Prostate cancer

[audikentman]

Got a telephone call booked with the urology team at UCLH on 17th July.
Let's see what they say.

[Damp Logs]

audikentman said:

Got a telephone call booked with the urology team at UCLH on 17th July.
Let's see what they say.

Excellent!!

Tell em I said hello 🙋‍♂️

[westberks]

not cancer thankfully, but with regards to some of the treatments available.....

Following on from my previous contributions, this week i've been under the knife (well i suppose jet spray is more accurate) for water ablation to further treat my enlarged prostate.

this involved a 2 night stay in hospital and a catheter being fitted; post op it was used with irrigation to help clean up afterwards for 1 day and then a day of regular catheter use. on the final morning (yesterday) i was given strong pain killers at 5.30am in prep for the 6.30am catheter removal. Following that it was just chill & drink water until I was able to pee 3 times with reasonable flow and clarity. All done and home by around midday.

having previously had issues with clotting and internal bleeding after a template biopsy, several years ago, I was very apprehensive about yesterday morning, but my fears were unnecessary and it has all gone exactly as hoped.....

hopefully that's me done for the time being, with just a post op check up in a couple of months. I opted for water ablation as at 57 i'm not quite ready for retrograde ejaculation; if there were no other options i'd have gone ahead, but water ablation has a much lower chance of this side effect that Holep or TURP (my prostate was still too large for the latter anyway)

so after nearly 10 years of suffering and eventually having PAE last year to start the surgical process I'm hoping that's my lot for now. I'll keep nagging at mates to get checked up; particularly as after posting about it on socials i've found out that 1 good friend was diagnosed with prostate cancer yesterday and another was recently treated and had to have a full prostate removal due to cancer and stuill awaits results of other biopsies.

[Penrhyn]

Westberks.

Glad the procedure worked for you.

I think all men over 50 should be offered a PSA test. Too many are being caught too late as symptoms do not present itself until its very far gone.

[ClaphamGT3]

Penrhyn said:

Westberks.

Glad the procedure worked for you.

I think all men over 50 should be offered a PSA test. Too many are being caught too late as symptoms do not present itself until its very far gone.

Absolutely this

[westberks]

Penrhyn said:

Westberks.

Glad the procedure worked for you.

I think all men over 50 should be offered a PSA test. Too many are being caught too late as symptoms do not present itself until its very far gone.

100% - i'm very open and public about my condition with friends and acquaintances; as I suspect we all are and need to continue to do so.

But it ought to be being promoted more as a required 50+ test

[AstonZagato]

I have pushed friends and family to get PSA tested too.

I beileve that the NHS argument against a wider testing regime is that there'd be too many false positives (PSA is not foolproof) and the system would become overloaded, making access for those with real need too difficult. That said, the current system is missing too many men like me - by the time I discovered I had prostate cancer, I was stage 4 and inoperable/incurable.

[audikentman]

ClaphamGT3 said:

Penrhyn said:

Westberks.

Glad the procedure worked for you.

I think all men over 50 should be offered a PSA test. Too many are being caught too late as symptoms do not present itself until its very far gone.

Absolutely this

100% this,
my problems only got pick up for it because I have a yearly blood test after recovering from Hodgkins Lymphoma, my brother also over 50 has to almost beg hos GP, mother has had breast cancer, father has Prostate Cancer, that's ticking a lot of boxes for us both.

[Armitage.Shanks]

I can understand the argument over PSA testing in isolation as it's a screening device that on its own is not necessarily conclusive. If you've got other symptoms then it's worth discussing with your GP.

Personally I'd rather pay a fiver each year to the Graham Fulford Charity for a prebooked PSA test at one of their organised local events than take up a GP appointment. It's far more convenient than getting a GP appointment first to be then sent for a blood test at the local hospital. The charity will forward the result to your GP surgery to add it to your NHS record if you give permission.

[kevinon]

Many men on here are advocating for wider testing. Thank you for bringing it back again and again.

