Dear community,
Thank you in advance for your time and insight.
As background, I am in my 50s and have a direct male relative, father, who had prostate cancer (in his mid-sixties) resulting in the surgical removal of his prostate and additional treatment. I have had and continue to have no symptoms which would cause me to suspect any prostate related problems though I know that this is typical.
While living outside the UK for work I had a blood test for an unrelated issue in late 2024 and a PSA check was recommended due to my age and family risk factor. I am 57 now. The result was elevated: 6.8.
A CT/MRI was recommended but due to issues (relocation, international travel, and other considerations such as my own reluctance to face this issue outside the NHS) I did not proceed as scheduled.
I planned to seek a follow up PSA test 6-12 months after the first, before I went ahead with a MRI. There ended up being a longer gap between tests than desired due to issues with work and travel; I did not have my second until February this year. It was also elevated and an urgent referral to urology was made.
A third PSA test was requested by urology just prior to scheduling an MRI, I am not sure why, but it came back elevated as well: 7.57. The MRI went ahead.
The results were disheartening: multiple abnormalities (lesions), scored at 5 - indicating it’s very likely there is prostate cancer present.
While the person who discussed the results over the phone made sure to say that there was no indication of abnormalities outside the prostate on the MRI, in the lymph or bone areas that were included in the scan, there was some concern expressed about the areas near or just in the area of the seminal vessels. I am still unsure what this means but even on a follow up call, it was stressed that the MRI results were not themselves definitive evidence regarding the presence of cancer.
I had hoped to avoid a biopsy but it seems the only sensible option. It sounds ridiculously avoidant but I am having a very hard time getting to grip with the prospect of treatment and (as I suppose it does for most people) each step keeps occurring at what feels like the worst possible time in relation to work and life.
Where do I start, with understanding what I need to know urgently, so both before and after the biopsy I will be in a better place to understand the results and my options?
Thank you,
Hello JME
A warm welcome to the group although I am so sorry to find you joining us. So:-
* You know your PSA is elevated (lowish but elevated).
* Your father had Prostate Cancer - that makes you high risk.
* An MRI Scan has given you a PI-RADS 5 (Clear view if the Prostate and 95% chance of being cancer).
* The Seminal Vesicles (they produce over half of your semen just in case you didn't know what they did) are located just above your Prostate and are the first place the cancer would go should it break out of the prostate and go "walkabout" elsewhere in your body.
My take on all of the above:
* You need a biopsy to find out how aggressive the cancer is - it may be a very benign cancer taking ages to grow, on the other hand in may not!
there was some concern expressed about the areas near or just in the area of the seminal vessels.
* Those words "some concern" are important.
So what's the major issue here - you don't fancy the biopsy? Once it's done it's over and you will know where you stand with the results - here's a link you may wish to read:
Or you think the treatment will cause time off work?
I had an initial PSA of 182 - I never missed a day of work due to Prostate Cancer.
Still have questions, fire away, nothing is too trivial.
Best wishes - Brian.
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