Mri scans prostate check

[Iforbach]

Hello all 

I would appreciate any information if anyone has had a mri scan for prostate check ..in thailand I know blood check is initial one and finger job ..thank u in advance ..

[TheFishman1]

And my yearly check ups they do an ultrasound to check prostrates

[simple1]

MRI scans for prostate Cancer are usually done if there is a concern the cancer has spread outside on the prostate itself. A more accurate check, if it is available in Thailand, is a PSMA-PET scan.

 

https://www.prostate.org.au/news-media/news/benefits-of-psma-pet-scans-for-prostate-cancer-diagnosis/

Edited May 12, 2022 by simple1

[swm59nj]

Is this only for a routine exam.?  I have had the routine exams since age 50.  I’m 66 now. Only the blood test and finger check every year.  Both in America and Thailand. 
Over the years my prostate has become quite enlarged.  So  periodically they would do an ultrasound. 
No doctor ever suggested an MRI. 
 

[metisdead]

A troll post that did not offer any helpful advice has been removed. 

[dlvinthai]

I am 70 and had a prostate biopsy in January, but even though it found cancer cells, the urologist said that it was extremely small and that I wouldn't have to worry about it for 50 years. He did suggest that I do an MRI for it, since he said that it would detect possible tumors that both the PSA and biopsy would not reveal.

[mran66]

I had one in Bangkok pattaya hospital couple of years ago. Recall paid about 19k baht. Probably can get cheaper in some other hospitals. 

[Farmerslife]

I have had an ultrasound and a subsequent biopsy for tumours on an enlarged prostate but it has not been suggested to me that I needed a MRI scan. Are there, perhaps, other reasons why your doctor feels this is necessary?

[ozimoron]

13 minutes ago, Farmerslife said:

I have had an ultrasound and a subsequent biopsy for tumours on an enlarged prostate but it has not been suggested to me that I needed a MRI scan. Are there, perhaps, other reasons why your doctor feels this is necessary?

I recently had an ultrasound which showed an enlarged prostate and they immediately followed up with an MRI. They also did a PSa blood test which was elevated but within the expected range for my age. I was diagnosed as having BPH.

[Sheryl]

As others have said, MRI is done only if manual exam, PSA level (including trebnd over time) and results of an ultrasound all suggested possibly malignancy. Never done for a routine screening, which seems to be what OP has in mind.

[chilli42]

4 hours ago, simple1 said:

MRI scans for prostate Cancer are usually done if there is a concern the cancer has spread outside on the prostate itself. A more accurate check, if it is available in Thailand, is a PSMA-PET scan.

 

https://www.prostate.org.au/news-media/news/benefits-of-psma-pet-scans-for-prostate-cancer-diagnosis/

Exactly my experience as well.  I am not sure why they would want to do an MRI for prostate 

[HauptmannUK]

In the UK the NHS are now recommending an advanced kind of MRI (multiparametric MRI - mpMRI) if PSA is elevated - rather than biopsy. mpMRI has some advantages over biopsy and ultrasound. The resulting image is scored on a PI-RADS scale of 1-5 to indicate the likelihood of cancer. mpMRI requires a more powerful MRI machine and these are being installed in hospitals in the UK.

https://prostatecanceruk.org/prostate-information/prostate-tests/mri-scan

 

Couple of years ago my PSA was a bit high and my GP recommended mpMRI scan - he said biopsy is unpleasant and carries risks of infection. My mpMRI came back with a score of 2 (low risk of cancer) and BPH was diagnosed. PSA subsequently dropped back down.

[Sheryl]

Parametric MRI is available in just a few places in Thailand (2-3 major government teaching hospitals) and very expensive. In additiojn only a handful of urologists here can interpret them.

 

Thus used here only when there is high suspicion of malignancy.

[SAFETY FIRST]

14 hours ago, Iforbach said:

anyone has had a mri scan

There was a recent topic on AN regarding MRI's. 

 

I saw prices as low as 8500 baht if I remember. 

 

Googlesearch should find it. 

[Sheryl]

1 hour ago, SAFETY FIRST said:

There was a recent topic on AN regarding MRI's. 

 

I saw prices as low as 8500 baht if I remember. 

 

Googlesearch should find it. 

That would not have been a multi-parametric MRI which is a very special type requiring special equipment. Last I heard only 3 hospitals in the country had it. Imaging centres do not.

[SAFETY FIRST]

3 minutes ago, Sheryl said:

That would not have been a multi-parametric MRI which is a very special type requiring special equipment. Last I heard only 3 hospitals in the country had it. Imaging centres do not.

Noted, with thanks. 

 

[Tropposurfer]

I'm now in my mid 60's ... had colonoscopies since 50 every 2 year or so.

Never had an MRI, never had one suggested to me either ... in LOS or Australia (top private insurance there to).

In Australia (and for quite some years now) there has been a program of awareness and national testing.

The definitive test to check for cancerous polyps or prostate cancer itself is a colonoscopy and is his optical rectal examination.