Sadly there's another well-known man who has joined the club.
Dermot Murnaghan has talked of his Stage 4 cancer and asked for more widespread screening.

https://www.theguardian.com/society/2025/jun/23/ex...

[westberks]

kevinon said:

Many men on here are advocating for wider testing. Thank you for bringing it back again and again.

Sadly there's another well-known man who has joined the club.
Dermot Murnaghan has talked of his Stage 4 cancer and asked for more widespread screening.

https://www.theguardian.com/society/2025/jun/23/ex...

very sad, along with Chris Hoy.

Hopefully the wider acknowledgement of this form of cancer and with high profile sufferers going public it will leader to more testing and men talking about it.

[B'stard Child]

I've been dipping in and out of this thread for the last few months so thank you everyone that has contributed but I've resisted posting because up to yesterday the jury was out so to speak.

Background back in 2020 I started to notice a couple of issues health wise both I regarded as minor and age related (was 55 at the time) and the world was going thro it's own health crisis and my little issues were pretty minor so I put them down to aging and carried on with my life.

1. my little finger on my right hand was starting to curl up and I couldn't straighten it (I now know this was Dupuytren's contracture and treatment options in the early stages are varied - later stages it's pretty much surgery, surgery or put up with it)

Link to that here - clicky

It's not life threatening but stupid stuff really irritates

- drop some coins or keys in your pocket and you can get you hand in to retrieve them

- brush what hair you have left and you poke yourself in the eye - never gets funny no matter how many times

- steady yourself (like to pull on a shoe) and put you hand out flat on something and you squeeze the feck out of the finger affected (that hurts a lot)

2. I couldn't piss like a race hourse anymore, sometimes I'd get the urge to piss and the noise to signal ratio was miles away from expectation but it's not that unusual to have an enlarged prostrate with age.

After the pandemic thing ended it seemed to me that GP's didn't want to see people anymore (other experiences may differ) and my attempts to see a GP were infrequent - bear in mind that having been with my GP surgery for 35 years and never actually set foot in the place in all those years I did find it a little frustrating that the process seemed nonsensical (Ring up for an appointment to be told there were none and I couldn't book anything in the future........... If it's urgent go to A&E was my experience)

About three years ago the surgery moved over to an online system for health issues and sent all their patients a how too guide. So I sent a photo of my hand and said I'd like to see what my options are to resolve this

Note that is as straight as my little finger would go (in the subsequent waiting period it got a lot worse)



The GP basically said not in my remit and referred me to an out sourced physio practice who advised frozen peas and a splint

Lets just say I went fking ballistic - none of my response to that is printable on these pages!!!

This resulted in a change of approach from the GP who referred me to hospital and after a year wait to see a consultant and a year wait for the operation last week I looked like this



Now in between those years Mrs BC has been encouraging me to deal with the "pee" problem (we all know the type of encouragement I'm talking about) but dealing with one thing at a time has been my modus operandi for all my life but in November I got the offer of a 60 year old health check (bloods, blood pressure and all that Jazz) and a phone number to call to book in.

So I booked in for Jan thinking that would also include a PSA test (It didn't but they took a look of blood for other stuff)

I used the on line system and asked specifically for a PSA test no actual response from the GP but I did get a notification of a date for more blood, this time for a PSA

Result 4.6 on the scale (at the time no idea if this was good bad or what so I looked in this thread and got a better idea from the first few pages. It wasn't good, it wasn't bad but was over the magic number which seems to be 3.0 or 3.6)

GP would want to talk to me about the results surely............. Nope

So I did another on-line thing and basically said 4.6 isn't below 3.0 or 3.6 whatever the threshold is where do we go from here?

Get an appointment for two weeks time for another PSA test

Result 5.9 OK that's more what next and who do I ask?

At this point everything changes I'm no longer trying to deal with a GP who doesn't want to see anyone it's the Hospital that contacts me with dates and times that they have for MRI scan so I pick the first one which is in 4 days time.

