Confused completely after second uro appointment with conflicting info.. what would you do?
Posted , 12 users are following.
Had uro appointment .. she booked MRI (on my insistence on a non-invasive test first) and a second PSA test .. now she said that my prostate "has lobes" but my previous understanding is that lobes cannot be felt by rectal finger exam (is this right?) . .
Did research..my hospital MRI only 1.5T resolution at best, not 3T .. so should I look for other hospitals?
oddly, my uro now says i could have cancer and now she is suggesting a biopsy (painful) whereas in her first rectal exam, she said "no nodules, no cancer"
..also earlier she said my PSA then at 13 was NOT "elevated" because at the time i suffered urinary wounding, cathing, and Cipro antibiotics; at that first appointment, she said that only a 40 pt. PSA reading would be "of concern" -- that's just 10 days ago...
so, I'm confused by her sudden turn around.
also, at the end of the appointment, she asked if I wanted to have her remove my Foley today. i said, 'no thanks' because i've only had 4 days of peace; last Friday, I was on my way to ER because of bloody in the urine returned and I couldn't pee despite the new Foley -- luckily the rough ride thru potholes evidently released the logjam in my bladder/Foley, and the new urine didn't have blood or blood clots any longer
Did some online research on ultrasound imaging for prostate cancer/size/lobes. There are new articles and studies proclaiming, "We're (the ultrasounders) back in business" - new types of sonography with Doppler, etc etc. however, i suggested this three times today, but my uro was completely unresponsive - if you've had the new ultrasound imagers, which appear to be less invasive than 3T or 1.5T MRI, what were your results?
what would you do, in my shoes?
0 likes, 39 replies
oldbuzzard bob31550
Posted
Yes, find another urologist. Get scoped - that will determine prostate size and an enlarged media lobe if you have one. There are less invasive ways (Scans - not sure which ones) than biopsies that can detect cancer. Also, most prostate cancers will never grow to the point that they impact you. Believe it or not, that number is 95%. They can do a Gleason score and make a very educated guess on cancer's likelihood of spreading. And there are less invasive ways of dealing with it than removal, which is almost always a crap show, while also almost always completely unnecessary.
bob31550 oldbuzzard
Posted
re: "Also, most prostate cancers will never grow to the point that they impact you. Believe it or not, that number is 95%."
I think you just explained what my former GP, who is also a surgeon, (in a distant city now, but we keep in touch) said, much to my surprise, "nobody dies from prostate cancer".
Thanks for your wisdom.
Tim-B bob31550
Posted
There is significant controversy surrounding over treatment of men with low grade prostate cancer (PCa) and so many statistics, claims of this and that - we can all find 'support' for whatever theory we want to believe or make us feel better. I was diagnosed in 2012 using an MRI guided biopsy that targeted the one visible lesion at the time, which came back 3+3, which most today lean towards active surveillance, which I did for 6+ years. During the first 12 months, I had 3 MRIs performed at 3 different locations and reviewed by 4 different radiologists as I was getting varying opinions from a wide range of medical professionals. In the end, I stayed with active surveillance and was comfortable with it.
In 2016, my latest MRI indicated the visible lesion was increasing in size, my PSA was ticking up as well and two of the radiologists I respected both indicated there was a spot within that lesion they believed was 3+4 or perhaps 4+3 and should be biopsied. I had been struggling with urinary issues since my late 40s (15 odd years by this point) and by this time, some interventional radiologists were using FLA for both the treatment of PCa and BPH. I chose to do all of this at once - biopsy, and FLA for both the BPH and PCa (a hat trick if you will). I am now 9 months post procedure and doing well. PSA is down 90% and my urination is the best it has been in 20+ years. That's not to say the road did not have some bumps and tribulations (which I've mentioned in your other post).
The point of all this is simply to seek advice from professionals you trust and not ignore the issue because some say whatever percent never die from PCa. Two months after I was diagnosed, my best friend of 35+ years died of PCa. I was at his home, by his bed for his last 3 days. That experience no doubt influences my opinions on this topic. PCa can and does kill. But, you may not even have it - which is yet another reason to invest in yourself and find physicians that you can trust.
dcooperxyz bob31550
Posted
Hi Bob
I wish it were not the case but the statement below is not at all correct .
“I think you just explained what my former GP, who is also a surgeon, (in a distant city now, but we keep in touch) said, much to my surprise, "nobody dies from prostate cancer".
