Urologist. Impossible to provide much advice since he hasn't actually been diagnosed with prostate cancer and there are many nuances depending on what type / grade / stage of prostate cancer we are talking about. Certainly a chance you can have an elevated PSA and no prostate cancer even with an MRI. Only way to find out is biopsy. Results of that would determine what needs to be done.If he does have prostate cancer it is almost certainly localized to the prostate. Options would then be surgical prostate removal, radiation, or surveillance and waiting. Obviously I don't want to go into these with out a proper diagnosis. Biopsy happens in the office, takes about 15 min. Results take a week or two to come back.
69M - prostate cancer? - what to expect?Hello, this is concerning my father (69M). He's 6'3" and about 15st. Anatomically this concerns this prostate, and geographically we're in the United Kingdom.He is a moderate regular drinker (2-3 small glasses wine most nights) but has never taken recreational drugs. He used to smoke but quit about 35 years ago.He has mild asthma and chronic sinus issues caused by nasal polyps that cause total nasal obstruction. He is awaiting followups for a cauterising surgery, but this seems unrelated.As part of routine bloods, my dad got a psa test about a month ago, which came back at 13.3, which is obviously elevated.His GP hasn't seen him in person and hasn't carried out a rectal exam, but instead referred him to urology. His urology referral was a telephone consult to tell him that he was being booked in for an MRI.He had the MRI (with contrast) last week and today was told that there was something suspicious on the left side of his prostate, and that he would need a biopsy. He hasn't had the biopsy yet.I understand that this is all geared towards a prostate cancer diagnosis, and I understand that at this stage, prostatitis is unlikely. All the clinicians with whom my dad has spoken have been very reticent when he has asked about cancer, but simultaneously tell him he might need a bone scan based on the outcome of the biopsy.I'm under no illusions that prostate cancer is high on the differential, but could benign prostatic hyperplasia still be on the cards? I understand that both conditions are diagnoses histologically, but it would be helpful to know whether PC and BPH look distinct on images?For background info - he has no urinary symptoms but has been losing weight steadily for about 3 years (maybe 4st in 3 years?). Assumption has been that he hasn't been eating much because his nasal polyps have robbed him of his sense of last largely. He also lost his wife (my mum) to breast cancer six months ago. He can't cook and eats rubbish, and also likely has depression.Any insight here would be useful in terms of differentials, outlook (based on the vagaries I've provided) and generally what to expect. I definitely feel that no clinical has been forthright with my father thus far. That's no criticism of the docs, but it hasn't helped him and has compounded his stress as he's gone straight to Google and catastrophised.