Get MRI (actually not a bad experience noisy with lots of frequencies that really resonate and it takes a while) and it's 2-3 weeks before I can expect the results but the hospital will contact me with next steps

3 weeks later I get a letter (and information/notes about a biopsy that they want to carry out) now I had a car show I help run and a trip to Spa for the classic in the short term so pushed the biopsy out to after that.

Biopsy (100% do not recommend and 100% do recommend at the same time)

Having a "new" arse hole added so the doctor can use a small hungry hippo to take 24 chunks out your prostrate whilst navigating with an ultra sound up your arse that you have had for 60 years (whats wrong with a tom tom!!) All that with feet in stirrups and your balls taped up to your belly and then pissing blood for a couple of weeks really really rates very fking low in my list of things to do again!!!!!

Then there is the wait again but I won't make you wait

T1 and Gleason 6 so yes prostrate cancer but very slow growing and the recommended action is active monitoring which was explained as

PSA every 6 mths
MRI every 18 mths

Any changes in either with be assessed (maybe I get another date with the hungry hippo - that would be so much fun...........)

Only fly in the ointment was the MRI picked up something in my pelvis - had I broken or fractured it at all in my past?

I've fallen out of trees, off pedal cycles, played rugby for years and had the odd motorcycle and car crash and generally been a bloody idiot most of my life so no, not that I know of but very possible I've done my usual approach to injury which is suck it up pain stops you been stupid so don't and have never taken pain killers

No idea if that helps anyone but I found it slightly cathartic to write it down

Has all the bandages and cast removed from my had today and first round of physio - scar looks a bit gnarly (if you squint it looks like one of those really twisty mountain pass roads with lots of hairpin bends but finger is much straighter

[westberks]

B'stard Child said:

I've been dipping in and out of this thread for the last few months so thank you everyone that has contributed but I've resisted posting because up to yesterday the jury was out so to speak.

At this point everything changes I'm no longer trying to deal with a GP who doesn't want to see anyone it's the Hospital that contacts me with dates and times that they have for MRI scan so I pick the first one which is in 4 days time.

Biopsy (100% do not recommend and 100% do recommend at the same time)

Having a "new" arse hole added so the doctor can use a small hungry hippo to take 24 chunks out your prostrate whilst navigating with an ultra sound up your arse that you have had for 60 years (whats wrong with a tom tom!!) All that with feet in stirrups and your balls taped up to your belly and then pissing blood for a couple of weeks really really rates very fking low in my list of things to do again!!!!!

well prostate wise that fits just into the glass half full category in that it is clearly small and apparently slow progress, so lots of options for treatment. Well done for getting it checked up..... eventually! Us blokes are often our own worst enemy, hope the hand recovers well too.

great description of biosy too!

Edited by westberks on Thursday 26th June 18:21

[JeremyH5]

westberks said:

B'stard Child said:

I've been dipping in and out of this thread for the last few months so thank you everyone that has contributed but I've resisted posting because up to yesterday the jury was out so to speak.

At this point everything changes I'm no longer trying to deal with a GP who doesn't want to see anyone it's the Hospital that contacts me with dates and times that they have for MRI scan so I pick the first one which is in 4 days time.

Get MRI (actually not a bad experience noisy with lots of frequencies that really resonate and it takes a while) and it's 2-3 weeks before I can expect the results but the hospital will contact me with next steps

3 weeks later I get a letter (and information/notes about a biopsy that they want to carry out) now I had a car show I help run and a trip to Spa for the classic in the short term so pushed the biopsy out to after that.

Biopsy (100% do not recommend and 100% do recommend at the same time)

Having a "new" arse hole added so the doctor can use a small hungry hippo to take 24 chunks out your prostrate whilst navigating with an ultra sound up your arse that you have had for 60 years (whats wrong with a tom tom!!) All that with feet in stirrups and your balls taped up to your belly and then pissing blood for a couple of weeks really really rates very fking low in my list of things to do again!!!!!

