Prostate One-Day Clinic

Your GP will have already talked to you why they think you would benefit from attending this clinic. Patients are referred for a number of reasons, the most common being raised PSA levels in their blood.

PSA (prostate-specific antigen in full) is a protein produced by the prostate. All men have a small amount of PSA in their blood and the levels usually increase with age.

A raised level of PSA may mean that you have a problem with your prostate. This could be prostate or urine infection, inflammation of the prostate, enlarged prostate, or sometimes prostate cancer.
 

You will have two separate appointments on the same day:

• a prostate MRI scan
• a consultation with a prostate specialist nurse.

An MRI scan uses a combination of powerful magnet and radio waves to scan your body. It will provide us with detailed images of your prostate gland.

Please tell the radiographer carrying out the scan if you have any metal devices or pieces of metal in your body. These include a heart pacemaker or a body piercing. We will ask you to complete and sign a safety questionnaire before your scan to make sure it is safe for you to go ahead with it.

The MRI scan will take about 30 minutes to complete.

Please note that you will need to provide a urine sample for this consultation.

After your MRI scan, you will have an appointment with a prostate clinical nurse specialist. The specialist nurse will talk to you about your PSA level and your MRI scan report. She/he will also:

• talk to you about your symptoms
• assess any medical conditions you may have
• answer any of your questions.

Depending on the findings from the MRI scan, the specialist nurse may also recommend that you have a prostate biopsy.

The appointment will last for about 30 minutes.

Occasionally, some men may have a transperineal prostate biopsy on the same day. This usually depends on the MRI results, consultation with the nurse as well as the availability of appointments.

The perineum is the area between your scrotum and anus. The transperineal prostate biopsy will involve taking between 18 and 24 small samples from specific areas of your prostate. This is done by using your MRI scan images as guidance.

A member of the prostate team will ask for your consent (permission) to go ahead with the biopsy. They will then give you a dose of antibiotic to help to prevent an infection. After that you will lie down on a couch and have an injection of local anaesthetic to numb the area. This means that you will be awake during the procedure and should only feel some discomfort.

You may choose to have the biopsy under sedation as well as local anaesthetic. This is to help you relax. If you would like sedation, please tell your healthcare team in advance. You will need to have some tests before the biopsy. You will also need to arrange for someone to accompany you home afterwards.

The prostate biopsy will take about one hour to complete. You will be able to go home once you have recovered and passed urine. We will send the tissue samples taken from your prostate to a laboratory to be analysed. This usually takes up to a week.

The prostate biopsy is a safe procedure but as with any procedure there are some risks associated with it. They include:

• pain or discomfort for one to two days after the biopsy.
• urine infection – you will take a course of antibiotics after your biopsy to reduce this risk. Very rarely, urine infection can lead to septicaemia (blood infection) which may require an emergency admission to hospital for treatment.
• bleeding at the biopsy sites.
• blood in the urine or semen (semen can be pink or brown for six to eight weeks).
• a small degree of impotence for a few weeks caused by bruising from the biopsy.

It’s important that you drink two litres of fluids for the first few days after the biopsy. This is to reduce the risk of urine infection and to help flush blood from urine and/or semen. If any of the above symptoms persist or if you are worried, please contact the prostate CNSs or your GP.

Go to your local Emergency Department (A&E) if you:

• have high temperature, feel feverish or have shivers
• find it difficult to pass urine, or need to pass urine more frequently or urgently
• experience heavy bleeding in urine and/or stool
• have signs of an allergic reaction, such as rash or hives, wheezing, runny nose, itchy eyes, swelling of the airways, tongue or face, breathing difficulties, or chest tightness.

• Expect to be in the hospital for several hours.
• Please bring a list of your current medicines.
• You can eat and drink normally throughout the day.
• If you were sedated for your biopsy, you will need someone to accompany you home.
• If you didn’t have a biopsy, or if you had a biopsy under local anaesthetic only, you will be able to drive afterwards.

• If you have had a biopsy, you will have a telephone clinic appointment within two weeks to discuss the results and follow-up plan.
• If you need a biopsy but you haven’t had it on the day of your appointment in the Prostate One-Day Clinic, we will arrange it for you within two weeks.
• Alternatively, you may be discharged back to your GP or have an appointment in the Urology Clinic to see one of the doctors.

The specialist nurse will discuss this with you in detail during your consultation.

Telephone: 07984 391126

Email: uclh.prostatecancercns@nhs.net

Prostate UK
Provides prostate cancer information and support.
Telephone: 0800 074 8383
Website: prostatecanceruk.org.uk

Macmillan Cancer Support
Provides support and information on the practical, social and financial effects of cancer for patients and those close to them.
Tel: 0808 808 00 00
Website: macmillan.org.uk

Cancer Research UK
Provides information about cancer, clinical trials and research.
Tel: 0808 800 4040
Website: cancerresearchuk.org

Orchid
National Male Cancer Charity supports research and promotes awareness.
Tel: 0808 802 0010
Website: orchid-cancer.org.uk

Healthtalk
Provides information about health issues by sharing people’s experiences.
Website: healthtalk.org

UCLH cannot accept responsibility for information provided by external organisations.