MRI scan after my surgery
May 2014, Saturday]: Had my post-surgery MRI scan
this Saturday morning in the NHS UCLH hospital.
Was pleased with their efficiency: no waiting
the radiologists were happy about my taking the
one Temazepam 10mg (as a mild sedative) about 20
minutes prior to the scan; they agreed that about
1 hour "hanging around" after the scan
should render me ok to travel on public
did that help?
Answer: yes! Certainly didn't feel claustrophobic
like I did last year (for the results of that
MRI, see above.
what will be done with the results? Well, my
consultant will receive the report, and I expect
a consultation to discuss it soon.
notice I had the radiologist report for my first MRI. Well, I asked the
radiologist if I could similarly have that, plus
the full CD of all images, after my scan today. I
was told to contact them during the next working
week. There would be a charge to pay.
May] Picked up copy of CD of MRI images
today-there was no charge, since I got them
within 40 days. Was told that the radiologists
don't also give a detailed annotated report as
for my first MRI. I now realise why - this second
MRI merely looks for the ablated
area, so will not report on remaining cancer, I
image below shows the cryo ablated (destroyed)
the dark area.
The surgeon says "it looks very
good", so I presume that means he ablated an
"left" in the image is the right
hand side of my body)
I must say, the area ablated looks much
larger than the red area marked on my first MRI. However, the surgeon did say
that he would target an area a little larger than
that, to be sure all the
index lesion was killed off, plus I guess the
precision of the cryo comes into play.
like me, you get your own CD
copy of your MRI images, you may need to download
a MicroDicom viewer to be
able to view the pictures. This is the one I used
for Windows: Click here for the viewer it's free! This
"RadiAnt" version is incredibly good!
it handles both my private pre-op images and
my post-op NHS ones, unlike
the first viewer I downloaded and tried. You can
even measure portions
of the image, in linear and square quantities!
There are even better viewers for Apple Mac. Very
limited choice for Android, don't know about
May]: follow-up appointment to discuss things
with the surgeon arranged for 28th May. PSA
blood test yet to be arranged, but been told will
be around 2-3 months time (update
- see below). Need to note
down questions to ask him.
"post-surgery consultation" for more details.
June 2014]: I'd be interested to know what tissue
has replaced the
tumour and good tissue that was ablated. Some
months ago, "scar tissue" was mentioned
whom I talked to at UCLH.
Update February 2017: PSA
3.6ug/L. This indicates that the cryotherapy is
remaining effective - the cancer tumour appears
to have been effectively destroyed, with no
evidence of recurrence.
July 2016: Dry Climax (orgasm) - click
June 2016: PSA 3.7 ug/L
January 2016: PSA 3.22ug/l. Prostate volume 23cc
Hospital consultation at UCLH Westmoreland
My cancer is now stable, no evidence of any
significant prostate cancer,
Recommendation: Remote Surveillance. Get 6
monthly PSA test done at my GP. If it goes above
4, then also do Mid-Stream-Urine test, to check
for an infection that may be giving the higher
reading. No need for another MRI provided PSA
remains below 4, see above.
[My understanding]: Repeat PSA 3 months later. If
still above 4, then go back to the hospital for
Note: a 6 monthly PSA test
should be mandatory for every
man aged 50+, see my notes
at the beginning of this blog.
I've put 3 MRI images taken in November 2015.
Compare these with my earlier ones below. Whilst
not commenting specifically on these, the
said that the overall MRI had not revealed any
significant (observable) prostate cancer.
[My observation]: I'm at no
more risk from prostate cancer than any other man
is the new loacation of the Urology department
(as of the date of writing this). It is no longer
in the Cancer Centre in Huntley Street.
PSA result, May 2015: 2.54.
This is a slight reduction from 3.1 measured in
So, it's a trend in the right direction.
following notes added on 24 November 2014]
18-day and 7-month MRI and PSA comparison - see
my prostate is roughly outlined in RED.
The original location of the tumour is roughly
outlined in YELLOW on the 18-days image.
The ablated area is outlined in GREEN on the
ablated area has shrunk to (I presume) no volume
My prostate volume has reduced by 5cc, which is
pretty close to the 5cc volume that Emberton
estimated would be ablated.
My PSA has rougly HALVED. The present PSA of 3.1
is within the range expected for a man of my age
(61 years) who does not have significant prostate
conclusion: Success! Cancer treated*.
Side effect: reduced ejaculation.
Future plan for tests, surveillance: to be
discussed on 10th December with Emberton.
Watch this space!
significant anterior tumour has been treated. I
am not experienced enough to recognise any
remaining lower-grade cancer by looking at the
December 2014]: Had follow-up consultation with
He said that it was "all good!" See
below for his dictated letter which gives a precise
statement of his observations.
said that there was scar tissue, outlined in the
2nd image above in BLUE. I guess this is the
left-over bit of the ablated area, see the 1st
image above, outlined in GREEN.
not make any comments about any further cancer
being visible, probably because my PSA now of
about 3 does not suggest there IS any significant
cancer. Remember: all men my age will have some
very low-grade prostate cancer, but it will
probably never grow fast enough to catch up with
them as they age.
There is even talk of not
considering low grade
prostate cancer as cancer, see this
future: I am to organise 6-monthly PSA tests
throgh my GP. If my PSA goes above 4, then I am
to contact Emberton again.
arranged another MRI scan for me in 1 years' time
that the 6-monthly PSA tests are what I was
having for several years before
my diagnosis of cancer.
As I say at the beginning of this blog, it's very
advisable for all men
over 50 years old, to start having 6-montly PSA
tests and continue them for the rest of their
graph of my PSA is shown below. (The best graph I
could make; my PSA probably dropped much faster
than the slope shows, from a figure of about 6
before my cryotherapy, to a figure of about 3,
soon after my cryotherapy that I had in April
steadily climbed over the years, until it reached
Then, the cryotherapy knocked it down to about 3
If it climbes again above 4, then I'll have
further tests. If necessary, repeat treatment
will be given.
However, it may well be that any remaining
low-grade cancer will never develop in my
lifetime to cause any trouble, see this
report above is the very latest update to this
blog. Apologies again for it all being a bit
disjointed! I'll get round to re-writing the
whole page someday!
[January 2015]: Just received my copy of
Emberton's consultation letter.
has done fantastically well with almost no
toxicity. The only thing he has noticed is a
change in the quality of the ejaculate, which we
would expect, treating in the anterior component.
His PSA is now steady at 3.1 µg/l and the MRI
shows no residual disease on the
late [24 November 2014] scan. We would recommend PSA's
on a six monthly basis and look forward to seeing
him in December 2015, with an MRI
2015]: Regarding "...a change in the quality
of the ejaculate" mentioned above: as
mentioned elsewhere, my ejaculation diminished to
zero about 4 months after my cryotherapy.
However, a very little ejaculate does appear
Emberton is probably familiar with this process
in some patients, hence he would classify this as
ejaculaion", and not "zero".
My erections and sexual desire remain good and
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