Then there is the wait again but I won't make you wait

T1 and Gleason 6 so yes prostrate cancer but very slow growing and the recommended action is active monitoring which was explained as

PSA every 6 mths
MRI every 18 mths

well prostate wise that fits just into the glass half full category in that it is clearly small and apparently slow progress, so lots of options for treatment. Well done for getting it checked up..... eventually! Us blokes are often our own worst enemy, hope the hand recovers well too.

Sorry to read that you’ve made it into here, BC, but it sounds like you’re in at the shallow end. I love your graphic description of the biopsy, I remember it well

Of course, you do realise you will very likely have to do that again if it grows . Mind you, that probably beats having a robot chop bits off like I had last summer.

[bexRVN-ret.]

westberks said:

B'stard Child said:

I've been dipping in and out of this thread for the last few months so thank you everyone that has contributed but I've resisted posting because up to yesterday the jury was out so to speak.

At this point everything changes I'm no longer trying to deal with a GP who doesn't want to see anyone it's the Hospital that contacts me with dates and times that they have for MRI scan so I pick the first one which is in 4 days time.

Biopsy (100% do not recommend and 100% do recommend at the same time)

Having a "new" arse hole added so the doctor can use a small hungry hippo to take 24 chunks out your prostrate whilst navigating with an ultra sound up your arse that you have had for 60 years (whats wrong with a tom tom!!) All that with feet in stirrups and your balls taped up to your belly and then pissing blood for a couple of weeks really really rates very fking low in my list of things to do again!!!!!

well prostate wise that fits just into the glass half full category in that it is clearly small and apparently slow progress, so lots of options for treatment. Well done for getting it checked up..... eventually! Us blokes are often our own worst enemy, hope the hand recovers well too.

great description of biosy too!

Edited by westberks on Thursday 26th June 18:21

For B'stard Child.

Can I ask, have they detected a tumour in your prostate via the MRI?

My husband did and was also told slow growing and could monitor over the next 5years.

However he, by then had had 2 mri's about 18 months apart. First one showed v. Little 2nd.obe.showed a significant change.

He decided to go for surgery whilst it was still encapsulated. They told him after the tumour was 3mm away from breaking out. If it had he would've needed radiotherapy/chemo (I can't remember which) he was only 48 so these would have caused issues for him later in life (so radiotherapy not ideal)

His surgery was curative, long procedure and long recovery process.

I am not saying this to be alarmist but in our opinion the monitoring seemed the wrong choice and still believe surgery was the right surgery rather than waiting and hoping.

[B'stard Child]

westberks said:

well prostate wise that fits just into the glass half full category in that it is clearly small and apparently slow progress, so lots of options for treatment.

Agreed will just have to see over time what options are needed

westberks said:

Well done for getting it checked up..... eventually! Us blokes are often our own worst enemy,

Thank you - you are 100% right about own worst enemy - men tend to put up and shut up rather than dealing with something

westberks said:

hope the hand recovers well too.

Hands getting better fast - great to be able to wrap my hand round a mug of tea (or a pint of beer)

westberks said:

great description of biosy too!

I wondered if it was a bit too graphic - I was trying to keep it "light" but be realistic about how it felt - I would not want to put anyone off having one if it was recommended for clarity after MRI.

[B'stard Child]

JeremyH5 said:

Sorry to read that you ve made it into here, BC, but it sounds like you re in at the shallow end.

Shallow end - I like that description a lot and I'll borrow it

JeremyH5 said:

I love your graphic description of the biopsy, I remember it well

Oh I shan't forget it for a while either

JeremyH5 said:

Of course, you do realise you will very likely have to do that again if it grows .

Yeah it might be so much better next time right??

JeremyH5 said:

Mind you, that probably beats having a robot chop bits off like I had last summer.

Ouch - hope the recovery process wasn't to long - robots for medical procedures sounds like an improvement on an overworked doctor on his nth procedure of the day

[B'stard Child]

bexRVN-ret. said:

For B'stard Child.

