help PSA 9.7

User

Posted 05 Aug 2018 at 15:58

Yes risk of sepsis negligible for TPM biopsy and from what I've read, between 3% and 5% risk with TRUS biopsy.

Also risk of sepis whilst in hospital on the increase according to this BBC report a couple of days ago

https://www.bbc.com/news/amp/health-45045438

Edited by member 05 Aug 2018 at 16:07 | Reason: Correct hyperlink

User

Posted 05 Aug 2018 at 16:54

You don’t need to be a consultant in colo-rectal surgery with a specialty in lower bowel, to realise that multiple perforations of the intestine to obtain biopsy samples from a prostate is fraught with possibilities of infection.

Despite enemas, and post-operative anti-biotics, s*** happens! With the inevitable risks of infections.

The template perineal biopsy avoids all of that.

User

Posted 05 Aug 2018 at 18:08

Yes but I bet most men would rather risk a treatable infection than cancer spread

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

User

Posted 05 Aug 2018 at 19:19

So, Matron,

I think we ought to agree to disagree about the TRUS biopsy versus template biopsy, to save our breath (or these days, keystrokes) in the future.

When I see the eminent Professor of Urological Surgery - he who cannot be named - next Tuesday, I will enquire of him as to his opinion regarding TRUS vs template biopsies.

That will be my last post on the matter, except if a ‘newbie’ needs advice, whereupon I will advise against a TRUS unless there are extenuating circumstances precluding a template.

Cheers, John

User

Posted 09 Aug 2018 at 11:56

ok so the URO called me yesterday and stated that he received the letter from my GP and understood my concerns regarding a biopsy.

He also said that the scan I had was a MP MRI. Strange that the staff that operate the scanner did not know themselves that their scanner was MP MRI or not??

He said that the outside of my prostate showed clear but the inside was intermediate risk? but said that it could be caused by prostatitis and he will try meds that make it easier to pee. I said I have no problem with pee and he said yes but your bladder may not empty properly and possible causing infection. He said try this for now and PSA test in 3 Months. He will see me in person on 17th to explain further.

Would be interested to hear from Bollinge re pros and cons of TRUS and template particularly which is most risk for causing prostatitis, ED and incontinence.

You probably all think I'm mad but thanks in advance to all who care to comment.

User

Posted 09 Aug 2018 at 12:34

When I met the Professor on Tuesday, he was running late and so we had no time to discuss the TRUS vs template debate. Sorry.

All I know is that when I was diagnosed, two friends told me independently not to have a TRUS, as they had had one and then were recalled for a more accurate template biopsy. And this forum is littered with stories from men who endured the exactly the same.

I don’t think either of the biopsies carry much of a risk for the conditions you mention.

User

Posted 18 Aug 2018 at 08:22

Originally Posted by: Online Community Member

Your uro has already booked scans for you. The most reliable route to diagnosis is a biopsy and an MRI; which order they come is less important than making sure that you do have both. My husband had TRUS biopsy which found cancer, the subsequent scans were clear. He had the biopsy on his way to work and didn’t really think about it again until he got a letter saying to come for the results. No blood or any other problems.

Don’t confuse loss of libido with loss of erectile function, they are different things entirely and most men keep their libido. And even if you did have cancer and did need treatment, the vast majority of men can get erections with or without help.

Very true Lyn. After 5 months on Triptorelin and 9 fractions of RT my wife and I still enjoy penetrative sex. Yes, I don’t initiate a session, as I have lost the initial desire, but with external stimulation, usually a video and my loving wife’s efforts I can manage an erection and a typical dry ejaculation.

IMHO men on hormone therapy should persevere and not give up blaming lack of testosterone. I accept my opinion may change after my 20 fractions and a year on Triptorelin, but we certainly won’t give up easily.

can I just say that I have heard a lot of bad stories about the effects of Prostap and for that reason alone I am glad I am not on it. Having researched the price of drugs to the NHS, Triptorelin is the cheapest ar £207 per Injection, so as my GP was given the choice of Triptorelin. Zoladex or Prostap, by my Oncologist, I guess his choice was the cheapest, but in my experience, the best

User

Posted 20 Aug 2018 at 18:59

My elder brother had a TRUS biopsy and he told me he would never do it again. Purely in my opinion, I must say it seems a wholly risky, painful and relatively inaccurate method.

when I was put forward to biopsy my Oncologist told me straight away I would be getting TPT biopsy, I was so relieved.

re. Sex life on hormone therapy, I do have a lack of interest, and do not now initiate intercourse, but my experience and yes, everyone’s will be differenot, on Triptorelin is with a little concentration and effort, dry ejaculations are obtainable. I persevere and always will, for my wife’s benefit, after 43 years of marriage I owe her the effort.

Triptorelin 11.25mg is an IM Injection into the thigh I get every three months

Edited by member 20 Aug 2018 at 19:03 | Reason: Spelling

User

Posted 20 Aug 2018 at 20:36

Is Matron the only advocate of the TRUS biopsy here? I don’t think she has had a prostate biopsy of any description.

She has got a heart of gold though, and is possibly the most knowledgable lay person about PCa in the country!

Edited by member 20 Aug 2018 at 20:37 | Reason: Not specified

User

Posted 20 Aug 2018 at 21:01

I didn't find my TRUS biopsy too bad. Probably on a par, pain-wise, with having a filling at the dentist - ie a sharp scratch at the beginning when the local anaesthetic went in, but no actual pain thereafter. I'm certainly not saying it's an experience I'd like to repeat, but it wouldn't scare me to have to do it again.

Chris

User

Posted 20 Aug 2018 at 23:58

I asked my UCLH surgeon about the risk of spread before my template biopsy and he said there was no credible evidence. He disregarded the spurling results. Also there is an assumption being made that all cancers have a potential to seed with the same degree of effectiveness. They don’t. We need to think of these things as different types of disease, different rates of progression, different levels of PSA output and different potentials.

G 3+3, G 3+4, G 4+3, G 4+4, G 3+5, G 4+5, G 5+4 and G 5+5

G5 Cancer cells being the least like prostatic cells, producing the least PSA, being least dependent upon hormones and being the ones that can operate effectively and efficiently outside of the prostate itself.

Base jumping without a parachute should be frowned at, never criticised. Fresh

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