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Not Good News after prostate biospy when MRI didn't look too bad
Last month I had PSA of 5.23 when a few months earlier it was 3.2. Then they scheduled me for MRI of prostate. Did another PSA and it was down to 4.16, but still wanted the MRI. Report is below, doesn't look good PI-RADS 5. At one point they say in report Lesions (PI-RADS 3 or higher). If I understand it, it hasn't spread. Wish I could get a plan with doctor!
FINDINGS:
Prostate measurement: 5.7 x 5.0 x 4.9 cm Prostate volume: 68.75 cc PSA: 4.16 ng/mL PSA density: 0.06 ng/mL/cc
Peripheral zone: See below.
Transition zone: No index lesion. Stromal and glandular BPH nodules.
Lesions (PI-RADS 3 or higher):
Lesion # 1: Location: Left posterior peripheral zone extending from the base to the apex Size: 2.4 x 1.3 x 2.6 cm (5.83 cc). T2: T2
hypointense DWI: Marked restricted diffusion DCE: Focal early enhancement, positive Prostate margin: Abuts the capsule without
definite invasion Overall PI-RADS Score: 5/5
Prostatic capsule: Intact.
Neurovascular bundles: Not involved.
Seminal vesicles: Not involved.
Lymph nodes: No lymphadenopathy.
Bones: No acute osseous abnormality.
Other findings: Small fat-containing right inguinal hernia.
IMPRESSION:
1. The prostate gland measures 5.7 x 5.0 x 4.9 cm with volume of 68.75 cc. PSA density is 0.06 NG/mL/CC. 2. Lesion # 1: PI-
RADS 5 lesion in the left posterior peripheral zone extending from the base to the apex measures 5.83 cc. No frank extracapsular
extension. 3. No pelvic lymphadenopathy.
PI-RADS Category 5: Very high (clinically significant prostate cancer is highly likely to be present)
Really doesn't look to bad, one spot that hasn't spread!
Then Bad Update 2/10/2026
Well got biopsy yesterday and results today, doctor hasn't called, just sent biopsy results to MyChart.
The MRI showed only one Lesion like shown above. Had biopsy done yesterday, they did 3 from the Lesion and 6 from each side of prostate. I wondered why they did more biopsy that were outside the lesion, but didn't ask. Got report today- not good. The lesion look better than areas where MRI saw nothing. They took 15 samples total.
Results:
Final Diagnosis
View trends
A. Prostate, "LLB", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 30% of needle core tissue.
B. Prostate, "LMB", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 70% of needle core tissue
C. Prostate, "LLM", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 60% of needle core tissue.
D. Prostate, "LMM", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 60% of needle core tissue.
Large cribriform glands present.
E. Prostate, "LLA", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 60% of needle core tissue.
F. Prostate, "LMA", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 50% of needle core tissue.
G. Prostate, "RLB", biopsy:
Benign prostatic tissue.
H. Prostate, "RMB", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 10% of needle core tissue.
I. Prostate, "RLM", biopsy:
Benign prostatic tissue.
J. Prostate, "RMM", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 50% of needle core tissue
Large cribriform glands present.
K. Prostate, "RLA", biopsy:
Benign prostatic tissue.
L. Prostate, "RMA", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 25% of needle core tissue
M. Prostate, "ROI#1", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 3 of 3 cores involving 70% of needle core tissue
Another thread I posted in a person said "You have a Gleason 4+3 7 BUT you have large cribriform and doctors a UCSF say that puts a 5 in your Gleason score." I believe he picked this up from the biopsy report. I don't know what a cribriform even is, it's not mention in report. From googling around it can only be determined by sieve-like or "Swiss cheese" appearance under a microscope and I don't see that in report? But this is all new to me. Doctors haven't talked to me yet, who knows when they will call or make appointment, took long time to get MRI and even longer to get the biopsy done. Sure were fast getting results, they said 7 - 10 days and they gave them to me the next day. Kind of wish they didn't give me results prior to talking with me.
My first thought is just get the thing cut out, not sure how that is done, as seems they got to leave something in there for urine to flow threw. So they couldn't take 100 percent of prostate out. Then I read about nerve sparing or not and not sure what that means. No doctors have discussed this with me yet. Seems if they take it out there shouldn't be any prostate cancer left? But then I read where people get it out and still have a PSA level, so like I said earlier, they must leave some in there, even when they call it total. Had to drive 150 miles to get MRI and biopsy They could have done that in Topeka, but KUMC is ranked as number 50 in top of prostate treatment so I went there Topeka doesn't have a Proton device, that would be back up to KUMC 150 miles RT. One of those radiations therapy is only a few days, not 30 some days. They do have SBRT radiation in Topeka, but I know of someone who had SBRT or maybe it was IMRT and it screwed up several other organs around the prostate, like bladder, kidneys and intestines.
Then some tell me I am lucky to have them all in grade group 2 or 3. But seems like I had a lot of them (12 of the 15) . So I would guess if they did 25 biopsy I could have had more grade group 2 or 3.
All confusing and stressful, other that this I am 78 years old healthy as a horse- no other issues and very active. Loss of what to do and all the different radiation types, that why just getting the pesky thing cut out of there, but seems they still leave some in.
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Right now just using Depends briefs or I guess also called pull-ups. Special nighttime briefs for bed. Not sure when to change them, sometimes may go to long as no place to change. Adding pad to briefs/pullup good idea. Believe I could find place to make a pad disposal or change. Whole new learning process, wondered if should use some cream? Keep praying this won't last long. Going to push doctor for quicker PT. Our daughter said PT should know a few things that wouldn't cause damage to surgery area. Doc said wait 6 mo for total healing.