Can I ask, have they detected a tumour in your prostate via the MRI?

During the consultation the word "tumour" wasn't mentioned but I'd assumed any cluster of cancerous cells was probably a "tumor" in some sense or other

bexRVN-ret. said:

My husband did and was also told slow growing and could monitor over the next 5years.

However he, by then had had 2 mri's about 18 months apart. First one showed v. Little 2nd.obe.showed a significant change.

He decided to go for surgery whilst it was still encapsulated. They told him after the tumour was 3mm away from breaking out. If it had he would've needed radiotherapy/chemo (I can't remember which) he was only 48 so these would have caused issues for him later in life (so radiotherapy not ideal)

His surgery was curative, long procedure and long recovery process.

I am not saying this to be alarmist but in our opinion the monitoring seemed the wrong choice and still believe surgery was the right surgery rather than waiting and hoping.

No it's fine and I guess everybody has different circumstances and I hope he's fully recovered now (albeit sans Prostrate)

I got the consultation summary letter (that was sent to my GP) thro the post today and it's pretty much "gobblygook" to a lay person although most of it aligned with my memory of the slightly dumbed down conversation with the consultant

Mrs BC ran it thro Chat GPT - no idea if it's accurate - she does this sort of thing with her own health issues!!!)

Diagnosis Summary

Biopsy Findings (30 May 2025):
Gleason Score:
Rt (Right) Anterior: Gleason 3+3=6, found in 2 out of 3 cores, involving 50%.
Lt (Left) Anterior: Gleason 3+3=6, 1/2 cores, 5% involvement + prostatitis (inflammation).
Lt Posterior: Gleason 3+3=6, 1/3 cores, 5% + prostatitis.
Prostatitis (inflammation of the prostate) in several areas.
HG PIN (High-Grade Prostatic Intraepithelial Neoplasia): Seen in right posterior and left middle zones. This is a pre-cancerous condition but not cancer itself.

MRI (10 April 2025):

PIRADS 5 lesion: This is the highest score on the MRI scale, suggesting a very high likelihood of clinically significant prostate cancer, located in the right anterior apical Transition Zone (TZ).
Capsule (outer layer of prostate) is intact.
No lymph nodes involved.

Other Details:

PSA (Prostate-Specific Antigen): 5.9 — moderately elevated.
Prostate volume: 49.7 cc.
PSA density: 0.119 — on the borderline; higher density can indicate greater cancer risk.
T2c stage (clinical): Tumor present in both lobes but confined to the prostate.
Cambridge Prognostic Group: 1 — This represents the lowest risk group.
ASA 1 & Performance Status 0: You are physically fit with no major comorbidities.
Overall Risk: Low

Management Plan

Active surveillance: Monitoring rather than immediate treatment.
Next PSA test in September.
Follow-up appointment (telephone) planned for late September/early October.

Action for GP (Family Doctor):

None at the moment.

What This All Means:

You have low-risk prostate cancer (Gleason 6) on both sides of your prostate.
Some prostatitis (inflammation) and HG PIN (pre-cancerous change) were also found.
The MRI showed a concerning lesion, but the cancer has not spread outside the prostate.
You are currently being managed with active surveillance, not immediate surgery or radiotherapy.

Mixed in above but I've separated it out was

Low signal foci in right iliac wing: This is a possible concern (e.g., bone lesion), so a bone scan is being requested to investigate further.

A bone scan is being arranged to be safe, due to a possible issue in the pelvic bone seen on MRI.

Bone scan appointment has come thro today as well - 7th July

[ClaphamGT3]

B'stard Child said:

No it's fine and I guess everybody has different circumstances and I hope he's fully recovered now (albeit sans Prostrate)

I got the consultation summary letter (that was sent to my GP) thro the post today and it's pretty much "gobblygook" to a lay person although most of it aligned with my memory of the slightly dumbed down conversation with the consultant

Mrs BC ran it thro Chat GPT - no idea if it's accurate - she does this sort of thing with her own health issues!!!)

