From MRI ... to Biopsy .... to Treatment

Hi Marcus,

I had trans perineal biopsy,  I found this approach more reassuring.  This was done as a day case, one week off work then more or less back to normal.  Although 1 week after biopsy I received devastating news that they found cancer , up until this point I believed my psa was false positive.  Two weeks after I had radical prostecomy so cannot comment longer than two weeks recovery..

In summary more samples oblivious to procedure so my preference especially given your history if none found you know it was a thorough test

How was the Trans perenial surgery?

Any side effects, things i should note, do's and dont's, pain etc?

I'm just getting over my last Cancer, so the thought of biopsy's and restarting treatment of any kind again is just depressing, but hey ho ! .....it will be what it will be i guess.

Many thanks as usual

Marcus

I had it as a day case. Badly bruised but not too bad.  Discomfort rather than pain. Follow they're advise less risk of infection and more thorough.  I had prostatectomy within fortnight so those effects took over

Prostratecanceruk has very good section. Slight bleeding and constipation from pain killers so take movicol or laxido to loosen stools as straining hurts and causes bleeding

Yes ..... I remember that well, still have some Laxido left from last time around !

I'm just going to go with the flow as i've said before, starting to come to terms with it all again now, not looking forward to the biopsy, and especially the wait for confirmation, but what choice do we have in these things ?

Anyway, for now i will take heed of what everyone has said.

Thanks as usual

Marcus

Okay .... So i had my Trans Perenial Op on Thursday afternoon ( now Saturday ) 

To be honest it went as expected really, day surgery admission, usual great staff and care from my local Hospital, admitted at 12.00 midday, visit from a very nice lady surgeon with everything explained fully and comprehensively, and on my way to theatre within the next hour, a chatty and friendly anaesthetist, did the usual "sleep well, off you go, well take good care of you" .... and within 10 seconds i was indeed gone .......

Awoke in recovery around 2.30pm lying on my back with little to no pain at all, a slight ache in the rear, but nothing to even concern yourself with, slowly came around from surgery and was wheeled back to day surgery room where i was the only patient at that time.

A couple of cups of tea and some delicious toast and marmite later, i was given a jug full of water and asked to drink it down and replenish at my leisure, i did this twice by which time my consultant visited again and said i should expect some blood in my urine and stools ( of which there was very little, and now nothing ) and that if i filled the other jug with between 200 / 300ml of urine and it showed no abnormalities and was a nice "rosy colour" as she put it ..... i was fit go !    

Another hour later i had done as asked, very little blood, no peeing razor blades, a tiny bit stingy, but hardly worth mentioning, and with only a slight ache down below and feeling like you'd eaten a very hot curry ! ..... home i went.

I've now a wait of up to three weeks for the results, and being perenial there was less chance of infection and targeted to my MRI scan, I had the choice, and for me i chose to go for the more targeted but longer procedure, you may not go with that, each to their own choice, however, staying positive, and hoping as we all do for the best outcome, and if not ? ....lets get on a treat it and deal with whatever that may bring.  

If you're having, or thinking of having this particular procedure, i can only relay my experience, but I must say, for me it was a very simple, virtually painless, and straightforward op.

Best Wishes to you all ......

Marcus

Hi Marcus,

That's great news. I would have gone for that type of biopsy but it wasn't offered. They only perform the Artemis MRI guided TRUS biopsy at my local hospital which is a bit more risky. I was lucky and didn't have too many side effects either.

Okay guys, So here we are some 4 weeks after the initial results of my Transperenial Biopsy.

All 24 samples (12 either side) showed as "No Cancer" not in the prostrate, outside the walls, pelvis, or bones, so a massive relief obviously ? Well yes, but with a BUT !

As i write this i've recently had the detailed letter back from the consultant as sent to my GP,  the MRI showed a small "suspicious" area in their words, but the more invasive Transperenial was unable to access the exact area of suspicion apparently ? it is a very small shadowed area at the front of the prostrate, according to my surgeon and specialist, at the general end of month case meetings, when mime was discussed over 90% of the room thought it so low level as to be simply a monitoring case ( fine, but what about the other 810% ? ) 

I was told to go away and enjoy my late summer holiday, in three months they will have me back for further PSA / MRI to see if the levels or numbers have changed, if so it's back in this time for a "targeted Biopsy" but for now they are not worried or overly concerned ..... they may not be, but as usual this leaves me with the "What is it exactly" question ? 

I'm not stressing, or overly worried, slightly concerned more like, meanwhile getting on with my days, and nothing else symptom wise has changed, it's just the fact there was a shadow / suspicious area, and that in itself is something is it not ?

Best wishes to all as usual, be you starting treatment or on your way through .....

Keep the faith 

Marcus 

Well I hope you can enjoy your holiday - easier said than done!.  The good thing is that you are aware of something being there and it is going to be treated early by the sound of things so that is brilliant.  I hope next time round they can find something more concrete to tell you.

All the best

Des

Hi Marcus,

a couple of comments from me which I hope you find helpful.

One is, in one of your posts you appeared to use your actual surname.  Mr R-----s.  This is not advisable and sometimes moderators may pick up on this.

I see you have a disappointing Biopsy result.  It would have been great to get the all clear, but the biopsies missing the "suspicious"area is a real shame.

You say that biopsy showed no cancer  outside the walls of the prostate,  pelvis or bones.  Sorry to disillusion you, a biopsy of the prostate gland only shows what's happening in the prostate gland, nothing else!!.

If your next biopsy shows the suspicious area is not cancer then you can safely assume there is no prostate cancer outside the gland, in the pelvic cavity, lymph nodes or bones.  However, if the biopsy is positive then you can't assume that and you would need a bone scan and a whole body scan.

I had an MRI AFTER my biopsy and I was never told what the report said, the biopsy was positive, so I never thought to ask.  I do wonder now, because after surgery the post op report said there was quite a large area of calcification in the right upper quadrant of my prostate gland.  I imagine this would have been reported as a "suspicious" ares, if the biopsy had not already shown it to be benign.

It is possible that the MRI did give more detail than you've been told.  It would probably have said how large the suspicious area was and how close to the prostate capsule (wall) it was.  It might be worth getting hold of the report.  If the urologt won't give you a vopy

It might be worth getting hold of the report.  If the urologist won't give you one, there are options.

1). you can approach the hospital's Patient Advice and Liaison Service to intercede on your behalf to get you one

2) In the hospital.where my urologist is, the X ray depzrtment, on request, will send a CD with all scans and X ray images on it and all the reports on them

3) If 1 and 2 don't work, you can formally request to see your entire medical record along with all the reports that in it.  A last resort sin e this is a fairly lengthy formal process.

One last thing,  the calcified area in my prostate was caused by chronic prostatitis which I had for years.  Prostatitis can cause raised PSA, so I had to have antibiotics for 2 months before having a biopsy.