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Best wishes on this journey.
What do you mean in stating all your best efforts have failed?
What is your PSA history?
How many MRI’s have you had?
Ever had a biopsy?
In your situation, in parallel to getting a biopsy performed, I would be searching for a great cancer center, surgeon(s) and radiation oncologist(s).
Biopsy results may show gleason 3+3 or 3+4, instead of higher grades. In general, I think it is better to concentrate on obtaining more information and not assume it will be worst-case.
If you share age and where you live, others will provide more help.
Possible ECE is not too unusual to be noted on an MRI. In your case, it may be correct, or just a possibility. This notation on your MRI may allow you to obtain faster insurance approval for PSMA PET scan.
Best wishes.
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@charlesprestridge I’m 63 and live in Portland Oregon. My challenge will be trying to get a transperineal biopsy within a reasonable amount of time. But I may just do the targeted trans rectal MRI fusion and go from there. This will be my first biopsy after 8 PSA tests and 3 MRI’s. I’m trying to not assume the worst but it’s definitely a challenge. Appreciate your response.