@diverjer - the downside of wearing a pad inside a pull-up is that it throws off the fit and can be a bit uncomfortable, especially when sitting.
The upside, though (besides the cost savings), is that pad changes are a snap: go into a stall with a new pad, a baby wipe, and a little trash bag tucked discreetly in your pocket, drop your drawers, have a seat, out with the used pad, in with the new, freshen yourself a little with the wipe, toss the dirties in your little trash bag and tie it up, then put yourself back together, and away you go, maybe 90 seconds…two minutes tops.
With the pull-ups, it’s a whole event - off with the shoes, off with the pants, just to get the pull-up pulled off, so to speak…that’s too involved for me.
Today, I’m going out for a haircut and light massage, which takes about 90 minutes, and it’s a 45-minute drive each way. I’ll be trying out some Menvault washable incontinence briefs. They’re supposed to be able to hold 300ml/10 ounces of fluid with no visible leaks.
I tried them once before and had my only public leaking accident in four months of incontinence, but working with the company, they advised going a size down, as these are meant to fit really tightly, like compression underpants, so we’ll see how that goes.
@turtbean
Under those conditions, I would just put on the Wiesner Clamp and get two hours of no leaking at all. I do that if I’m invited over to somebody’s house for a meal. When I get there, I go in the bathroom and put the clamp on. Don’t have to worry about leaking for two or 2 1/2 hours. Put it on when I go to the gym or go dancing with my wife on Saturday night.
You might try it, it can solve a lot of problems.
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4 ReactionsWell today has been horrible, had issues last night (4am this morning actually)of couldn't speak and right arm and leg tingling/numb. Lasted maybe a few minutes. Got up after and seemed okay, changed diaper and did some test to see if had stroke. All looked well went back to bed. This morning wife said to call doctor and tell him, well his nurse said go to ER. Then she called back and said not to drive myself, if couldn't get ride call ambulance. Nine hours later I get home, they think I had a TIA or mini stroke. All blood work was good, CT with contrast was good and MRI of head was all good. Ten or eleven different test in all and none showed damage or sign of stroke. But they talked with neurosurgeon and want me on Plavix for 21 days and a baby aspirin every day. Regardless of testing they said what happen sounded like a TIA or mini stroke. Also, called my urologist who said okay let him take those meds.
Never had any problem like this before, this prostate cancer and especially post surgery has been terrible. ER is horrible, you wait 4 hours to see anyone and test take forever.
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3 Reactions@diverjer Man, WTF??? It’s a definite possibility that all your surgical issues have led to this, though I am no expert.
Unfortunately, blood thinners are really going to prolong all that bruising just when it was beginning to resolve.
I really think you need to get a consult from a cardiologist to determine what might have caused this and how it can be prevented from happening again.
Don’t wait, do it now. Best,
Phil
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1 Reaction@diverjer
Your ER experience sounds like the Pitt. Terrible having to wait so long.
I’ve gone to my ER at least three or four times in the last couple of years. I’ve never waited more than about 20 minutes to be treated. They have had to do an EKG a couple of times and it was done within 10 minutes of my arriving. They take blood test and I have the results on my phone within about 20 or 30 minutes. I just never seen more than about five or six people sitting in the waiting room. I sure would be frustrated with you what you are having to put up with.
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1 ReactionThe ER at Stormont Vail is always like that. One guy came and and seen everyone and ask how long wait, they said 5 hours- he left. There is another hospital in town, but people don't like going there. Except for the MRI, I got all test done in a couple hours (9 blood test and head CT with contrast), but took about 4 more hours to see a doctor. Then the ER doc and a neurologist decided to do a MRI. They got 2 MRI machines, but they were busy.
They do a triage as soon as you get there, but then take in order of serious needs.
Our RN daughter (about 1 week of finishing her APRN) works there, came down to see me. Said the hospital ER was on Diversion (which means they won't take any ambulance or helicopter coming in). They are on diversion a lot. However, will still take walk ins, which seems strange to me. When doctor's office told me to go to ER as they didn't have equipment to check me out, I almost cried as I knew what I was in for.
This all has to be what my body went through from 2 surgeries in 14 hours, one lasted around 4 the other 3 hours. Maybe this is why some folks said their doctor wouldn't do surgery of this kind on a person almost 79- even one in good shape. I don't feel in all that good shape right now.
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1 Reaction@diverjer - very sorry that happened to you. Since having surgery myself (January), I’ve read a lot of stories about unexpected occurrences after surgery.
I myself had a severe bout of Afib, something that’s never been a problem for me before, and while that was eventually dismissed by my cardiologist, I did (after much testing) end up on a med to treat mild microvascular disease.
I agree with others who say to get checked out by a specialist for that TIA. You don’t want to take any chances. I hope you’re feeling better soon.
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4 ReactionsYes instructions say to followup with neurologist Monday, which I will do as instructed. Hopefully, your microvascular is under control and not causing pain.
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1 ReactionTry that putting a pad in the depends pull ups. Think it will work okay, but believe I should not pull sticky thing off pad. When I pull pad off to just use pull ups, it's so stuck to depends pull ups, it pulls off a bunch of liner on the depends pull ups which was a real mess and I think would not be as effective. Now trying again, but not pulling off sticky cover and it seems to still be staying in position fine without using sticky.
Put in my ER followup appointment request with neurologist. My Chart has a special appt request form for ER followup visit and my ER release instructions says to get this followup ASAP.