Since you have 1 lesion visible on your MRI, it's important to make sure that the biopsy you're undergoing is and MRI fusion biopsy where the images from your MRI are "fused" with those of the ultrasound device and that the region of interest is "targeted" for core samples. You do not want the standardized systematic biopsy where 12 samples are taken (two each) from the 6 zones of the prostate. It's OK to that as addition just for mental satisfaction, but you want to make sure focus is on core samples from the region of interest. You need high assurance the biopsy procedure is focused on samples from the lesion.
Pi-Rads 4 indicates a high likelihood of prostate cancer. The lesion size is big enough to warrant a biopsy for sure. I wouldn't freak out about this, talk to your doctor first and he might want to follow up with a biopsy to see if it's worth addressing (if he does, ask for a Decipher as well).
Many prostate cancers don't need treated as they are very slow growing, just because you have it doesn't mean you are in for trouble. The saying that always goes around for many men: more likely to die WITH prostate cancer than FROM it.
Feb15
I just joined Mayo Connect. Great resource. I am new to Prostate problem world. Age 76. First MRI this coming Friday. urologist offered little as to how I should get ready for MRI.
ANY SUGGESTIONS TO PREP FOR MRI? Is enema helpful? I do 3 sets of kegels daily past 2 weeks.
Newcomer
Feb15
I just joined Mayo Connect. Great resource. I am new to Prostate problem world. Age 76. First MRI this coming Friday. urologist offered little as to how I should get ready for MRI.
ANY SUGGESTIONS TO PREP FOR MRI? Is enema helpful? I do 3 sets of kegels daily past 2 weeks.
Newcomer
An enema likely won't be required nor will be helpful, they are going to inject a dye into you so they can get prostate pictures with and without contrast so they can see if your prostate cancer has gone beyond the prostate bed.
MRI's a a cakewalk, don't worry about that. You lie down for 30 minutes while a machine runs over you.
3 sets of kegels every day is FANTASTIC! I'm glad to hear you started them early! Keep them up, but make sure you learn to force their release because that's more important. To make sure (and to learn the sensation of the release) take a deep slow big belly breath and that will force them to relax.
I was also Pi-Rads 4, Gleason 7, Decipher 0.68. Once removed I was upgraded from stage II to stage III.
I have no incontinence - not even a single drop, I have no erectile dysfunction and am basically as I was two weeks ago (prior to surgery).
This is to say that positive outcomes are possible. I worked for months hammering my pelvic floor through exercise and kegels, dropped 25lb and gained back 10 in muscle. I started working the problem the instant I found out and between that and an excellent surgeon I'm on the other side of it relatively intact.
I let myself get into a deep gloom over my diagnosis but still worked it hard. Part of the reason is that forums like this, inherently, don't have a lot of great news - most guys sticking around have issues or are like you and have questions - few of the success stories stick around but I'm trying to be the guy that does so that the next poor guy that has to go through all of this at least can see that it's not all bad.
Hey survivor
Any suggestions on a pelvic floor Physical Therapist. I am in the Phoenix area and so far no one has given me any help or suggestions and I want to get to the same post surgical position in terms of continence. I have read Life after Prostatectomy by Vanita Gaglani, RPT but I just don't seem to be making any progress. Thanks
Hey survivor
Any suggestions on a pelvic floor Physical Therapist. I am in the Phoenix area and so far no one has given me any help or suggestions and I want to get to the same post surgical position in terms of continence. I have read Life after Prostatectomy by Vanita Gaglani, RPT but I just don't seem to be making any progress. Thanks
Just Google pelvic floor therapist Phoenix, I just did and there's plenty out there. Just know they tend to be busy, between guys with incontinence/ED and women with post pregnancy issues.
What I did first was book with every one that could fit me in, then went back and canceled the ones that were the furthest out. In the end I canceled them all because I lucked into the one I have.
A good therapist will do a very physical exam on you - how you stand, how you sit, how you walk - and then may do a digital exam to actually feel your pelvic floor muscles as you engage and release them. They will also give you exercises to do and show you the proper way to Kegel - there IS an improper way that will hinder your progress.
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Since you have 1 lesion visible on your MRI, it's important to make sure that the biopsy you're undergoing is and MRI fusion biopsy where the images from your MRI are "fused" with those of the ultrasound device and that the region of interest is "targeted" for core samples. You do not want the standardized systematic biopsy where 12 samples are taken (two each) from the 6 zones of the prostate. It's OK to that as addition just for mental satisfaction, but you want to make sure focus is on core samples from the region of interest. You need high assurance the biopsy procedure is focused on samples from the lesion.
Feb15
I just joined Mayo Connect. Great resource. I am new to Prostate problem world. Age 76. First MRI this coming Friday. urologist offered little as to how I should get ready for MRI.
ANY SUGGESTIONS TO PREP FOR MRI? Is enema helpful? I do 3 sets of kegels daily past 2 weeks.
Newcomer
An enema likely won't be required nor will be helpful, they are going to inject a dye into you so they can get prostate pictures with and without contrast so they can see if your prostate cancer has gone beyond the prostate bed.
MRI's a a cakewalk, don't worry about that. You lie down for 30 minutes while a machine runs over you.
3 sets of kegels every day is FANTASTIC! I'm glad to hear you started them early! Keep them up, but make sure you learn to force their release because that's more important. To make sure (and to learn the sensation of the release) take a deep slow big belly breath and that will force them to relax.
Hey survivor
Any suggestions on a pelvic floor Physical Therapist. I am in the Phoenix area and so far no one has given me any help or suggestions and I want to get to the same post surgical position in terms of continence. I have read Life after Prostatectomy by Vanita Gaglani, RPT but I just don't seem to be making any progress. Thanks
Just Google pelvic floor therapist Phoenix, I just did and there's plenty out there. Just know they tend to be busy, between guys with incontinence/ED and women with post pregnancy issues.
What I did first was book with every one that could fit me in, then went back and canceled the ones that were the furthest out. In the end I canceled them all because I lucked into the one I have.
A good therapist will do a very physical exam on you - how you stand, how you sit, how you walk - and then may do a digital exam to actually feel your pelvic floor muscles as you engage and release them. They will also give you exercises to do and show you the proper way to Kegel - there IS an improper way that will hinder your progress.