Many men die of PC including a relative of mine who was in his 60’s. It spread to his bones
bob31550 dcooperxyz
Posted
sasquatch oldbuzzard
Posted
oldbuzzard,
When you say get scoped, what is the specific test you are referring to? I'm still learning all of the lingo. Thank you.
dcooperxyz bob31550
Posted
Tim-B bob31550
Posted
Try not to worry about that - just focus on getting a good diagnosis. Our brains tend the think the worse when we are stressed and stuck in the unknown. When I hear there is a small chance of something say 20%, I focus on the other side - oh an 80% chance that I am fine!
raffie bob31550
Posted
Hi Bob:
One of the differences between the MRI & CT is there people with metal implants in their body that cannot have an MRI scan because the magnets would damage the implants and possibly kill the patient.
Those people usually get CT scans instead.
Regards,
Raffie
bob31550 raffie
Posted
Ohh.. I had hernia fixed with "staples" decades ago. Problem?
kenneth1955 raffie
Posted
Raffie & Bob I had the Urolift done 3 1/2 years ago. I have 4 clips. I had 2 MRI last year and had 1 this year. I just have to show them my card that I was given by my doctor. Have a great day Ken
Waffalobill raffie
Posted
Can actually move metal parts. Like rust in your eyes from working under cars. The real issue is it can heat metal parts up. That s**t hurts. Been there. Doc put staples in my knee and didn't tell me. After one operation he sent me for another MRI. He thought they be gone by this time. The staples hadn't disolved yet. They heated up. That hurt.
raffie Waffalobill
Posted
I'm with ya Waffalobill.
I have pins in my hands & a chunk of metal in one of my arms.
Had a rad tech tell me once I could have an MRI when my docs have all told me stay away.
The tech was bragging he could do it without too much problem.
I respectfully declined.
Regards,
Raffie
bob31550 Waffalobill
Posted
pete25515 bob31550
Posted
The likelihood is that your PSA is raised due to the retention and at that level in this situation is unlikely to signify anything worse than early localised disease (unless your urologist felt a hard knobbly prostate).
If concerned then an MRI will be useful. Arguably a 1.5 Tesla with contrast is as good as a 3T. Don’t get distracted by ‘equivocal changes’ which are likely to be due to inflammation from the retention also, but if there is a significant lesion then a biopsy would be worthwhile- if significant cancer (hopefully not) then the way forward could be curative surgery to treat the cancer and the retention. If no lesion then there’s good info from the MRI regarding size/ median lobe which can guide treatment options for the retention. Hope all goes well.
pete25515
Posted
bob31550 pete25515
Posted
Thanks, Pete, your info is priceless.
Read about Chuck Norris' wife and the MRI chemicals' side effect on her. So, now, I'm thinking that the ultrasound imaging should be my first test. In the meantime, I'm reading about how they deal with BPH in Asia, and my initial thought: It's a totally different approach.
Btw, I was a super-healthy guy when suddenly I couldn't pee; apparently drank too much liquid at one sitting and ate very spicy food, according to the uro, at our initial consultation. She thought this was a one-time event. However, around 2 liters of pee was cathed due to the hours spent at ER, waiting, before the bladder scanner was put to use.
UPDATE: Fellow tribesmen in this forum. Thanks for all your suggestions. I got a referral to the #1 urologist, an award-winning doctor. The referring doctor said "you'll be waiting months"; however, this doctor's receptionist already told me that she could get me in by Oct 4th or 5th.
ULTRASOUND UPDATE: I found out that a private clinic offers "pelvic ultrasound" and the Foley can stay in, too. Am I correct in thinking that these new ultrasound imagers are the least invasive?
hank1953 pete25515
Posted
Hi Pete, where did you find out about retention raising PSA level ? It's very interesting. Hank
bob31550 hank1953
Posted
My uro said something similar earlier on. Lookup the book by the psa's discoverer, too.
bob31550 pete25515
Posted
The price-differential (3X more for 3T MRI) could be indicative of accuracy.
In my case, the anorectal exam by my uro said there were "no bumps" and "no cancer likely" initially, and only 50ml size, my age 67.
However, I am mentally-fragile and pain-adverse. Not wanting to rush into any operating table, since my best friend's prostate cancer disappeared completely, by meds and alt-med.
I also sat on toilets sometimes 45 minutes a day while defacating. Now, with squatting, each defacation session is 35 seconds average.