Prostate Cancer - To Biopsy or not biopsy! ( or MRI scan)

This is my first posting. I did not know of this vibrant forum until this morning. I’ve spent the last few hours digesting such interesting experiences and advice regarding prostate cancer. Its the forum I’ve been looking for! I was confirmed as having pc about one year ago. I have been using the Prostate Cancer UK site for support - that organisation is brilliant with the trained specialist nurses who operate a helpline exceptional. I have however felt very frustrated and anxious living in France having this condition and being unable to access services that I believe exist.

My current struggle is deciding whether or not to have a second biopsy. My situation briefly is a PSA of 6.1 ( reduced from 9.3 1 year ago); Gleason 3+3 ( one lobe only) ; no issues on standard scan. I am in my mid sixties , blessed with a wonderful partner and felt very healthy until I received this news!

I am scheduled to have a second biopsy in one month . This would be without a second standard scan. I have read much about the development of parametric MRI ( rather than standard scan) that , in general terms, can detect( with results that are far better than a biopsy) if you have signs of Gleason 3+4 or greater. A positive mpMRI might mean for example a targeted biopsy, closer surveillance or maybe surgery. A negative mpMRI means that no or insufficient cancerous cells /signs were identified and probably no requirement for a biopsy.

I am really struggling to identify centres in France that offer mp MRI ( I think the french term would be IRM parametrique). Does anyone have any knowledge to share? My local doctor had not heard of this type of scan . My consultant felt only one facility was available in Paris - I feel he is not correct but don’t wish to challenge him…again!. In the UK 250 facilities are available under the NHS or privately. I have the option of going private at a cost of £750 -£1000. Obviously if the same facility is available free in France ( I live in Normandy) that would be my preference.

Thanks again for all your previous posts that I enjoyed reading so much this morning. There are dark moments when you are told you have pc especially in a foreign country when precision in communication regarding health is so critical. This forum is invaluable in encouraging men ( and their families) to take action, not feel isolated and to be informed.




Hi Les and welcome to SF!

Sorry to hear about your prostate cancer but whatever happens you’re not alone - neither virtually or, most importantly, at home! You may have read a discussion I instigated a while back after being diagnosed and subsequently operated on myself at 53 years old ( Gleason 3+4 / PSA 7.1)

Here’s the link:

I’m afraid I don’t have any words of wisdom to share about mpMRI but I’m seeing my lead surgeon in a couple of weeks do will quiz him and revert - I had my first mpMRI back in Feb 2016. I’m really lucky being near Toulouse which has amazing cancer facilities - Oncopole / Cancer pole etc.

I agree, Prostate Cancer UK is an amazing organisation as is Anamacap in France - both provide loads of info and support.

Treatment paths and decisions are very personal choices and shouldn’t be rushed if at all possible.

Anyway welcome to the Prostate Cancer club - growing membership can only mean more support!

Reminder boys - PSA blood tests take a couple of minutes, results are normally same day in France, they save lives. At age 53 I never had any symptoms, issues or problems - a random annual blood test was the first indication I ‘may’ have had a problem.

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Hi Les and Welcome to the forum…

I would suggest you do not “refuse” the 2nd biopsy, which is already scheduled… after all, what harm can it do… ???

My OH is also a member of the PC club…

Is your Consultant French (in the French Medical System) ?? if so… he should know all about what is available… might there be some misunderstanding due to language… ??

(Simon is our PC Champion :hugs: and he is on your case… )

best of luck…

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Thanks Simon for the comments . I’ll be really interested to hear what your consutant knows about mpMRI.

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Thanks Stella. These decisions are so difficult and about managing risk. Yes, having a biopsy is not to be dismissed without very good reason. It does however carry some risks and the biopsy might miss any suspect area. That is why I think the mpMRI scan is potentially so exciting as it covers the whole prostrate in 3D rather than just where the biopsy is taken from. As Simon has stated something to think carefully about.


Age is another huge consideration - I was (am!) simply too young to leave it in my body! I needed to head it off at the pass - get it out of me, both mentally and physically.

Even though I had a robotic prostatectomy - I’ll still need to be PSA tested for the rest of my life.

I wish I’d known about and understood PSA testing earlier - I would have been tested in my 40’s. But hey - better late than never! :wink:

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I’d been having a few problems with my waterworks identified following a triple bypass (here in France) and whilst in hospital I was referred to a urologist surgeon for investigation.
An outpatient appointment at her clinic was arranged and she arranged for me to be admitted a few days later for surgery to investigate a suspected over large prostate (a common issue).
Long story short, she took a section for biopsy during the procedure and the result came back as low risk.
Since then, she has been providing an ordinance for a PSA test the last of which was only about a month ago. The result came back at 0.88 but she will continue to see me at 6 monthly intervals and an annual PSA test to make sure everything continues to be monitored.
I have to say that Mme Dr Benmezzianni is an absolute gem and has re-assured both myself and my OH throughout.
I’m quite sure that in other circumstances, the temptation would be just to say there is no problem so forget it but in France, these matters are taken very seriously and once ‘in the system’ they will look after you exceptionally well.
If offered the biopsy (again), I would go for it.


I was merely thinking that a “cancelled” biopsy… without anything else definitely organized… would/could be inadvisable. :thinking:

Multi-parametri MRI can certainly be useful in follow up but I confess it’s not an area I know enough about; time for some research.

However this article from 2016 suggests access should be fairly good in France so I’m surprised Les is having difficulty finding a centre.

I’m a bit at sea at the moment (literally :slight_smile: ), if I manage to find any centres in France that offer it (I suspect it is mostly a question of software on the MRI scanner) I’ll post some info.

Hi Graham. It sounds like you have had more than your fair share of health treatment in the french system. Great to hear your you have been treated so well. Out of interest after/or before you had the biopsy for prostrate cancer did you also have a MRI scan ?

Yes. IRM following stroke (head and neck) and CAT regarding poor kidney function

so neither IRM or CAT was related to PC investigations …? is that right… ?

I’m trying to recall what OH had… it was all so quick… thank heavens.

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Hi again Les - some more info for you - I’ve been having a trawl around!

The correct term for the type of MRI scanner you’re referring to in France is an IRM multiparamétrique (IRM-mp). Essentially they are enhanced MRI scanners that are available in most major centres around the country.

You have a cancer centre of excellence up in Normandy - The Henri Becquerel Centre in Rouen. Maybe you could contact them for further info / advice (just click the link to go to their website) ?

As you’ll know - Prostate cancer is classed as an ALD (Affectation de Longue Durée) and is 100% covered by your CPAM.


Correct stella. The PC investigations came later but at the same hospital (Angoulême Girac) and they seem to have a pretty joined up care philosophy.
For example, the specialist treating me for poor kidney function is very closely associating with my urologist (indeed, he seems to be very much on side with all the specialisms involved in my care) keeping them up to date. He has influenced the cardio on which tablets are ‘kidney’ kind who in turn has influenced which medication is prescribed for type 2 diabetes.

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Hi Les… I am not clear on how long you have been living in France… . are you in the French health system… ???

Or are you paying privately or paying into full health insurance …??

It is a wonderful system… where the Specialists all talk to one another… and don’t waste time… either… :hugs:

Thanks Simon. Brilliant. I’ll be calling them tomorrow. I’m in the french health system so hopefully if I can be referred to should be covered. I’ll let everyone know how I get on. Les


I’m in the french health system under “longue duree”. Thanks Stella.

And even better now with the introduction of the online DMP - Dossier Médical Partagé !


Excellent… then, do your research and, depending on what you find… ask your Doc to refer you…

good luck.