MRI result

Hello Patrick (Patrick100022a3b9) 

Reading the above I think a bone scan would be beneficial as well as the Prostate biopsy to come up with a full treatment plan.

Patrick100022a3b9 said:

It appears to have broken out of the capsule

With that statement I think I would be asking about starting Hormone Therapy ASAP to put the Cancer to sleep and stop any further potential spread.

Patrick100022a3b9 said:

if not the cancer pressing on the urethra?

This was an issue I had - the cancer had caused the Prostate to grow, it grew into the urethra causing issues. These were fixed by fitting me with a catheter until I could be booked in for a TURP operation where they "shave" the Prostate. Link here:

T U R P Operation NHS.

You can read my full journey by clicking on my name or avatar.

I hope the above helps - any questions - just ask.

Best wishes - Brian.

I've always wondered how TURPS works. When they insert the various tools through the end of your penis do they cut through the wall of the urethra to get to the prostate (and then stitch it back up again)? 

As a note of encouragement for people having HT and RT: I have an enlarged prostate and before treatment I would visit the bathroom in the middle of the night about 50% of the time. 4 months after the completion of treatment and I don't get up in the middle of the night at all.

Hello Agent99 

They use a Resectoscope and it's so thin it passes through the urethra wall without causing any damage.

When I saw my surgeon before the operation he asked me if I knew what he was going to do. Having done my homework I explained the operation and he was so impressed he said I could teach his students!! . Later in the operating theatre as I had chosen the epidural he talked his way through everything he was doing. (We did have a break to listen to the Pop master Quiz on the Radio).

Although I don't do pain (my threshold starts at nothing and tapers off) and I can't stand needles and the sight of my own blood I found the whole experience fascinating.

Best wishes - Brian.

Hello Patrick100022a3b9 My PSA was initially slightly higher than yours at 18 (although a later pre-treatment PSA came in at 11?) and the uro’s post-DRE estimate was T2 with a low prostate volume and a focal bulge to one side. Unfortunately the MRI date was arranged for after the DRE and the T was upped to 3 with a 32cc gland size when the MRI results became available. Since then I’ve had a CT with dye, biopsy and a PET scan which I believe are part of the standard staging and treatment-planning process for this Trust. These showed no bone metastases but suspicious lymph node involvement and the handover to the onco was ‘?T3a N1’ on the letter I was sent. I definitively had a reduced flow but nothing too concerning, I presume as the growth was outwards at the side of the prostate? Now, after 9 months of HT and 60Gy of pelvic RT, the flow has improved, almost back to normal. The HT start was delayed until immediately after the staging PET scan. No doubt there was a good reason but think I would have preferred it to start much earlier…and would have asked, knowing what I now know.

Thank you all for  your replies. Looking back at yesterday, I had a note of about three questions I would ask them. Whether it had spread outside of the gland eg Lymph nodes etc.. prostate size (normal),  Likert scale (they couldn't tell me ) Biopsy appt timescale (1-2 weeks)

Forget to explicitly ask for the Staging grade T, am assuming T3 (something) from what they said and looking it up, given the capsule mention but not sure when that is formally provided.

Hello Patrick100022a3b9 

You will get your TNM once the biopsy results are known. This will also provide you with a Gleason Score. Here's a link that will help you understand the staging and grading:

Staging-and-grading-of-prostate-cancer.

Feel free to ask any questions.

Best wishes - Brian

Thanks for all your replies. Yes, I had wondered if then a cancer causes partial blockage of the urethra , that if treatment reduced any size,  that some urinary symptoms might ironically improve, but of course , treatments can  then cause their own often worse problems longer term.

They hadn't mentioned the seminal vesicle yesterday , and I hadn't previously thought to note it's possible significance in spread.