the MRI, but had to wait six weeks for the MRI having being told this was to give the bruising time to subside to facilitate good MRI results.

User

Posted 05 Aug 2018 at 14:34

While discussing my options with the surgeon he made the point, twice! that if RT doesn't work surgery is, seldom, a successful later course of treatment.

User

Posted 05 Aug 2018 at 14:50

I developed sepsis 2 days after the Trus biopsy, luckily it was diagnosed quickly and just spent 3 days in hospital. The Biopsy itself is nothing to worry about, I was just unlucky.

I’m booked in on the 21st for my RARP.

User

Posted 05 Aug 2018 at 15:22

Luckily I had researched the 2 types of biopsy and even a “low risk of sepsis” was too much, sepsis can be a killer.

When I went in to see my oncologist I asked her if I could have the template biopsy as I did not want the trus biopsy and she said we don’t do the trus biopsy anymore only template biopsy as there is a risk of sepsis and it’s not as accurate.

that is Weston area health trust, there probably thousands of patients that had trus biopsies without any issues and every patient is different but I’m just glad I had the template biopsy as it found I was Gleason 4:5 T2c

User

Posted 05 Aug 2018 at 15:26

Originally Posted by: Online Community Member

Also the risk of sepsis (although still low) is much greater in a TRUS biopsy vs a TPM biopsy.

as the Template Biopsy goes through the perenium it doesn’t puncture any organs containing faeces? So sepsis risk must be close to zero?

User

Posted 05 Aug 2018 at 15:28

Originally Posted by: Online Community Member

I had the biopsy before the MRI, but had to wait six weeks for the MRI having being told this was to give the bruising time to subside to facilitate good MRI results.

that rea seems strange way of doing it? I had DRE on 7th Feb, MRI 8th Feb, Template Biopsy 1st March, results 15th March

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