← Return to PSA 8.6, MRI PIRADS 5, Biopsy scheduled, so a bit worried

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@handera

See you just joined our support group….hopefully you’ll find it a place where you can share your concerns and find folks who have similar experiences and develop questions that you can take back to your doctor(s).

Please recognize that nothing I (or anyone in this group) write should be considered medical advice…we share our experiences with prostate cancer in hopes that it will encourage and elicit questions that others can direct to their physician(s).

First, let me congratulate you on your weight loss, assuming you had some excess to shed, that’s a significant feat!

The post, that you reference, is ~14 months old, so I went back to refresh my memory.

Much has transpired since that post…my Decipher score came in at 0.22 (low risk), so I embarked on a recommended active surveillance program.

My PSA levels (I’ve had 6 tests since then) have averaged 6.2, as compared to 7.8 prebiopsy.

More importantly, I’ve had a 12 month follow up mpMRI which showed the PIRADS 3 and 4 lesions were not visible and the PIRADS 5 lesion had weakened signaling.

In any case, I continue my AS program and I’ve maintained my lower weight (a drop of 25 lbs in first three months after diagnosis) for over a year.

I have changed various aspects of my diet; and now it’s quite diverse.

IMHO, based on all the research I’ve done I believe my cardio exercise (running) regiment is more important than diet when it comes to slowing the progression of PCa….but again…that’s just me….results may vary…

I understand your concerns about biopsy…you can review my related post, for specifics, under discussions in my profile. However, I don’t think my biopsy experience was typical of what the vast majority apparently experience.

I think you are right in asking for a mpMRI PRIOR to submitting to a biopsy…from what I’ve read that’s “standard of care” protocol by the vast majority in the field…and it’s critically important if you end up pursuing AS.

All the best!

Alan

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Not sure how to proceed with a result like this. Confusing. No clear direction from my doctor…..

HISTORY: Prostate specific antigen above reference range R97.20: Elevated prostate specific antigen (PSA)

COMPARISON: None.

TECHNIQUE: Multiplanar multisequence MR imaging of the pelvis performed without and with intravenous contrast using the prostate protocol. Multiple B-value diffusion-weighted imaging in the axial plane was also performed through the prostate gland with
ADC mapping.

IV Gadavist 10 mL.

FINDINGS:

PROSTATE VOLUME: 6.8 x 4.29 x 6.1 cm with a prostate volume 95 mL.

PERIPHERAL ZONE: Diffuse abnormality of the peripheral zone noted characterized by low T2-weighted signal and mildly elevated diffusion-weighted signal and mildly decreased ADC signal without focal lesions. The capsule is well defined.

TRANSITION/CENTRAL ZONE: Diffuse nodular transition zone noted

OTHER PELVIS: No pelvic adenopathy identified. The seminal vesicles appear symmetric. The bladder appears normal.
Impression
IMPRESSION:

1. Diffuse abnormality the peripheral zone. This is a nonspecific finding and can be seen in both acute and chronic prostatitis or other inflammatory process and rarely in diffuse malignancy. Malignancy being considered less likely in the presence of
a well-defined capsule. Consider follow-up MRI in 6 months.

FINAL PI-RADS: 3, intermediate. The presence of clinically significant cancer is equivocal.