- Reference Number: HEY1577/2025
- Departments: Radiology
- Last Updated: 31 October 2025
Pathway A information
Introduction
This leaflet has been produced to give you general information about your investigations for suspected prostate cancer. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.
What does the pathway involve
You have been referred by your General Practitioner (GP) into the urology department as you have had some symptoms that may indicate a problem with your prostate. This can include a raised Prostate Specific Antigen (PSA) test, an abnormal Digital Rectal Examination (DRE) or trouble with urination. We are doing these investigations to exclude, or diagnose, prostate cancer.
Not all abnormal tests mean that you have prostate cancer. If you are found to have prostate cancer, it is important to remember that not all prostate cancer will have a significant impact on your life. In some cases, you may have prostate cancer that does not actually require any treatment. Further information can be obtained from the Prostate Cancer UK website. Prostate Cancer UK | Prostate Cancer UK
You have already had an appointment with a urologist or nurse specialist. As a result of your symptoms (raised PSA, abnormal DRE or trouble with urination), you have been referred to radiology. The types of investigation offered are dependent on your urology assessment. Due to your, presentation, you are offered an MRI and biopsy.
Please read this leaflet in conjunction with the leaflet titled LATP.
Appointments you may receive
Where possible, you will be given an appointment for the MRI within 5 days, and for the biopsy within the following 7 days of us receiving the referral – providing we have been able to contact you by telephone. We aim to do these procedures as soon as possible as you are being investigated for prostate cancer and we want to reduce the length of time you have to wait to have this confirmed or excluded.
We may ring you to bring your appointment forwards if we have cancellations. Please do provide us with up-to-date contact information and accept calls from unknown numbers during this time. We do appreciate that you may have other commitments in life, but we ask that you prioritise these medical appointments to help us help you as quickly as possible.
The MRI Scan
Before you have your MRI scan you must inform us if you have any metal implants or fragments of metal within your body. This is because some metals are not safe to be around the MRI scanner.
An MRI looks for area of change within the prostate.
If your MRI scan is positive, i.e. shows areas of change within the prostate, then you will be offered to continue to have the biopsy to investigate why those changes have occurred.
If your MRI scan is negative, then your biopsy may be cancelled, and you will be invited to have another discussion with the urology department. If you wish to continue to have a biopsy, that is ok, however you will need to discuss this with your urologist before continuing.
In some cases, the MRI can be negative, but we would still invite you to have a biopsy. This includes when your Prostate Specific Antigen Density (PSAD) is raised. PSAD is a ratio between the size of your prostate and the amount of PSA you have in your blood. Either of these are a risk factor for prostate cancer and biopsy is recommended, even if the MRI is negative.
The sonographer performing the biopsy will explain the MRI results to you before the procedure. They will explain the benefits to you for having the biopsy and will answer any questions you may have related to the investigation at this stage in the pathway.
What about my family history?
A positive family history for prostate cancer is when either your father, your brother or your son has had this diagnosis (first-degree relative). We always assess your MRI findings in conjunction with your family history. If you have a family history of prostate cancer, our audit data has shown that when the MRI is negative, and you have a low PSAD ratio, your risk of having low-grade prostate cancer is the same as for men without a first-degree male relative having this disease. As such, we do not routinely offer a biopsy but will be very happy to arrange one if you want this reassurance even if the MRI is negative.
Before having a biopsy
There is some important information that we in the hospital need to know before you have any of these tests done.
- If you are taking anti-coagulant medication (blood thinning medication). Examples include warfarin, apixaban, clopidogrel, rivaroxaban or dabigatran. Some blood thinning agents should not be taken up to 5 days before your biopsy. Please contact the ultrasound department BEFORE your appointment to seek advice (number below)
- If you have symptoms of a urine infection. This is because it is unsafe to perform a biopsy when you have an infection. Please contact the ultrasound department BEFORE your appointment and seek some advice if you believe you may have a urine infection.
Please read the leaflet Transperineal Ultrasound Guided Prostate Biopsy under Local Anaesthetic for more information about the procedure.
Important contact details
If you need to change your MRI or biopsy appointment, or if you need to inform us about metal implants, anti-coagulation medication or if you have symptoms of an infection, please contact the ultrasound department on the number below.
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Ultrasound Department on tel: 01482 624044.
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