Diagnosis Summary

Biopsy Findings (30 May 2025):
Gleason Score:
Rt (Right) Anterior: Gleason 3+3=6, found in 2 out of 3 cores, involving 50%.
Lt (Left) Anterior: Gleason 3+3=6, 1/2 cores, 5% involvement + prostatitis (inflammation).
Lt Posterior: Gleason 3+3=6, 1/3 cores, 5% + prostatitis.
Prostatitis (inflammation of the prostate) in several areas.
HG PIN (High-Grade Prostatic Intraepithelial Neoplasia): Seen in right posterior and left middle zones. This is a pre-cancerous condition but not cancer itself.

MRI (10 April 2025):

PIRADS 5 lesion: This is the highest score on the MRI scale, suggesting a very high likelihood of clinically significant prostate cancer, located in the right anterior apical Transition Zone (TZ).
Capsule (outer layer of prostate) is intact.
No lymph nodes involved.

Other Details:

PSA (Prostate-Specific Antigen): 5.9 moderately elevated.
Prostate volume: 49.7 cc.
PSA density: 0.119 on the borderline; higher density can indicate greater cancer risk.
T2c stage (clinical): Tumor present in both lobes but confined to the prostate.
Cambridge Prognostic Group: 1 This represents the lowest risk group.
ASA 1 & Performance Status 0: You are physically fit with no major comorbidities.
Overall Risk: Low

Management Plan

Active surveillance: Monitoring rather than immediate treatment.
Next PSA test in September.
Follow-up appointment (telephone) planned for late September/early October.

Action for GP (Family Doctor):

None at the moment.

What This All Means:

You have low-risk prostate cancer (Gleason 6) on both sides of your prostate.
Some prostatitis (inflammation) and HG PIN (pre-cancerous change) were also found.
The MRI showed a concerning lesion, but the cancer has not spread outside the prostate.
You are currently being managed with active surveillance, not immediate surgery or radiotherapy.

Mixed in above but I've separated it out was

Low signal foci in right iliac wing: This is a possible concern (e.g., bone lesion), so a bone scan is being requested to investigate further.

A bone scan is being arranged to be safe, due to a possible issue in the pelvic bone seen on MRI.

Bone scan appointment has come thro today as well - 7th July

Sounds largely promising. The only point I'd make is push for a PET scan rather than just a bone scan - it is much more comprehensive and accurate.

[motco]

B'stard Child said:

westberks said:

well prostate wise that fits just into the glass half full category in that it is clearly small and apparently slow progress, so lots of options for treatment.

Agreed will just have to see over time what options are needed

westberks said:

Well done for getting it checked up..... eventually! Us blokes are often our own worst enemy,

Thank you - you are 100% right about own worst enemy - men tend to put up and shut up rather than dealing with something

westberks said:

hope the hand recovers well too.

Hands getting better fast - great to be able to wrap my hand round a mug of tea (or a pint of beer)

westberks said:

great description of biosy too!

I wondered if it was a bit too graphic - I was trying to keep it "light" but be realistic about how it felt - I would not want to put anyone off having one if it was recommended for clarity after MRI.

I had a transrectal biopsy about fifteen years ago - maybe more. There's a problem with this compared with the transperineal method you so vividly describe. That is that the sampling needle(s) penetrate the walls of the rectum and inoculate the prostate gland with faecal matter and all the microbes therein. Prior to the procedure I, and others having this procedure, are given two powerful antibiotics before, on the day, and afterwards. I cannot recall exactly which antibiotics but suffice it to say that one of them on its own has been used to clear up gonorrhoea in a single dose. That might be Ciprofloxacin. My gastro-intestinal tract took many months to recover. A chum of mine had severe infections from his biopsy - twice. The 'new ahole' method sounds brutal but the alternative is too!