Enlarged Prostate Gland

[exiledred]

Hi
Back in 2018 while an inpatient at Chesterfield Royal Hospital with an unrelated problem I found out I had an enlarged prostate. Not unusual as I am now 79 years old.

Subsequent examinations proved it to be benign until March this year when an examination revealed a nodule.

My Consultant told me that the only way to establish if it was cancerous was to have a biopsy. She then listed the problems that this could cause. She told me I could contract sepsis. As I have had this twice I declined a biopsy.

Then 2 weeks later lockdown.

I have had 2 telephone reviews in June and September. My PSA reading in September was 14.

Covid permitting I will see my Consultant next March for a further examination a PSA blood test. Maybe an MRI.


Do the risks of a biopsy outweigh the possibility of me having prostate cancer?


Thank you.

Norman Martin

[Mr Benjamin Challacombe]

Norman
If you have had 2 biopsies previously then i wouldn't have another at this stage.
An MRI would be a very sensible thing to do if they can manage it.
Prostates above 100cc often will result in a high PSA due to the benign growth and the urinary symptoms. This can be up to around a level of 20-30.
The biopsy can cause bleeding and infection and yes rarely sepsis.
In your situation it would only be indicated if a large abnormality was found on an MRI.
and the biopsy in that case should be via a trans-Perineal rather than the old fashioned trans Rectal route.

Ben

[Dr Prasanna Sooriakumaran]

Dear Norman

I'd recommend an MRI first. And then a trans-perineal prostate biopsy ONLY if the MRI is abnormal.

Cheers

PS
scastle@santishealth.org

[exiledred]

Thank you for your reply.

Is the biopsy you mention done under a general or local?

Regards

Norman Martin

[Mr Benjamin Challacombe]

Almost always best to do a trans perineal biopsy
this can now be done under local anaesthetic in many centres

https://pubmed.ncbi.nlm.nih.gov/30431694/
https://doi.org/10.1111/bju.14620
Hopefully these links from our unit will work and explain it more

Ben