Prostate cancer

[Derek Smith]

Viper201 said:

Sheepshanks said:

Should have had my biopsy today but they wouldn't do it as blood pressure too high.

Having got worked up for it - which is maybe part of the problem - I feel a bit deflated. Blood pressure has never been flagged as an issue before but they seem to decide immediately at the first check they weren't going to do it, although they did two more checks when it read even higher, then back down.

What was slightly odd is the Consultant spoke to me as if I hadn't been given the MRI results, when I had, I'd been back in to see the lead consultant - although that was on one the strike days and had been arranged at short notice so I wonder if that was just some filling in of time that had become free. He (today's guy) started to talk about not doing the biopsy and just monitoring. I said I've already been through this discussion and it was decided I would have the biopsy. He didn't challenge that but I was left with the impression that they'd rather not do it.

My wife had a cataract operation at the same hospital a few weeks ago with higher blood pressure than I've got - it was mentioned, but no suggestion of not doing her op.

Anyway, wife has somehow managed to get me an appt with our GP later this afternoon re high blood pressure.

None of this is doing my blood pressure any good!


I did find out my PI-RADS is 2.

With a Pi-Rad of just 2 - the official definition is: LOW (clinically significant cancer unlikely) - is why they are reluctant to do the biopsy.

The biopsy is not the most fun way to pass an hour and given the choice in your situation with such a low rating, would not have it done. However, you must follow the advice of the team and make your own decision.

The biopsy caused me concern. I mean, having a tube stuck up your fundament, made worse for me by my brother telling me it went up 8 inches. However, I had the same (by same, I mean type. I just hope I do) down my throat and into my stomach some years before (vitamin B12 deficiency caused by my stomach lining they said) and that was many times worse than having it up your bum. There's no real pain as such, but it is uncomfortable, like sitting on a stone.

My blood pressure was elevated on the day, but I said to the nurse, 'Is it any wonder?' She, no doubt, knew that it was nothing to fear, or even get worried about.

[Sheepshanks]

Derek Smith said:

The biopsy caused me concern. I mean, having a tube stuck up your fundament, made worse for me by my brother telling me it went up 8 inches. However, I had the same (by same, I mean type. I just hope I do) down my throat and into my stomach some years before (vitamin B12 deficiency caused by my stomach lining they said) and that was many times worse than having it up your bum. There's no real pain as such, but it is uncomfortable, like sitting on a stone.
….

That doesn’t sound too bad - mine was going to be a ‘Transperineal template prostate biopsy’. I don’t know why that, rather than what you described.

My GP this afternoon said he was bit surprised they wouldn’t do it as my BP isn’t madly high but that they’d likely have been concerned about excessive bleeding.

[Viper201]

Sheepshanks said:

Derek Smith said:

The biopsy caused me concern. I mean, having a tube stuck up your fundament, made worse for me by my brother telling me it went up 8 inches. However, I had the same (by same, I mean type. I just hope I do) down my throat and into my stomach some years before (vitamin B12 deficiency caused by my stomach lining they said) and that was many times worse than having it up your bum. There's no real pain as such, but it is uncomfortable, like sitting on a stone.
….

That doesn’t sound too bad - mine was going to be a ‘Transperineal template prostate biopsy’. I don’t know why that, rather than what you described.

My GP this afternoon said he was bit surprised they wouldn’t do it as my BP isn’t madly high but that they’d likely have been concerned about excessive bleeding.

The biopsy Derek had, the same as me, was not really too bad as they use local anaesthetics. However, there is a certain randomness to where the samples are taken from and it is possible to miss a small cancerous area. One of the samples taken was a miss: it hit something else, not the prostate and not being under anaesthesia was like a hard kick in the crotch.

The template biopsy is more accurate especially if you are under a general anaesthetic rather than a local one. You may have up to 30 samples taken under a general. Perhaps you were to have a general and in the current climate, there were no doctors or beds available?

[Sheepshanks]

Viper201 said:

The template biopsy is more accurate especially if you are under a general anaesthetic rather than a local one. You may have up to 30 samples taken under a general. Perhaps you were to have a general and in the current climate, there were no doctors or beds available?