It is now and has been the definitive standard test for diagnosis of bowel and prostate cancers in Australia.

I was told by surgeon (all of them) that blood tests, MRI scans, and rectal digit exams, are NOT definitive in diagnosing bowel or prostate cancers - benign or malignant.

 

[HauptmannUK]

1 hour ago, Tropposurfer said:

 

The definitive test to check for cancerous polyps or prostate cancer itself is a colonoscopy and is his optical rectal examination.

It is now and has been the definitive standard test for diagnosis of bowel and prostate cancers in Australia.

 

If this statement is accurate then Australia is greatly out of step with the rest of the developed world. I don't see how colonoscopy would definitively diagnose prostate cancer.

From my discussions with my daughter (she's a doctor) and a urologist it is a systematic biopsy of the prostate which can definitively detect prostate cancer. The problem is determining whether the cancer is clinically significant or not.  And of course biopsy itself is uncomfortable and not without the potential for adverse effects. 

mpMRI is now commonly used in UK and Europe to determine whether or not systematic biopsy should be undertaken, and to guide the biopsy if one is recommended.

In the UK NHS an elevated PSA gets you on the two-week screening pathway, which mostly involves DRE, mpMRI and then biopsy (depending on PIRADS score from MRI).

[KhaoYai]

The old way was PSA check then DRE + biopsy.  There is now an enhanced MRI scan that cuts out some of the need for a biopsy. I can't speak for Thailand but in the UK they still do a biopsy if the MRI indicates a likelihood. A rectal biopsy carries a considerable risk of infection - some doctors don't like them at all.

Edited May 12, 2022 by KhaoYai

[CM4Me]

About six years or so ago, as a result of àn a/checkup which showed a slight rise in my PSA Levels, my GP here in Thailand recommended I see a urologist. 

The urologist recommended I have a biopsy, wnich I did. 24 hours later I suddenly came down with a temp around 40, spent the next 5 days in hospital. As a result I never wanted another prostate biopsy ever again.

My research showed me that many advaned countries favour MRI of the Prostate over biopsy, and this is the action I've been taking, yearly.

I understand that the best MRI image is from a Telsla 3.0. As Sheryl indicated there is only a small number of these machines in Thailand. A Multi-paramatic MRI with contrast costs about 25-30k Tbh.

Unfortunately, my cancer continued to grow, and right now I'm in BKK being treated for PC. Fortunately though, the cancer is still contained within the prostate capsule

[Tropicalevo]

8 minutes ago, KhaoYai said:

A rectal biopsy carries a considerable risk of infection - some doctors don't like them at all.

A doctor friend of mine, whilst not a urologist, treats lots of old guys.

When my PSA shot through the roof, he said that a biopsy should be the last thing that you do. in his words 'you are putting wounds into your prostate and it is hit and miss for finding anything'.

Every visit to the urologist here on Samui ended with a 'you should have a biopsy' from the doc. I said no thanks.

We compromised with annual MRI scans. After the last one - they were concerned about some changes on the scan so a 'targetted' biopsy was recommended.

Results were negative.

No idea about the type of MRI but it was at a big expensive hospital near a convent school in Bangkok.

I lost confidence with the docs at that stage.

The new urologist on the island wants to do biopsies. No thank you so it is a blood test and an ultrasound then 'see you next year'.

[Tropicalevo]

8 minutes ago, CM4Me said:

Unfortunately, my cancer continued to grow, and right now I'm in BKK being treated for PC. Fortunately though, the cancer is still contained within the prostate capsule

Good luck. ????

[KhaoYai]

15 hours ago, swm59nj said:

Is this only for a routine exam.?  I have had the routine exams since age 50.  I’m 66 now. Only the blood test and finger check every year.  Both in America and Thailand. 
Over the years my prostate has become quite enlarged.  So  periodically they would do an ultrasound. 
No doctor ever suggested an MRI. 

If I was you I would demand a biopsy. I'm guessing you've had PSA tests?  They give an indication but only a biopsy will confirm the cause of the enlargement.  High PSA's don't always confirm cancer and low ones don't always negate it but they are all that is offered in many countries unless you pay .  I've been living with the disease for over 7 years now, my PSA was 189 on diagnosis which was pretty damning, a DRE gave a further indication and the biopsy provided confirmation.  I've had both radio therapy combined with hormone therapy and brachytherapy folliwing a slight re-occurence last year.  The one thing you must not do is procrastinate. 

 

I've been extremely lucky - despite such a high PSA level, the tumours had only just broken through the prostate capsule - once it gets out there's very little they can do except for slow it down.

 

Yep, I'm preaching but I make no excuse for that - I take every opportunity to advise guys to get a PSA test regularly and if there's anything wrong, demand a biopsy.  A lot of doctors advise against biopsies because of the risk of infection.  I prefer not to take the risk of dying thanks doc.  If the new type of MRI is reliable then that is probably a good option (others will have better knowledge of it than I do) but take action - cancer waits for no man.

 

As I say, I've been extremely lucky and responded far better to treatment than many do - I know of others that have not been so lucky - get tested!

