What's you advice ??

Hi All

3 years ago when I was about 60  I had a couple of routine checks on an ongoing kidney cyst, and the doc ordered a routine PSA test. It came back as 12.5 and so a CT scan was done and followed by a MRI. This came back as PIRADS 2 ( highly unlikly any tumour present). 7 months ago I had another PSA, this time was 16.4. Another MRI performed with same result - no cause for concern. Another PSA test was performed about 10 weeks ago and the PSA was now 16.8. The urology dept have now asked me to attend for a multi point perineal prostate biospy- which I have refused on the basis that two MRIs have shown nothing of concern, and my cousin has suffered two of these unecessarily and didn't recover from them for 3 months. This is not something I want to do unless someone can point to a visible area on an MRI and tell me 'this is concerning.' I have no symptoms of any sort - and just wondered if anyone here has been in a similar position ? 

  • This is probably a bit unusual Cap, nothing showing on the MRI , unless the tumour is too small although PSa is going up albeit slowly.  

    You could wait a bit longer but eventually you would probably have to go ahead with biopsy , also they don't tend to like it if u go against their advice.

    Other thing that u could do would be go for a second opinion privately, cost about £250.

    If it was me I would probably give it a bit longer and I would get another opinion, that's just my advice, doesn't mean it's the right thing to do. 

    See what others say.

    Steve

  • MRIs are great, but by no means perfect. the 'Gold Standard' is still biopsy, and if it were me, I wouldn't allow my cousin's untypical bad experience to influence me.

    PSA is, of course, totally unreliable as a test, so it may very well be that there's nothing there. But if it were me, I'd want to be sure.

    I have prostate cancer, and I know that the the earlier it's detected, the better your chances (even though it is a slow-developing cancer, especially in the early stages).

    Good Luck, whatever you decide. You can also ask for a second opinion on the NHS for free.

    - - -

    Heinous

    A healthy-looking decrepit, 69-year-old male, mentally alert but forgetful. I no longer have an urge to choke people who say "all you need to beat cancer is the right attitude" - better to smile and move on.

  • Have you been treated for a possible UTI with antibiotics?  This can sometimes cause a rise in PSA.  If they truly believe PCa is not a concern then have they discussed what might be causing the rise and how to treat you?  Although I had been having regular annual PSA tests from about the age of 50 no one told me that if you exercise hard or have intercourse within the 48 hours before the PSA test this can also cause the PSA to be slightly higher than it would be.  I didn't know this until after my cancer was found.  I was a physical training Instructor so was forever exercising, taking classes, jogging and cycling.

    If it were me I would go for a multiparametric MRI (MpMRI) if there is a hospital near you that can do these as it may show a clearer picture of what is happening..  If there isn't a hospital near you that does these  then go for the biopsy.  The sooner this cancer is caught the better.  My PSA was just under 13 when my cancer was caught and the PSA had been rising slowly over the previous year but my GP refused to do more regular PSA tests - I should have paid for private tests but thought they knew what they were doing.  At the beginning of the year it had risen to 9.  When I finally got to see the rad. onc. who oversaw my treatment.  Eventually I paid privately to consult with my rad onc. in the first instance and he then put a case forward to the local health board to get me into his cancer centre for treatment.  He said he wished I had managed to get a referral to him when my PSA reached 9 with my history of prostate problems.  His plan of treatment went well and I have few minor but expected side effects from the treatment due to other bladder and bowel problems I already had.  Had the cancer been caught earlier the treatment plan would have been different  but  still successful.  So I am glad to have caught things just in time.  As your PSA is rising you should be able to have a PSA test every 3 months or 6 months - this is what my GP refused to do and kept me to yearly checks.   I had no problems from the biopsy at all and this is true for the vast majority of  us.

    Like others have said I would ask to be reffered (whether you pay privately or not) to another urologist or even oncologist for a second opinion when they read your MRI  they may see something others have missed - which of course may not even be cancer but could show why your PSA is rising.

    Good Luck with whatever you decide to do.

  • I'be spent the last few years as a bus driver and I did wonder if sitting on it for 7 or 8 hours a day with all the vibrations and road bumps that I experience may have an effect like your excersice regime. I retired last saturday, so I'd be interested to see where my PSA is  a couple of months down the road ( excuse the pun ). 

  • Worth seeing if it makes a difference but it will likely only be a very small one of a point something.  Be interesting to see if there is a slight difference.