No, it was going to be local, done in several stages. There were three of us in there and they did the other two. One guy came back before I left - he walked back OK and was chatting to me. He’d had two anal biopsies and this was his fourth in total so unless there’s another type it must have been his second template.

I was told 24 samples - don’t know if that’s ‘up to’ or if it’s the actual number.

[Viper201]

Sheepshanks said:

Viper201 said:

The template biopsy is more accurate especially if you are under a general anaesthetic rather than a local one. You may have up to 30 samples taken under a general. Perhaps you were to have a general and in the current climate, there were no doctors or beds available?

No, it was going to be local, done in several stages. There were three of us in there and they did the other two. One guy came back before I left - he walked back OK and was chatting to me. He’d had two anal biopsies and this was his fourth in total so unless there’s another type it must have been his second template.

I was told 24 samples - don’t know if that’s ‘up to’ or if it’s the actual number.

The more the merrier they say. 24 is a good number to locate any potential problems.

Your mate must be like a colander now.

[twinchoke]

I have been following this topic for a while now.
Following a visit to the Doctor in November my blood test result showed a PSA of 4.9. I then went back and saw a nurse and had the finger check, which she said the prostate didn't seem abnormal. She was unsure what to do next so said wait 6 weeks and do another PSA. This came back at 5.1. Then saw another nurse who referred me to a Doctor.

This was in January. At last I saw a Doctor who then sent me for an MRI scan. This showed up a change in the prostate.
I then went for a biopsy earlier this month (PSA again 5.2) but unable to carry out due to high blood pressure. This was almost certainly due to anxiety.

Back to the Doctor for meds to lower blood pressure. Another biopsy booked for 28th Feb, however they now think this is too soon for the meds to work so have just received a new appointment for the biopsy in July!! Not happy to have to wait so long. They gave me a likelihood score of 3.

I am going to chase up as I feel this is too long to wait.

[Sheepshanks]

Viper201 said:

Your mate must be like a colander now.

Having read (with my eyes partially squeezed shut!) through the leaflet about the procedure he seemed remarkably chipper. He did ask for a pad before he would sit down though.

[Sheepshanks]

twinchoke said:

Back to the Doctor for meds to lower blood pressure. Another biopsy booked for 28th Feb, however they now think this is too soon for the meds to work so have just received a new appointment for the biopsy in July!! Not happy to have to wait so long. They gave me a likelihood score of 3.

I am going to chase up as I feel this is too long to wait.

I was given one 5mg Amlodipine per day and told (by GP) it'll take 3 weeks to take effect. Hospital told me to call and rebook when blood pressure is down.

I've had to ring the consultants secretaries when things seemed to stall at one stage - I've always felt awkward doing that kind of thing but everyone in the NHS will tell you to get on the phone and chase. The department has some kind of admin / organising type person and she gave me her direct phone number after telling me she'd call back that afternoon with a biopsy appt. She didnt call and I had to chase her, but she had reserved the slot, she just hadn't told me!

Edited by Sheepshanks on Wednesday 22 February 16:16

[Viper201]

twinchoke said:

They gave me a likelihood score of 3.

Most Pi-Rads scores of 3 do not contain clinically significantly prostate cancer. The current guidelines say a biopsy should be done. However, there is still doubt about the need of an immediate biopsy and many prefer to do monitoring. If your PSA had been higher then you would likely have been called in sooner.

Remember that prostate cancer is a slow growing one compared to many others so urgency is not the same.

[twinchoke]

Quick update, going for a blood pressure check Friday to see if things are improving and have managed to get my original biopsy appointment reinstated, the July date was a mistake.

Fingers crossed the blood pressure is OK and stays ok for the biopsy.

[Sheepshanks]

We have a BP machine at home and during yesterday - so I'd only taken two days of BP tablets - mine dropped back to more normal level, and it's same this morning. Surprised as GP told me it'd be a while before I saw any difference so maybe a lot of it was due to white coat syndrome.

I'm really unsure about going ahead with the biopsy though.

