Dueling Radiologists
Posted , 3 users are following.
Are year ago my hometown radiologist read my 3T MRI as 3. Last month he read my most recent 3T MRI as 4&5. However my urologist at the Cleveland Clinic read the same 3T MRI and came up with twos. Which one do I believe? My Cleveland urologist recommended a transrectal biopsy if my PSA was over 4 and it turned out to be 3.7. but I've been having pretty severe rectal pain for the past two years and I'm not quite sure what to do. In addition to the rectal pain I've also over the past year developed pain where I would think would be above the epidermal area and possibly lymph nodes. I've been scared of the transrectal biopsies because of the significant rate of infection and sepsis. All I need is more pelvic pain. I have had internal physical therapy which over the last year has dropped my rectal pain from eight or nine to three or four. And I've got an appointment with my local urologist on Tuesday where I have to find the best way to say why does your radiologist read the MRI as four and five when the Cleveland Clinic only finds level 2? I ask my primary care doctor the same question a couple weeks ago but didn't stick in my heels and demand that he give me some advice to my regret. I hate having to be my own doctor. Thoughts?
0 likes, 7 replies
richard98806 rolf61809
Posted
There is a risk of infection but at some point you will probably need that biopsy. Also express your fears of infection and make sure anti biotics are prescribed.
Openly talk with your Urologists and let him know your concerns. In the end you will need to trust someone whether it is this Urologist or another
rolf61809 richard98806
Posted
My primary care doctor didn't say a thing one way or the other after I explained all this to him. My problem is I spend a lot of time thinking of the right questions and In the Heat of the Moment don't realize that I'm not getting answers. Obviously one of the Radiologists is dead wrong and I assume my primary care doctor didn't want to get involved personally. I think the best advice he could have given me was to go back to the first radiologist and demand to know why he was seeing fours and fives when the Cleveland Clinic was seeing twos, which is what I'm going to do tomorrow anyway.
auntiebeanie rolf61809
Posted
Rolf, my husband had two biopsy's and with both he was given antibiotics and didn't have any infection, we went from being told, low grade small amount. to more aggressive found on 2nd biopsy in the same half. His gleason remained the same as 3+4 but scan upgraded to T2b, after removal of prostate, the cancer was in the whole of it and final T score, was T2C. I would definitely get some answers as to why the difference.
Greebo64 rolf61809
Posted
Quote from above post:- I hate having to be my own doctor. Thoughts?
I am afraid you do, if you do not do your own research research & research more & question question question, you will not be given all the correct information you need from your doc' .... you have to let them know you know what you are talking about. I am in the UK & I have to fight for everything especially if it involves surgery,
I am fighting right to get the "correct" surgery for spinal stenosis & sciatica, I know the correct surgery I need after researching on the web' for many hours & talking to other people who have experienced the same but the 2 consultants I have seen are trying to fob me off, in the UK we rely on the NHS [free at the point of access] but if the surgery is costly they will do their very best to steer you away from it , they are now putting the NHS funding before proper Patient
care.... do as I am going to do & dig in hard, make a nuisance of your self until you get the anwers what you want
rolf61809 Greebo64
Posted
Yeah I saw my local urologist again this week and despite my best efforts he wouldn't commit himself to which of the two MRIs I should depend on. His radiologist with the pi RADS of four and five or the Cleveland Clinic with the pi RADS of 2. And the Cleveland Clinic won't even do a Fusion biopsy because their pi RADS is only 2. So I'm probably going to go ahead and get the transrectal fusion biopsy anyway, seeing as I have met my $6,500 deductible for this year and it won't be out of pocket at all. Best I can do is ask the urologist who will be doing the biopsy how he accounts for the big difference in the two MRIs. And how many cars he will be taking and where. The suspicious areas were in the transitional Zone which I think means near the uretha. In the last year or so My PSA has been as high as 9.5 and as low as 3.7 which it is now. And I've been getting bi monthly testosterone shots of 200 mg as my testosterone was below 200 when they finally checked it a year ago. My situation is complicated by the fact that I've had extreme rectal pain for the past couple years and more recently pain in the epididymal area. Whether that has any connection with my prostate problems I have no idea, and the urologist isn't very interested in trying to diagnose the cause. Very frustrating.
Greebo64 rolf61809
Posted
Hi Again
I have recently had a TURP for an enlarged prostate that was greatly affecting my flow, my PSA last week was 0.3, so no worries there, but have a bit of incontinence I am hoping that will settle.
You say you have had testosterone shots do you mean a drug to kill or reduce the testosterone levels ? reason I ask is that testosterone feeds any possible cancer cells..my brother had prostate cancer & he had injections every 3 months to kill or reduce the testosterone, my brothers cancer was inoperable because of the location within the prostate so the treatment they gave him was the injections, & the Doc' told him don't worry the cancer will not kill you, he said you will Die with the cancer "Not From It"...& the Doc was right my brother died in 2014 from heart failure he was 75 years old. he had had the prostate cancer for 6 years.
rolf61809 Greebo64
Posted
Yeah my problem is that I'm trying to approach this rationally but I actually had my local urologist suggested I stay off the internet because it was only confusing me. The same doctor who referred who me to a useless internal physical with virtually no experience in male internal therap. well I went online and found another therapist group who was able to have my pain. He also refused to go on record as to what I should do when one radiologist saw P I rads scores of 4 and 5 and the Cleveland Clinic radiologist read the same MRI and call them Pi rads level twos. The bottom line is that I have so much rectal pain and side pain radiating down through my thighs into my upper legs that I cannot ignore the fact that it may be prostate cancer related even though that in itself is that supposed to cause pain. so I'm going to have to bite the bullet and get a transrectal fusion guided MRI by end of the year. But before that I'm really pinned down the urologist who will be doin thg the actual transrectal prostate MRIl why the results of two different mris can have totally different results. Fine if my MRI shows definite cancer that will be a different world I will have to travel. But my faith in seemingly well approved urologist is plummeting. For normal problems doctors seem to be fine but give them a little gray area involving pain or surgery and then waffle like you do not believe. They run on all four legs from any diagnosis that does not agree with their own. I guess it's a sign of the times that I'm wanting not to be sued ? who loses in the process?0; those patients who want honest answers 2 serious questions.