Been to see consultant, results are in.
Posted , 9 users are following.
I have just been with my partner to see urologist and get the results of 3T MRI which he had done last week. Scan clear, no areas of concern showing which is a massive relief. It does show that his prostate is approximately 70cc so it's not surprising he can feel it. The urologist is content that this accounts for the PSA level of 7.6. He did however advise us that there still could be a tiny Pca in there that the scan would not have picked up, and whilst it would probably never cause any harm or concern he did give the option of a biopsy with 14 cores to be certain. My partner is a worrier and wants this biopsy done. Hopefully he won't regret it. There was no pressure to agree to biopsy and we did feel quite well informed. I think it's for the best as free PSA % is 16. This didn't concern the consultant but as it falls into the "intermediate" category according to some websites we feel happier proceeding to biopsy. So we are looking at early march probably for the procedure to be carried out. Thanks to all of you who have read and replied to my many posts, you have all been a great help and I will continue visiting daily x
0 likes, 45 replies
Supertractorman caz11527
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Don't rush into a biopsy if you don't have to. I was also told the risk of infection was extremely low and ended up with Sepsis 2.5 years ago and am still suffering urine infections and Prostatitis. If you do have it done especially under anaesthetic make sure they give you proof antibiotics were given.
caz11527 Supertractorman
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Oh goodness, that must have been awful for you. It's exactly what I am scared of. Once it's done it's done, no turning the clock back. They said they would give him an antibiotic 2 hours before the procedure and for a few days after. Why not start them a week before?? Also, if it is true that antibiotics don't reach the prostate easily, will these few tablets even be of any use? It will be done under local and doesn't sound pleasant at all.
kenneth1955 caz11527
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They say you can't and you only have a 5% chance of a infection but I like Super had Sepsis in 2014 Was in the hospital for 6 days with IV's and came home with a port Had to have 11 more IV's treatments at home. With everthing clear I would wait and have another 3T MIR done in 6 month's I would check with the doctor and have him giv your friend something to help relax the prostate so he can pee better. Ken
kenneth1955 caz11527
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Caz make sure you and your friend read the post by Captain Al It is worth the time. Ken PS It's about how good the 3T MRI is
caz11527 kenneth1955
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Where can I find this post, Kenneth? I'd be interested to read it. Thanks. He is peeing fine, that's why I don't quite understand the diagnosis of BPH. Unless the prostate is enlarged more in another area as I did ask on the forum a day or so ago. He had been given Contiflo at the start but he was only on it for a short time. Made his vision blurred!
geoff90305 kenneth1955
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Ken, I saw that stat about "only" 5% chance. But I read a paper last year saying it was more like 30% had a serious infection, 10% would require hospitalisation due to sepsis and 1-2% may die from sepsis. The main opinion was the antibiotics given were ineffective due to recent use of the same or similar family of the antibiotic. Not really a good feeling as you present for a transrectal biopsy..and roll the dice.
kenneth1955 caz11527
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kenneth1955 caz11527
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kenneth1955 geoff90305
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Supertractorman caz11527
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Tim-B caz11527
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1) Send his MRI images to 1 or 2 other specialists. Interventional radiologists that specialize in PCa. They will all provide a second opinion at no charge.
2) Read up on TRUS biopsies. Having a random sample when MRI shows nothing, is (IMHO) not worth the risk/reward. At 70cc, a 12 core TRUS would sample less than 1% of the total tissue. What good is that?
Also, read up on PSA - especially comments / papers from the doctor who discovered it (Dr Ablin), perhaps that will give him some comfort on the PSA numbers.
Good luck.
geoff90305 caz11527
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When I mentioned this to me urologist, he said most of his biopsies are now done transperineal, not through the rectal wall and you never get infections.
I have to agree with Tim-B, because you have a MRI that clears your husband of any serious cancer, I would not have the transrectal biopsy, due to the risk. I have chosen to wait the 6 months for my next PSA to confirm it is retreating.
IF the MRI found something, THEN it is a different ball game, as you need a biopsy to score the lesion.
Anyway, the correct decision is what allows your husband to sleep at night that counts.
Geoff
harveybronx caz11527
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From what I've read, the mpMRI does NOT miss "small" PCa. It just misses non-aggressive or indolent PCa.
Hence, there is no chance that a biopsy will find aggressive PCa if the mpMRI is clear, unless there is a reading error, which is certainly possible.There are, apparently, "atypical" but benign prostate cells that put out a lot of PSA.
?And, again, it seems that a random biopsy, as others have also written, would have zero chance of finding PCa that is of concerning enough agressivity, even if there were a small spot of such PCa that the mpMRI missed.
?My prostate is 70cc, and my PSA went from 6.2 in 1999 to 8.5, where it has been, for a couple years. I had two random biopsies, in 1999 and 2005, both negative, a PCA3 test which was borderline in 2014, and an mpMRI in 2015 with PI-RADS=2.
?I just keep getting PSA tests every 6 months. If it goes up I will have another mpMRI, but a biopsy, first? Never!
?BTW, Caz, did you ever get a copy of the mpMRI report?
?There are too many new discussions on this topic; hence, my delayed comment.
?Harvey.
kenneth1955 harveybronx
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caz11527 harveybronx
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Hi Harvey. We didn't get a copy of the written report. The consultant has been abroad and is only arriving back tomorrow. We will ask him, no reason why he should refuse. Anyone is entitled to see their medical records. If this were up to me i would be insisting he forego the biopsy and have repeat psa's but he has set his mind on having this procedure and I cannot change that. All I can do now is support his decision. It's happening on Tuesday morning. He is in a lot of pain in the back passage area, a dull, heavy type pain which has developed in the past few weeks. The biopsy won't help it, goodness knows what pain he will be in afterwards. It must be BPH, or an inflamed prostate. Hopefully he can get medication to reduce the size of the gland and the pain will subside in due course. I appreciate all of the answers and advice I have had on here, thanks you all.
harveybronx caz11527
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The report will be pretty specific about its recommendations that come from true experts. The PIRADS procedure was developed with input from international teams of radiologists and urologists depending on scientific evidence, not random guesses that make absolutely no sense.
?Search on: PI-RADS V2 and you will find the entire protocol. It should be a must reading of what the results mean and what uncertainty means.
?And make sure that you get an actual copy of the original PI-RADS report. Can't you get a copy from the radiologist who prepared the report? Why do you have to go through your consultant?
Harvey
kenneth1955 caz11527
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Well if you can't change his mind youi may have well be with him But if he has a infextion they will not do the biopsy Take care Ken
caz11527 harveybronx
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I contacted the private clinic where the scan was carried out, I asked for a written copy as we cannot understand the disc containing the images. I have not heard back from them. We don't know who prepared the report, only that it was a consultant radiologist. I just hope he or she is experienced in prostate imaging. It is in a large teaching hospital which is also a centre of excellence. The urologist didn't mention PI-RAD, I only know of it through this forum. It's ridiculous that we have to email and phone numerous times just to get a copy of what should have been shared with us in the first place!!
geoff90305 caz11527
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Waffalobill caz11527
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