[KhaoYai]

4 minutes ago, Tropicalevo said:

The new urologist on the island wants to do biopsies. No thank you so it is a blood test and an ultrasound then 'see you next year'.

Read my subsequent post.

[KhaoYai]

23 minutes ago, CM4Me said:

Fortunately though, the cancer is still contained within the prostate capsule

If its still contianed within the capsule your chances are good. However, if its growing, how do they know it hasn't spread?  An MRI will not necessarily show that and certainly isn't used at your stage in the UK.  The usual following diagnosis, treatment and re-occurance is a full body PET scan. To the best of my knowledge an MRI is not good enough to detect small cancerous areas.  PC can show up anywhere once it escapes the capsule but the usual spread is to the bones, lungs or brain - it travels via the lymph nodes.

 

If I was you I'd insist on a PET.

 

Best of luck.

Edited May 12, 2022 by KhaoYai

[CM4Me]

KhaoYai, you're spot on.

The MRI I had in Jan this year showed an increase in cancer. I researched for recommendations for an experienced Dr and that's how I'm in BKK, down from CNX.

This Dr examined this lasest MRI report and recommended I have a PSMA-PET scan, which I have had (cost 76k Bht).

Now I'm being treated by this Dr

 

 

[Iforbach]

Thank you all for advise and knowledge ...I will digest and gratefull again for all info ????

 

[KhaoYai]

16 hours ago, dlvinthai said:

I am 70 and had a prostate biopsy in January, but even though it found cancer cells, the urologist said that it was extremely small and that I wouldn't have to worry about it for 50 years. He did suggest that I do an MRI for it, since he said that it would detect possible tumors that both the PSA and biopsy would not reveal.

I believe that most cases of prostate cancer are very slow moving - there's a saying that you die with it, not of it.  In such cases the treatement is usually 'watchful waiting' (continual monitoring).  I'm not a doctor but to the best of my knowledge a doctor cannot determine the grading of the cells - Gleason Score without a biopsy. As you've had a biopsy I presume your cancer was graded?  If so it was probably determined as low grade and not requiring immediate treatment. Was your doctor recommending regular MRI's?  I guess that would establish the size and any growth of the tumour(s) but its not something that's usually done here in the UK or it wasn't when I was diagnosed - The first steps are continual monitoring and as the progress increases you may well be recommend to have hormone therapy. I've not heard of MRI's being used as part of that regime but I suppose its possible that they newer type of MRI could be useful.  Just be sure your doctor worked out your Gleason Score.

[simple1]

6 hours ago, CM4Me said:

KhaoYai, you're spot on.

The MRI I had in Jan this year showed an increase in cancer. I researched for recommendations for an experienced Dr and that's how I'm in BKK, down from CNX.

This Dr examined this lasest MRI report and recommended I have a PSMA-PET scan, which I have had (cost 76k Bht).

Now I'm being treated by this Dr

 

 

Here in Oz my oncology specialist stated must wait until PSA count is at a minimum of 0.5, (ideally at or over 0.8) when coming out of remission, prior to a PMSA-PET scan, as below that number difficult to identify area/s of cancer spread.

 

Below is a review of PMSA-PET scan technology and benefits.

 

https://www.petermac.org/sites/default/files/media-uploads/proPSMA health economic Eur Urol 2021_0.pdf

[Sheryl]

9 hours ago, KhaoYai said:

If I was you I would demand a biopsy. I'm guessing you've had PSA tests?  They give an indication but only a biopsy will confirm the cause of the enlargement.  High PSA's don't always confirm cancer and low ones don't always negate it but they are all that is offered in many countries unless you pay .  I've been living with the disease for over 7 years now, my PSA was 189 on diagnosis which was pretty damning, a DRE gave a further indication and the biopsy provided confirmation.  I've had both radio therapy combined with hormone therapy and brachytherapy folliwing a slight re-occurence last year.  The one thing you must not do is procrastinate. 

 

I've been extremely lucky - despite such a high PSA level, the tumours had only just broken through the prostate capsule - once it gets out there's very little they can do except for slow it down.

 

Yep, I'm preaching but I make no excuse for that - I take every opportunity to advise guys to get a PSA test regularly and if there's anything wrong, demand a biopsy.  A lot of doctors advise against biopsies because of the risk of infection.  I prefer not to take the risk of dying thanks doc.  If the new type of MRI is reliable then that is probably a good option (others will have better knowledge of it than I do) but take action - cancer waits for no man.

 

As I say, I've been extremely lucky and responded far better to treatment than many do - I know of others that have not been so lucky - get tested!

 

There is no reason at all to get a biopsy based solely on an enlarged prostate -- almost all  older men have an enlarged prostate.

 

Biopsy would be indicated if there were indications other than simple enlargement that there is a malignancy. In the absence of mpMRI, such indications inclucde:

 

- a significant  increase in PSA level and inflammation has been ruled out as cause  or  very high PSA with inflammation ruled out as the cause

 

- prostate feels irregular on manual exam

 

- ultrasound findings suggest malignancy