[Casa1862]

Viper201 said:

You are fortunate that they do the Nano Knife. A breach is still considered suitable for surgery if it hasn't spread very far so I think you are probably worrying too much. Until they have a look inside they wont really know for sure. With any luck they will be able to spare the nerves.

Sorry a bit of mis googling there, it's actually NeuroSAFE (not Nano Knife) which they use to hopefully spare the nerves. Seeing a surgeon on Sunday and hopefully get myself booked in for Prostate removal. Current estimates 6 to 8 weeks, pre new year they were doing with 4 weeks.

[Viper201]

Sheepshanks said:

We have a BP machine at home and during yesterday - so I'd only taken two days of BP tablets - mine dropped back to more normal level, and it's same this morning. Surprised as GP told me it'd be a while before I saw any difference so maybe a lot of it was due to white coat syndrome.

I'm really unsure about going ahead with the biopsy though.

Its the only sure way of knowing if there are cancerous cells there. It would put your mind completely at ease if the results were good. Otherwise you will be thinking, 'What if...'

[twinchoke]

Had my biopsy yesterday, blood pressure just low enough despite the meds, but anyways done and behind me now.

Just the wait for results and what follows.

[Sheepshanks]

twinchoke said:

Had my biopsy yesterday, blood pressure just low enough despite the meds, but anyways done and behind me now.

Just the wait for results and what follows.

Hope that goes well for you. Did you have the template biopsy?

I'm still waiting for my BP to settle - been told three weeks. Wife had a go at getting me an appt in advance with GP and failed, although I'm not sure it's necessary.

[twinchoke]

Hi, yes template biopsy with around 16 taken. They took my blood pressure 3 times, two above the hundred cut off and one below which was good enough. Strangely after the biopsy my blood pressure was lower than the two above a hundred before?

So far so good with just some soreness and no blood showing in my urine which I thought was a given.

[Derek Smith]

twinchoke said:

Hi, yes template biopsy with around 16 taken. They took my blood pressure 3 times, two above the hundred cut off and one below which was good enough. Strangely after the biopsy my blood pressure was lower than the two above a hundred before?

So far so good with just some soreness and no blood showing in my urine which I thought was a given.

There's something primaeval in the fear of having blood in your urine. Despite knowing that it was possible/probable (prossible?), seeing the bowl turn red was quite a shock.
You did well to avoid it.

[crankedup5]

Little update regards my rectal bleeding post R/T treatment one years ago.
Colonoscopy showed clear although consultant wants a CTC scan of my bowel. The colonoscopy was not clear enough and consultant wants to be absolutely sure he can give me an all clear of the bowel.
I am advised that gross rectal bleeding is caused by the R/T treatment which has damaged colon area. Sometimes these symptoms appear within a few months of R/T or much later as in my case it seems.
I really did think the worst when my symptoms presented and now feel I have been given a massive reprieve.
Hope these comments may help PHers of the future. Keep well chaps.

[Viper201]

Good news there Crankedup.

There is very little info on the damage that R/T does to the intestines and I certainly was not told about it. For 4 years the oncology nurse did not accept it had anything to do with R/T. A change of nurse and last phone appointment she said it was quite common.

Pre R/T I could eat just about anything and even after I was okay. Slowly but surely the effects have become worse so that now I can no longer eat mundane things like a slice of toast without stomach pain and loose stools. Mince is another that is banned but the list grows slowly month after month. The intestine will not repair itself so is something I have to get used to. My wife struggles to find 7 foods that I can eat for my tea.

As for bleeding, so far I have not suffered like you have although having self-administered 37 enemas prior to zapping, I ended up with proctitis which needed treatment.

[Casa1862]

Derek Smith said:

There's something primaeval in the fear of having blood in your urine. Despite knowing that it was possible/probable (prossible?), seeing the bowl turn red was quite a shock.
You did well to avoid it.

Yep, have to agree, even when expected after my biopsy, the clots and day or two after where a little disturbing. Worst was the first load of Siemen, was told some blood will be present, nope pure blood and lots of it!! Gets better but still nasty brown colour.