Prostate cancer

Posted , 6 users are following.

Hi there

My 58 year old husband suffered a heart attack in December. As a result of ongoing abdominal pain he had an ultrasound and a prostate examination. The ultrasound showed an slightly enlarged prostate, margins 3.4cm x 3.4cm x 3.4 x 4.0cm . His PSA is 0.8 Doctor was unable to get round back of the prostate and referred him to Urology due to family history of prostate and breast cancer. Urologist decided on an MRI and thus has picked up an area of concern. I'm very worried about it all Thank you

0 likes, 12 replies

Report / Delete

12 Replies

  • Posted

    Hi Mary,

    "Area of concern" may range from Indeterminate to Suspicious. Stronger concern usually requires a biopsy as a next step. This is unpleasant and has its own risks.

    Some consolation to you may be the fact that statistically aggressive prostate cancers are rare and most cases can now be treated.

    Personally, I'd take my MRI images to a good radiologist or another urologist for a second opinion.

    There is a new CT PET now available for the prostate, which is extremely expensive but is a good alternative to an MRI before you decide on anything invasive.

    However, if concerns remain, your husband may consider a radical prostatectomy. Though it is usually done under general anaesthesia, which may be problematic after a heart attack.

    Best wishes with whatever you decide to do next.

    Report / Delete Reply
    • Posted

      Hi there

      Many thanks for your reply. We are in the UK so under the NHS we are allocated a consultant and his prescribed treatment. The MRI results obtained are not as clear as those that you get with the mp MRI, hence the biopsy. Holding on to the fact that PSA is quite low. Just have to keep fingers crossed I guess!

      Report / Delete Reply
    • Posted

      Hi Mary,

      I am also in the UK and you have the right to chose a consultant. Your GP has to make a referral, you'll have to wait and in the current situation your appointment may not be face-to-face, but you are definitely not tied to a consultant.

      My first MRI was done privately on a 3T scanner, cost around £900 and the report was much more detailed than the following NHS scans.

      Depending on where you live, you may prefer to travel to one of the good hospitals (pending referral).

      I never had a biopsy. My position was to have a quality MRI and only consider a biopsy if a suspicious growth is found.

      It is generally a good idea to have more than one opinion.

      PSA test is not informative. It may indicate a problem, but for many men it is either false positive or - worse - false negative.

      Fingers crossed you'll be OK. Just exercise your rights.

      Good luck!

      Report / Delete Reply
    • Posted

      There is no choice of Consultant in Scotland, you have to take who is in your local Health Board and a second opinion is from another in the same team, so for best independant advice choose the best and pay privately.

      Report / Delete Reply
    • Posted

      I was not aware about this difference between England and Scotland. I can't imagine what would happen to me if I stayed under the local hospital care instead of switching to a good one.

      Private appointment costs £250-300 and still requires a quality MRI. NHS guidance changed several years ago and MRI referrals are now much easier to obtain without doing biopsy first.

      Report / Delete Reply
    • Posted

      As someone who has gone through from scans to surgery to radiation to hormone treatment, I can not stress strongly enough the importance of a 3T mp MRI over a biopsy. The MRI is highly accurate IF reported on by a PROSTATE EXPERT.

      A biopsy has risks attached to it. Of course, less risks with a highly experienced surgeon, but more risks nevertheless than a non invasive mpMRI.

      Report / Delete Reply
  • Posted

    Thank you all for replying. Because the MRI already has been carried out they will be able to biopsy the suspicious area. The nearest mpMRI private scan provider to us is in Manchester, unfortunately not an option for us at the moment due to lockdown Thanks again for your help

    Report / Delete Reply
  • Posted

    Mary,

    The prostate size you described, "3.4cm x 3.4cm x 3.4 x 4.0cm" is small. Usually there are three dimensions, so if you take 3.4x3.4x4 (to be worst case) and use it in an online prostate size calculator it comes up with 30 cubic centimeters, which is about normal. His PSA is also very low at 0.8. Below 4 is considered normal.

    When you say "Doctor was unable to get round back of the prostate" I assume you mean he gave a DRE (Digital Rectal Exam but could only feel the side near the colon). If he did not have a DRE, he should have one.

    If you have an MRI it should be a 3T multi parametric MRI to get the best resolution. I think multiparametric means they use contrast solution. I am not sure if an MRI with less than 3 Tesla magnetic field has good enough resolution. With lower than 3T, there may be a way they can use a RF coil in the rectum during the procedure that gives better resolution.

    The MRI images need to be viewed by a person skilled in interpreting prostate images, not just a generalist.

    Best wishes,

    Thomas

    Report / Delete Reply
  • Posted

    My husband spoke to his urologist today who told him that his lesion is 17mm and had been assigned a PIRADS 5 PSA 0.8 Think this new info has made me feel worse i just hope biopsy can go ahead on 1st April as Cardiac team do not want him coming off his blood thinners so soon after his heart attack. There is a much higher risk of bleeding out after biopsy if on blood thinners The waiting is the worst Thanks again for help

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up