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Low PSA, MRI shows likely cancer

Prostate Cancer | Last Active: 6 hours ago | Replies (22)

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@neville44

I just opened my MRI report yesterday and have to wait a week to see my Urologist. I’ll never do that again.

59 y/o, Annual PSA test for past 15 yrs ranged from 0.5 - 1.05.

2 legions (1.9 and 2.4 cm - one right and one left)
PI RADS 5
Both lesions noted as: "Extraprostatic extension into the neurovascular bundles (one is right side, the other is left).

Only “good” info …
Lymph nodes: No pathologically enlarged lymph nodes.

Vessels: Normal appearance of the visualized vasculature.

Abdominal wall: No acute abnormality.

Musculoskeletal: No enhancing osseous lesions.

No symptoms of anything - healthy and fit. I NEVER need to urinate at night; sleep 7 hrs without needing to get up. Work out daily and eat well.

Very concerned about Neuroendocrine prostate cancer , small cell carcinoma.

Again, I must stop Googling until I meet with my Urologist in one week (a very long one week).

Biggest “gut punch” I’ve ever felt - Anxious and afraid

I appreciate all I’ve read here - thank you all!

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Replies to "I just opened my MRI report yesterday and have to wait a week to see my..."

I had a similar experience when I got my biopsy results before my doctor talked to me, by a week. I freaked out when I saw all the cancer in there and got really pissed at being sent that before my doctor could review it with me.

One thing to remember is that MRI's are imperfect and not to get too upset. My MRI showed I had a bulge, which I did, and that I would lose half my nerve bundles as a result, which I didn't.

Three things that give you as complete of a picture as you can get before treatment: Biopsy, MRI, Decipher. You could add PET scan to that but most insurance won't cover that until after treatment (my insurance did cover it, which was unusual, and then I didn't get it), but this isn't going to reveal anything about your prostate cancer so much as if it has spread.

I'm 54, nearly 5 weeks out from prostatectomy where my actual results were better than the MRI implied they would be. Take a deep breath and know that lots of folks here can help.

Gut Punch is the most accurate description there is; the only thing worse was going to my father’s wake and seeing his full name on a placard outside “Chapel A”. His full name and mine are the same; I felt like Scrooge with the third spirit of things yet to be!!
Going online is emotional suicide ; we all do it and we can’t stop but your anxiety is totally normal. In fact, your MRI findings are not that bad compared to some of the men on this forum -even me, and I’m still here 6 years after that jolting biopsy read which showed a gland full of cancer, perineural invasion in every single sample(laterally) and Gleason score of 4+3 unfavorable.
As has been pointed out by @survivor, MRI’s are hints and suggestions that something needs a closer look, which your biopsy will do. No matter what is found, you are gonna be OK, you are NOT gonna die.
You might need treatment but rest assured: the treatment is a piece of cake compared to the anxiety of not knowing. I practically ran into the OR for surgery and swooned with joy 5 yrs later when I was told I needed salvage radiation and ADT. Totally f***ed up, but the 5 yrs of PSA’s, the anxiety, the fear of metastasis, the constant Googling of what everything might mean….THAT was true hell…
Just take it easy and do your homework; knowledge is key and this forum is a good place to ask questions; we’ve all been there. Best,
Phil

Perhaps the next step is PET scan. My PSA was increasing about one point a year..now at 5.67.
Had MRI and rated 5 (the same as your result). I then had a PET scan and the summation was no absolute prostate cancer. The PET scan shows calcifications that is normal and can under the MRI appear as "cancer". Both the MRI and PET scan are "read" so the result is essentially a subjective opinion. Often best to get a second opinion on issues critical to overall health. Research "calcifications within the prostate". for further information. Use Google AI by asking any question about anything..and normally the response is accurate and timely. In my case, I have scheduled a PSA test every four months to measure the velocity of any changes. Remember, the worst case for men is when the cancer has metastasized outside the prostate gland. RH/Florida

Yeah, the waiting really sucks. I had to wait two weeks after my MRI to get my biopsy. I was was scheduled two weeks out to get the results of the biopsy. I literally was talking to my urologist as she was doing the biopsy and pleading for an earlier date, she grabbed her phone and told me OK, I’ll see you in two days. Once I decided on TULSA Pro for my Gleason 7 (4+3), I had to wait 2 months. I figured if Mayo was not concerned with that timing, I probably shouldn’t be.