Pirads level 5

True Chris but their management of my treatment so far has been appalling. I’ve no confidence that will improve. I know it sound irrational I accept that but to give me no explanation or appointment to explain my MIR result and have an appointment clerk give me advice to come off blood thinning medication with no counter measure if my heart goes into a sharp heart rise I’m talking up to 170 beats per minute with the high risk of stroke for 4 days with no advice to counter act this is just unacceptable. 

My apologies; the way you worded your post makes it look like you are having the biopsy on the 9th? 

Best wishes,

Chris

Hopefully one day men will be offered a choline PET/CT or PSMA scan before the old fashioned needle biopsy ( wishful thinking I know).

Roy

Edited by member 31 Dec 2019 at 13:08  | Reason: Not specified

A long shot, but if he gets a clear bone scan (which is pretty non-invasive except a single injection in the arm), I wonder if they might be prepared to just do HT+EBRT on him? The gleason score, and cancer mapping in the prostate don't matter for this treatment. They could treat it as high risk (his PSA isn't, but staging and gleason are unknown and therefore would probably have to be treated as high risk, and the PIRADs hints at it), which would mean treating seminal vesicles and pelvic lymph nodes too, which ups the risk of radiation side effects to the rectum a bit.

OTOH, I wouldn't be surprised if they refuse RT without a biopsy. RT is the expensive treatment option, and doing it without being 100% certain it's prostate cancer in the first place might not wash. (They wouldn't treat me when they were only 90% certain, which is why I had to have additional diagnostic tests, although that was because they regarded 90% certain as not high enough to justify the side effects, it wasn't due to the cost.)

If they had the common decency to explain the result of my MRI either over the phone or by appointment then I’d have more trust in the next step. They didn’t they just sent a letter to forward me into the next stage of a biopsy. The appoint clerk advised I stop the blood thinning medication 48 hours before. 
I live on the west coast of Scotland and our health service is in crisis. 
Your  your replies are so helpful and I can’t thank you enough that you’ve taken time out to reply. So much construction valid information of which I agree with it all. 
But my issue is not what I’m hearing on here it’s what I’m not hearing from a prospective surgeon as to why they want to do this. Yes I know in medical terms the biopsy should be pain free that’s not my concern it’s the lack of information as to why I need it. 
I think I should stop posting on here because I’m just not making sense. I’m probably more fearful of what they find. Tbh one reply nailed it in that I wouldn’t want any further treatment if they do find cancer. Sorry for wasting your time folks but to be truthful the who idea has spooked me and I’m not good at dealing with this. If you knew me I’m one of life’s problem solvers  I give out constructive advice but I just don’t deal with my own issues. 
Thanks again and good luck with your journeys from here. 

Your surgeon and anaesthetist will be fully up to speed with your medical condition when you go for your pre-operative tests, and they won’t put you at risk if they feel you are not OK with the biopsy procedure.

Once you have the facts you can weigh up what treatment (if any) you want to undergo.

Best of luck for 2020!

Cheers, John.

Honestly, would you be prepared to treat him on this basis? I wouldn't. If Ian is this angry about what seems to be a fairly normal diagnostic process, can you imagine what it would be like if treatment caused side effects? Claims, counter-claims, PALS, threats of being sued, 'no-one told me there might be side effects', 'no-one told me that not having a biopsy might mean the RT was targeted to the wrong area', etc, etc.  

Ian, I hope that with a little time, your urologist will either agree to see you and explain in more detailed or you will find another urologist that you can trust more. Or you could phone the number at the top of this website and order the toolkit which explains everything you need to know.