1. < Prostate Cancer

69 years old recent MRI DCE positive PR4

Posted by jck6455 @jck6455, Apr 24 2:24pm

Hi all brand new to this site but have been reading though the posts on here and find there to be a general wealth of knowledge and experience. I know you are not medical "experts" but would like some input on my recent scan.

I had a scan 5 days ago and have yet to hear from my urologist - i recently sent a message.

Basically my summary says DCE Positive PR4, nothing noted outside the prostate. PSA 7.4 and Lesion is 15 mm thin strip. The other finding was 5 "suspicious" pelvic Lymph nodes measuring 7mm.
I assume next step is biopsy.

My reading of other general knowledge tells me to get on it.

Please render your opinion of how bad this may be - I am generally dismayed by the lack of communication. BTW I am in Des Moines.

Jim

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

mn281 | @mn281 | May 9 7:58am
In reply to @jck6455 "Hello - I have an update - Since previous prodding my urologist has been going quickly...." + (show)
@jck6455

Hello - I have an update - Since previous prodding my urologist has been going quickly. I have now completed the scan and the biopsy was last week. Received the results today of 14 cores. The2 lesion cores came back 3+4,
6 Cores 3+3, 5 cores 3+4, and one 4+3. A decipher test was requested but have not seen that yet. So I now have a PET scan scheduled to check out lymph nodes etc. Very apprehensive about this result. Those that have responded are greatly appreciated.

An additional question - I have previously been a patient at Mayo Rochester for other issues and wonder if that will help me get seen for the PCa?

Thanks

Jump to this post

jck6455, you can just ask the Doctor you saw previously to refer you to the Mayo urology department in Rochester. I did this through the message center on the Mayo portal and had an initial appointment with urology the following week.

Good luck!

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kjacko | @kjacko | May 9 8:54am
In reply to @wellness100 "PET as in PSMA PET scan? That is important. From you description, only the PSMA PET..." + (show)
@wellness100

PET as in PSMA PET scan? That is important. From you description, only the PSMA PET has the sensitivity to pick up the 7mm lesion. It is not hard to deal with. But it can become a problem later. The low Gleason score can be misleading.
Dont mind me. I am only a layman trying to make some sense of the whole thing.

Jump to this post

I agree that the low scores can be misleading. My second MRI came back clean. The following biopsy showed two cores out of 14, one at 3+4. After I had my RP, the pathology report came back at 4+5 and near the capsule. Was glad I chose RP. My two follow up PSA tests show < 0.01. Hoping for more of the same in the future!🙏🏻. Good luck to you.

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wellness100 | @wellness100 | May 9 9:28am

You did not mention the pathology report 4+5. Once again shows MRI plus biopsy can be misleading. That is the reason some doctors prescribe systemic with RP. You should get PSMI.
Dont mind me. I am just another layman trying to make some sense of the whole thing.

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jck6455 | @jck6455 | May 9 12:00pm

Wellness100, there was one core that was 4+3, I didn't get a 4+5. The urologist says the worst core (4+3) drives
the approach. I have asked for the report and will be picking it up this afternoon, then perhaps I can learn more.
thank you for asking.

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kjacko | @kjacko | May 10 8:01am
In reply to @jck6455 "So an update - I did hear from my Urologist and they are setting up a..." + (show)
@jck6455

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 🙂

Jump to this post

My urologist also believed that my 7.8 PSA aligned with the volume of my enlarged prostate My follow up MRI was clear. However my biopsy showed 2 cores of cancer, one at 3+4. I elected to have an RP. The post RP pathology report showed my cancer was actually at 4+5 and close to the capsule. So far my two follow up PSA blood tests show < 0.01. Praying for more of the same in the future. Bottom line, do everything possible to ensure your results are accurate and give you the information needed to make the best decision and give you some peace of mind. Best wishes!🙏🏻🤞

REPLY
1 reply
jck6455 | @jck6455 | 6 days ago
In reply to @kjacko "My urologist also believed that my 7.8 PSA aligned with the volume of my enlarged prostate..." + (show)
@kjacko

My urologist also believed that my 7.8 PSA aligned with the volume of my enlarged prostate My follow up MRI was clear. However my biopsy showed 2 cores of cancer, one at 3+4. I elected to have an RP. The post RP pathology report showed my cancer was actually at 4+5 and close to the capsule. So far my two follow up PSA blood tests show < 0.01. Praying for more of the same in the future. Bottom line, do everything possible to ensure your results are accurate and give you the information needed to make the best decision and give you some peace of mind. Best wishes!🙏🏻🤞

