Advice Sought on Diagnosis Path/Early Treatment Options

Hi JME you are a typical bloke so I fully understand why things have drifted, but pleased you are now being checked over.  Currently a biopsy is the only way to Grade any Prostate cancer - slow growing to faster growing (although they are all fairly slow). It also shows where it is. 

My take on this is that your PSA is fairly low, which is usually a good sign..  The scan doesn’t confirm if you have cancer but gives a very good idea if something looks odd.  I think the MRI probably says PIRADS 5 which really means the picture was good and is highly likely to mean cancer.  The good news is if they said no sign of spread.  This would put you on a curative path, so either an operation or Radio Therapy.  

Hopefully others will explain about the biopsy.  Please feel free to come back with any questions before or after you get the results.

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!

JME said:

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:

The Transperineal biopsy.

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.

Hi JME,

2 great answers from David2017 & Millibob so I won't add anything extra to that part of your query. 

As your father had PC which makes you a higher risk, although work & life events always seem to get in the way of other activities, I think it's time you now prioritised your own health to find out what's going on.  Once you do know, there won't be something lurking at the back of your mind all the time, & should it transpire you do have prostate cancer, then if treatment is required, the sooner it starts the better.

Best Wishes

Brian  

Hi.   I can understand your confusion and yeah every decision feels like the worst.   The mri.   Then the biopsy   Then the bone scan ( not everyone needs one ) was my darkest time as I was scared it might have spread.   This all happened in March and apr last year and I am now 9 months post op     You will look back and wonder what happened and how you got through it.    I honestly believe that after all that goes on you do develop a sort of ptsd as it all seems to happen so fast and you are bombared with facts but trust me when. I say , you will get through it.      Once you know what you’re dealing with you can make the options for treatment     All the best.   You’ll be ok     Best wishes.  Simon. 

Thank you to all those providing comments and advice.

Update: The day after I posted, I received a call and my appointment for the biopsy(ies) in two weeks time.

Reading "95% chance of being cancer" fills me with dread. The information however, is still appreciated. In another thread a link to Staging, grading and risk groups for prostate cancer has helped to fill in a lot of the missing pieces.

I understand that many others are going through or have gone through more challenging circumstances and I am reading through as many guides and FAQs a the moment to get myself up to speed.

Hello JME 

I wish you well going forward and once you have the biopsy results you will have a good idea where you stand.

JME said:

I am reading through as many guides and FAQs

Try and stick to trusted sources, The NHS, Prostate Cancer UK, Cancer Research UK and Macmillan. Dr Google and AI can come up with some amazing treatments and cures but some are just not right!

We are all happy to answer any questions, however trivial.

Best wishes - Brian.

Thank you,

The MRI results have hit harder psychologically than I anticipated, as I was/am still clinging delusionally to the hope that it isn't PC.  

Hi JME we can all relate to this.  Just focus on the ‘curative’ part if cancer is confirmed.  We can help you through this, so keep in touch.

Thank you very much for both your kind words and information.

It isn't in anyway relevant to my ongoing diagnosis but I am struggling with it due to having had a series of setbacks and losses, as we all do in life I know and many are worse than mine, that have one by one erased my sense of identity over the past ten years: as a husband, a father, a son, a professional, and 'my health' which I have always been fortunate to have, feels like it was the last thing I had left. Pride before a fall and all that.

A diagnosis of cancer and treatment I worry, will further erode what little remains of 'me.'

Rationally, I can understand this is nonsense but the emotional impact brushes right past and keeps landing punches. I will pick myself up, and go on going on but I'm on the ropes at the moment.

Indeed, my situation isn't great, outside the diagnosis. My support network is gone, and my economic and housing situation is vulnerable at best. The same week I received my MRI results, my position was deleted and I have been made redundant due to impacts of the current crisis on my industry. Now I am scrambling to find a new job, which will require relocating at least to another town or city or even region of the country almost certainly.

So, I'm deeply worried about being out of work. I simply can't afford it. I am no longer young and while I'm in great physical shape, time doesn't stand still and there will be a point sooner than later when my decades of experience will be less of a value to employers and more of a burden compared with being in ones 30s or 40s (already, even). There is no retirement for me; like a growing number of people I will be working at some level (if I am lucky) until I die.

I don't think surgery or any treatment that will require or at least benefit from: stable housing, a partner or family of some kind, savings, or time off work, will be possible at this point. It is not the only reason I'm very reluctant to undergo it, but honestly, it is something that I don't have the means to even contemplate. I didn't want there to be any cancer but I was hoping at worst, that it would be something that active surveillance would allow me to put off confronting for another ten years or more. A weak and foolish wish.

I will have to come to terms with whatever the diagnosis brings.

At this stage my hope is that:

1. Surgery will not (immediately) necessary

2. The cancer will be slow growing

3. The cancer will have not yet spread outside the prostate

4. Delaying treatment will be possible at least until I have a more stable situation

5. I will be able to work and provide care for myself on my own

I don't need to live forever. I just was hoping for a little more time before a serious health issue occurred. But then, we make plans and the gods laugh.

Hello JME 

Thank you for your response - I can appreciate that wasn't easy to write and that's one benefit of this group - anonymity.

I am so sorry to read of your present situation. We do try on the group to be "a listening ear" and we certainly are not judgemental, and we all know life isn't a bed of roses. 

I am 70 and still working (I run my own accountancy practice) but I chose to work as i enjoy the daily challenges but have enough staff to come and go as I please. having been Self Employed for over 40 years I can understand your worries about the future.

As a Community Champion I have access to plenty of resources for you but I feel in your circumstances you would benefit from a chat with one of the staff on our Support Line - please feel free to give them a call on 0808 808 00 00 (8am to 8pm - 7 days a week).

As far as the possibility of cancer goes, I will stick with my original post at the top of the thread. My personal thoughts are, and don't forget I am not medically trained (although you can read my personal journey by clicking on my name or avatar) 

* It's PI-RADS 5 on the MRI - 95% chance of being cancer.

* You have a low PSA so it's more than likely contained within the gland.

* The only way to find out is a biopsy.

* If it's a Gleason 6 or low Gleason 7 (3+4) and not (4+3) yes you could go onto Active Surveillance (personally not a fan - it's cancer get it sorted).

* Surgery isn't always the answer - the majority of Gleason 6 and 7 get the choice of Surgery, Hormone/Radiotherapy or Brachytherapy.

* I never lost a day at work and my personal journey has been some ride!

We on the Community are here for you - keep talking to us, keep asking questions. 

I hope the above helps.

Best wishes - Brian.