69 years old recent MRI DCE positive PR4

Do you have any prior PSA results? The doubling rate is of primary importance in the early stages of evaluating the cancer growth rate. What prompted the scan and what kind scan? Just a casual take on scans, the body is a host to so much stuff, imaging will show things that might have been there for decades, so perhaps do a history of incidents you have had so that it can balance out any findings on images. (example, I did a bone scan and it showed huge uptake in my jaw, but that was because I just had an implant posted in my jaw).

I agree that getting educated and prepared for action is the right course of action (from your tone, it sounds like you are on it!) but give yourself some breathing room, your PSA is relatively low (in the grand scheme of things) and the counter is at 69, so with the approach of "early detection equates to many options" there stands to reason that you a treatment plan will be in your grasp sooner than later and the counter can continue for many more years.

not happy to meet you in a literal sense, but glad you found the community here, we are here to help.

Edmond - I have been bad about taking care of my health and took a 3 year absence from seeing my doctor 🙁
At the end of 21 my PSA was 4.05 then three years later it was 7.5. My doctor was unsure therefore that this was sudden or not and had me visit a urologist. My urologist didn't like the number and felt my Prostate was enlarged, that's what prompted the scan. I might add that I have been overweight for those years as well but have dropped around 25 lbs and nearing a normal weight.

jck6455: I think you are right...get right on it. Its the potential spread that I was worried about because waiting too long (an undetermined number) could change the quality of life because of treatment choices that come into play.

I had a 10.2 psa and started my MRI and then a biopsy but mine was contained. My brother was 6.5 and it had spread.

If you decide on the biopsy, you might want the Decipher test, which takes the biopsy material and tests for aggressiveness and treatment modes. Doctors use it for their diagnosis. I had a twilight drug for my biopsy.

Jim, PR (PI-RADS Prostate Imaging reporting and data system) has a scale of 1-5. 4 indicates likelyhood of significant cancer.
DCE is a specific sequence of images that highlights vascularization of the tumor and reflects angiogenesis-- the development of new blood vessels. Positive DCE is indicative of active cancer.
Yes, biopsy next. You might want to get a copy of your MRI, research oncologists to choose the best in your area, and schedule a MRI/US fusion guided biopsy. Depending on your insurance, you may be able to schedule it without the uncommunicative urology office.
Because of the nodes, I suspect you'll be on androgen suppression therapy.
It's good that you found Mayo Connect. Keep posting

Sorry you have joined the group. Deep breath; 1 step at a time.
At 72, after PSA 5.9, MRI suggested cancer, including a specific lesion, in the prostate. Pelvic Lymph nodes were suspicious.
Fusion guided biopsy found many positive cores; including 8s and a 9.
PSMA PET scan followed and did NOT confirm PCa in the lymph nodes.
I chose surgical removal of the prostate, and would do so again. Others have chosen radiation.
Your test results may indicate treatment is warranted; or maybe not.
Patrick Walsh, MD book "Surviving Prostate Cancer " is an excellent resource, together with free download or hard copy of Patient Guide from Prostate Cancer Foundation (PCF.org).
Try to locate a Center of Excellence (COE) or a very reputable Urologist to help guide you with your decision making.
Best wishes.

So an update - I did hear from my Urologist and they are setting up a biopsy next week (1st week of may).
His response was that he viewed the actual images and currently not overly concerned and felt I was 50/50 for cancer. He also indicated that I have a very enlarged prostate (4x) that accounts for the raised PSA levels. So he said that level PSA 7.8 aligns with a gland of that size. So if it is cancer it may be early IDK. I'm being hopeful but
vigilant. The biopsy is guided via the MRI data and an ultrasound device.
Many thanks to those who responded to reduce my anxiety 🙂

Michaelcharles, thanks for your reply. How long ago did you have your MRI and are you doing well? I did download the book and again thank you!

Best Regards

Communication? Great point. We, My Primary Care Doc and I, skipped two years of PSA exams during my annual physical. First was my trip to Europe, Second he took an extended duck hunting trip. Year three, age 67, we finally get back on track. Dam, higher PSA, wait 6 weeks for a new PSA exam, It keeps rising. Referral to a urologist take 3 months. Another PSA exam, dam it keeps rising. He scheduled a biopsy, another two months. PSA went from 22 to 118 in two months. Pain, lots of it, I end up in the emergency room middle of the night, CT scan, sorry PA says you have stage 4 advanced prostate cancer. Lesson learned? Communication, communication, communication. Now my number criteria for my oncology team is their communication skills.