Jump to this post

kjacko,

well it was obvious that my hopefulness was going overboard. The numbers I posted of my biopsy results were based a a very fast paced phone call with my urologist giving me numbers and saying he was ordering PSMA pet scan to check those 5 suspicious lymph nodes . I was able to actually get the report and realized I had stated things incorrectly. As it was in the reports out of 14 cores 8 were benign. 1-3+3, 4-3+4, and, 1-4+3. The 4+3 was on the line of 50% pattern 4 which is one point above max for a 3+4.,So overall i'm rated 4+3. My stage is T1c for now until I get the scan. I am waiting on the decipher test. Interesting that where the MRI found a PR 4 lesion, the two cores there came out benign and 3+4

My father had prostate cancer at in 1999 at 75 and lived to 91, but succumbed to it later on. Im not sure he was doing any thing watchful. He had bracytherapy LDR with it and not aware if he took anything else other than flomax. I'm hopeful that since his was slow growing so will be mine.

Unfortunatly I wish it was the only thing going on. My Cardiologist is recommending a Stent be placed because scans and other test have been inconclusive about a blockage, But that requires blood thinners for a year and that would preclude any prostate surgery or radiation. So im kinda going to have to gamble on the balance here on cancer treatment vs the unknown Cardiac risk.

Trying to keep my Spirits up.

REPLY
2 replies
kjacko | @kjacko | 6 days ago
In reply to @jck6455 "kjacko, well it was obvious that my hopefulness was going overboard. The numbers I posted of..." + (show)
@jck6455

kjacko,

well it was obvious that my hopefulness was going overboard. The numbers I posted of my biopsy results were based a a very fast paced phone call with my urologist giving me numbers and saying he was ordering PSMA pet scan to check those 5 suspicious lymph nodes . I was able to actually get the report and realized I had stated things incorrectly. As it was in the reports out of 14 cores 8 were benign. 1-3+3, 4-3+4, and, 1-4+3. The 4+3 was on the line of 50% pattern 4 which is one point above max for a 3+4.,So overall i'm rated 4+3. My stage is T1c for now until I get the scan. I am waiting on the decipher test. Interesting that where the MRI found a PR 4 lesion, the two cores there came out benign and 3+4

My father had prostate cancer at in 1999 at 75 and lived to 91, but succumbed to it later on. Im not sure he was doing any thing watchful. He had bracytherapy LDR with it and not aware if he took anything else other than flomax. I'm hopeful that since his was slow growing so will be mine.

Unfortunatly I wish it was the only thing going on. My Cardiologist is recommending a Stent be placed because scans and other test have been inconclusive about a blockage, But that requires blood thinners for a year and that would preclude any prostate surgery or radiation. So im kinda going to have to gamble on the balance here on cancer treatment vs the unknown Cardiac risk.

Trying to keep my Spirits up.

Jump to this post

Thoughts and prayers🙏🏻

REPLY
bens1 | @bens1 | 6 days ago
In reply to @jck6455 "kjacko, well it was obvious that my hopefulness was going overboard. The numbers I posted of..." + (show)
@jck6455

kjacko,

well it was obvious that my hopefulness was going overboard. The numbers I posted of my biopsy results were based a a very fast paced phone call with my urologist giving me numbers and saying he was ordering PSMA pet scan to check those 5 suspicious lymph nodes . I was able to actually get the report and realized I had stated things incorrectly. As it was in the reports out of 14 cores 8 were benign. 1-3+3, 4-3+4, and, 1-4+3. The 4+3 was on the line of 50% pattern 4 which is one point above max for a 3+4.,So overall i'm rated 4+3. My stage is T1c for now until I get the scan. I am waiting on the decipher test. Interesting that where the MRI found a PR 4 lesion, the two cores there came out benign and 3+4

My father had prostate cancer at in 1999 at 75 and lived to 91, but succumbed to it later on. Im not sure he was doing any thing watchful. He had bracytherapy LDR with it and not aware if he took anything else other than flomax. I'm hopeful that since his was slow growing so will be mine.

Unfortunatly I wish it was the only thing going on. My Cardiologist is recommending a Stent be placed because scans and other test have been inconclusive about a blockage, But that requires blood thinners for a year and that would preclude any prostate surgery or radiation. So im kinda going to have to gamble on the balance here on cancer treatment vs the unknown Cardiac risk.

Trying to keep my Spirits up.

Jump to this post

jck6455: As a layman, I would think that the doctor would consider the location of the stent, the type of blood thinner you are on, and the nature of the radiation therapy being proposed before eliminating radiation totally. Maybe you can use a narrow margin built in MRI radiation machine like the Mridian or Elekta. Some doctors are more or less familiar with these machines than others.
As suggested, check out Mayo and/or get a second or third opinion by sending your reports and images to another center of excellence and do a telehealth consultation. Explore your options.

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