New to group, usually don’t join groups that would have me as a member

Hey @matthew61

I'm not a doctor or expert, I just have been down this road.....

Unfortunately, this kind of test analysis can't always be very definitive. It points to things that need to be evaluated.
"no pelvic lymphadenopathy or suspicious lesions" is kind of self explanatory, the PI-RADS score is fairly concerning, while the PSA on it's way down is obviously a good sign. It could have been bumped up by any number of things. There is something the MRI is interpreting as a lesion of some kind, it could be anything at this point.

My guess is the docs will likely do one of two things, watch the PSA for a while and see if it continues down and stays down, or, perhaps if your urologist is a bit more aggressive in their treatment approach, they may suggest a biopsy. A lot may depend on your age and general health otherwise.

Unfortunately, it's likely going to be a long weekend of waiting and wondering....
The best thing is probably to keep busy this weekend and try not to think to much about it till you see your doc.

Best of Luck to you!

Thanks for your insight web265, this helps a lot, appreciate your kind words. I’m 62 and am in above average health. Will keep busy this weekend working in the yard - Garden therapy. Hope you are well.

Matthew 61:

Web265 covered it well.
You want to pick up a copy of Dr Walsh's book Surviving Prostate Cancer.
It is a very good review of diagnosis and treatment. Also, PCF.org free downloadable or mailed print Patient Guide.

And for better or worse, everyone is welcoming, considerate and comforting on this site. So you've found an inviting group.

Good luck Monday.

"May want" to pick pick up book.
Recommended by me and many others on this site.

Thanks Michael

I also had a Pi-Rads 4 lesion of 7 mm with a PSA of 2.9 and called T1c. I then had a trans perineal MRI guided fusion 30 core biopsy as my prostate was 120 grams. 5 cores were taken from the area of concern. 2 were 4-3 and 3 were 3-4 Gleason. This classified me as an unfavorable intermediate risk. Mayo did a PSMA Pet Scan that showed that it was confined to the prostate and had not spread. I elected to do 5 Proton Pencil Beam radiation treatments at Mayo Phoenix and I had the SpaceOar Gel inserted. I am now 11 days after my last treatment and have had very little urinary trouble at all. First week was a little harder to go and would not hold my normal amount without having the urge to go. My bowel has had a little bleeding after the 7th day but it is only a little pinkish discharge with a wet fart before having a bowel movement but none after it. So, I have been pleasantly surprised to say the least. Five treatments were much easier and way less driving than the 28 originally suggested by the radiation oncologist. Good luck making your decision as to which way to proceed.

Mathew61: I had a 10.2 psa and grade group 2 and 3+4. Get backup opinions where you can . You will find variations. Ask for the Decipher test with your biopsy material. This will help you and the Dr's evaluate aggressiveness and give you another backup "opinion". I was given prostate removal or radiation as a choice. I chose radiation and narrowed it down to Proton or Mridian linac. I chose the MRIdian Viewray and insertion of spaceoar. 2mm margins with MRIdian vs 4-6 mm with proton and other types of radiation. That meant less radiation hitting healthy tissue and better quality of life. Urine restriction initially and no bowel issue. Also, MRI and radiation is built into the machine. This is the only one of its type in existence. MD Andersen, Cornell Weill and other centers of excellence have it. Good luck on Monday.

Thank you, sounds like you have a good plan in place.

Thank you, I appreciate your feedback and kind words.

Already executed for better or worse. What concerns me is the studies that have come out in the last month that show there is no difference in death rates from prostate cancer in groups who did nothing, had a proctectomy, or radiation treatment at 15 years. Most deaths were from something else. At almost 74 if I lived 15 years, I am almost 89 years old. Would have doing nothing been a better choice? Only time will tell about the longer-term side effects. My PSA had been in the 2.3 to 2.9 range for the last 5 years.