"Prostate Urology"

About: Macclesfield District General Hospital

Following a Digital Rectal Examination, I was alarmed that the urologist was intending to undertake a biopsy without even discussing the options or risks with me (I was lucky that my Dad was able to advise me before seeing the urologist) like 3-6% risk of blood poisoning with little hope of finding anything as it only targets one part of the prostate gland.

I wasn't even told until I spoke to another urologist that it would be a Trans Rectal Ultra Sound guided (TRUS) biopsy. I was then told that having had two Prostate Specific Antigen (PSA) readings very close to one another (within a fortnight) was a trend and that with my father having prostate cancer and his father dying of prostate cancer (in his early 60's) was not a family history; without asking about any other family history - such as my mother dying of breast cancer aged 60 (in 2002, having had two forms of the cancer) and my paternal grandmother dying of breast cancer aged 50 (in 1952), or my maternal grandmother dying of ovarian cancer. My father had a similar PSA to mine when he was 20 years older than I am, with prostate cancer being diagnosed only a few years later.

I have been left with a sense of little trust in MDGH regarding prostate care. I am very strongly of the opinion that unless an Magnetic Resonance Imaging (MRI) identifies an area of concern in my prostate gland then there is no point in undertaking a biopsy, especially a TRUS biopsy.

MDGH need to get up to speed with Basingstoke, Oxford, Milton Keynes, etc. in using MRI before biopsy of the prostate.

TRUS biopsy is only 30% accurate; a targeted biopsy following MRI is 60% accurate.

The MRI needs to be at least 3 tesla and multi-parametric with at least 3 imaging methods to be accurate enough.

If the MRI doesn't find anything suspicious, then the biopsy won't find anything either.

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Responses

Response from Macclesfield District General Hospital

We were very disappointed and sorry to read your comments. Mr Adebanji Adeyoju, our clinical lead for urology, is personally aware of your concerns and would very much like to discuss them with you. Our urology department fully appreciates the import role MRI scanning plays in diagnosis and while it may not be appropriate to use in all cases, the department was one of the first to routinely use it in the assessment of suspected prostate cancer.

Mr Adeyoju can be contacted via his secretary Sylda O'Brien via 01625 661244 or sylda.o'brien@nhs.net The trust aims to continually improve the quality of services we provide and your feedback is key to achieving this.