Hi Guys, Last time I wrote here a few weeks back a lot of people were kind enough to reply, hoping for some more informsation from people with this experience.....
Briefly: 58 Years old, been referred by GP and having tests at hospital for a sudden rise in PSA from regular 3.1 to 7.5 after a 14 month gap between tests.....Whilst waiting for hospital to get in touch went to a private clinic for a new PSA test with "Free PSA".....Test came back at 4.3 PSA and a free PSA of 23%.....Also had a consultation with private consultant from the clinic who is a well known prof of urology ....40 minute consultation and DRE and he tells me "No Cancer".....
Since then I have been called to hospital, had a cystoscopy (Tests clear)...a CT Urogram and a 3T MRI....They wanted to give me a biopsy, but in light of the lowered test result and the "diagnosis" from the prof I asked my hospital consultant (via his secretary as I have yet to meet him) if I could swerve the biopsy and see what the MRI threw up...He agreed. ....Hospital appointment yesterday to discuss results with urology dept. Doctor called me in, never introduced himself, was a bit stand offish, not unpleasant but very business like, asks why I did not have the biopsy? (he isn't the consultant obviously) I explain my reason and he asks to see the lowered test results, I show him. He explains that the MRI is showing "something" and it is small. I ask him if it is confined to the gland (it is) ....But they need to do a biopsy to see what it is. I say that I thought that a 3T MRI could tell the difference between something nasty, something benign or inflammation....He says that this is not the case, his words were something like: "PSA means nothing, Free PSA means nothing, Scan means nothing only a biopsy can see what this is"
He did say that if I wasn't worried I could leave it until the next PSA reading to see what has happened, but I don't have that kind of personality.
I now feel like I have shot myself in the foot as I have now booked a biopsy for 2 weeks time and the results 2 weeks after that, so instead of finding out yesterday I now have another 4 weeks to sweat before I get a (maybe) definitive answer.......Basically my question is this: Has anybody had the experience where an MRI scan has shown something up which eventually turned out to be nothing to worry about.....I'm talking up to date equipment here guys....
My scan only showed abnormalities but at least they
could then target the area for biopsy. Instead of going in blind so to speak. I know this may not help your decision but I am glad I had the targeted biopsies.
Hi Soloco, So the question is were your "abnormalities" Cancer or something benign?
When I mentioned targeted biopsy to the doc yesterday he didn't actually say yes, just that they would know "roughly" the area to look.....Maybe I got the janitor.....
Well I had a 1.5 T mri which showed a probable small tumour in one side. The biopsy proved this to he the case. It determined it was stage 1, then increased to T2a. After my prostatectomy, the spread was even more, and it was upgraded to 3b, which shows how useless the mri actually was. It only shows concentrated lumps and won't show cancer cells that are more spread out. Have your guided biopsy.
Unfortunately they didn't know or they didn't tell me if they did.
I read there is less risk of infection "The risk of serious infection is less with a Transperineal biopsy, because the needle doesn’t have to pass through the rectum to access the prostate"
S.
The risk of serious infection is less with a Transperineal biopsy, because the needle doesn’t have to pass through the rectum to access the prostate
Hi Dave, having the biopsy in 2 weeks time, just trying to ascertain whether the 3T MRI (which is supposed to be 2 times clearer/better than the 1.5) can tell the difference between malignant or benign "somethings".....clutching at straws really
Hi Soloco, I'm confused now (which isn't hard for me)....the abnormalities in your scan I assumed were your gleason 6 or 7 which was later discovered .....If that's not the case then it's mighty incurious of you not to ask....or did I miss something?
The 12 biopsies in 2014 showed my Gleason 6, 3+3. I assumed they suspected something more than this. They were correct, the targeted biopsies revealed the Gleason 7, 3+4 tumour. After prostatectomy the 3+3 was still there and was still 3+3!
I can only speek from personal experience, here in the US. From your experiences with the PSA tests, the numbers are an indicator of something throwing your number off. PSA tests are horribly influenced by external influences such as eating poppy seeds, having sex, riding a bike. MRI's have a limited role in determining cancer. My biopsy experiences were quick easy with few side effects. I went to work after my test! I had a previous sonogram and a physical that failed to show anything and I felt great. The biopsy identified the cancer, the cancer type and the extent. As it was explained to me, MRI's can't answer those questions. My urology doc was kind, attentive and easy to talk with. My biopsy results were back in LESS than 5 days.If you are not satisfied with the Urologist, please seek out someone who will be more focused on your needs. Im glad my docs are both male, and KNOW men's health issues and complaints. That's their specialty.
Hi aksns, I was hoping that because my numbers had dropped from 7.5 to 4.3 within 2 weeks (different lab granted but 3.2 ng !!) I was hoping I had an infection of the prostate.....what amazes me is that no one has said to me "Hang on here, lets cool it and redo the PSA"....I still dont know now what my current PSA is...has it dropped? stabilised? risen? The National Health Service are throwing procedures at me like a drunken sailor on shore leave. I suppose I should be grateful.....Just want to hope that the "something" that they can see on the images isn't something "nasty".....Maybe it was the radiologists first day
My doc (regular GP) told me that PSA tests sequence should be OVER a month apart to be reliable. Here in the US, its a standard 3 months, because many many external influences throw off the results, including having any health condition where your taking an antibiotic or recent vaccination. I had 2 types of PSA tests, including the PSA free test which gives more information than the the everyday variety. I am surprised that none of your docs suggested a longer period of time in-between tests. Our insurance limits the number of tests, unless there is a compelling . reason. Once they said- hang on, they should have waited at least 4 weeks. PSA is only a indicator, nothing more. Getting repeated tests in a short time period isn't recommended here in the US. Please look at PSA testing guidelines published by Natl Inst of Health, Johns Hopkins and Mayo Clinic, available online.
Hi, I only had the second test done (paid privately) because the NHS in the UK don't fund Free PSA tests (fair enough)....Went to a private clinic and had the lab test done (new reading 4.3 free PSA 23%) part of the deal was a consultation with a urologist at the clinic....Got the top dog there...Here in the UK he's very well known, always in the papers on TV talking about mens health etc. Written around 40 books on the subject. It was him that said I didn't have cancer.....(after a 40 minute consultation and a DRE).....maybe he got a bit carried away....Like a typical man I wanted to believe him...I was all for forgetting the NHS tests and walking away.....My wife had other plans.....Hell! he may even be proved right (I hope)...I appreciate that you shoiuldn't have tests too close together because of natural fluctuations in PSA but I don't think 3.2ng in 2 weeks could be called a natural fluctuation....assuming someone at either lab didn't make a boo boo something has caused that hike and subsequent drop
The PSA is indeed meaningless as I have explained in reply to you before. Have a Transperineal Fusion Biopsy and be sure what the situation is. There is no chance of infection as the samples are not taken via the anus.
Even a 3T MRI cannot definitively say whether a small lesion is PCa or not. Been there, done that.
Hi Stewart, you've answered my question.....I'm hoping that this small "something" is benign but was under the impression that the 3T machine was "all knowing"....Got to get what I'm given biopsy wise (I'm in the UK under the NHS) but hopefully they'll be able to target it better using the image from the MRI
Tony: I am sure you have nothing to worry about. The MRI result will give a PI-RADS type indication and if like my result the Radiologists will say how suspicious the lesion is. The biopsy is the only sure-footed way to know what the Gleason score is.