Recommendation for second opinion on prostate MRI scan?

Thanks for information. Very helpful. I belong to three support groups (one local, the other two are online). They all stress the importance of second opinions because of the subjectivity involved and because of the reasons you mentioned above. Dr. Mark Scholtz, founder of the Prostate Cancer Research Institute and double board certified medical oncologist has an excellent series on seeking opinions from radiologists who are experienced in reading prostate MRIs before making a decision on treatment.

I only had one core with cancer 3+3 very small if my PSA does not go down when they tests in September I plan to go with radiation

More opinions don't make treatment decisions any easier but in my case I believe it's necessary. I don't presume to advise what is right for someone else in different circumstances.
I'm 72. If I were younger, at higher risk, and had an aggressive case of prostate cancer then I would certainly feel pressure to "get on with it" as you say. Getting second opinions doesn't indicate a lack of trust. It's simply an acknowledgement that diagnostic tools and the personnel who use them aren't perfect. Dr. Mark Scholtz, founder of the Prostate Cancer Research Institute and double board certified medical oncologist has discussed the importance of second opinions and, more importantly, finding medical professionals who are experienced in interpreting prostate cancer biopsies and scans before seeking treatment.

I had three different Gleason scores on the same biopsy slides in one week from two pathologists (one of those pathologists downgraded his score). If that isn't cause for a few questions then I don't know what would be.
If my biopsy results from J. Hopkins are correct (Gleason 3+3) then treatment would not be recommended. In most cases, the biopsy is the most important diagnostic tool that we have. In my case, if the initial interpretation of my MRI is correct then the the results would be "discordant" to use the word of my urologist) with the interpretation of biopsy from Johns Hopkins.
In any event, my urologist indicated that I had a couple of months to think through my options and that's exactly what I'm doing.

I think you can wait without too much worry. Your PSA at around 10 is elevated but mine was around 12 or so for 3 years and I only took action when the PSA went to 18. I did just finish proton therapy and pretty happy with the outcome.

At 72, you could probably let it run wild (read no treatment) and still live to 90.

Once you are on forums and such however, your ability to wait and see will be tested. The data says do nothing for a while and see where we are in a year or two. Humans on message boards have you getting all sorts of things done to you which in all likelihood is rather harmful.

Your call.

Looks like from all you provided your's is probably low risk. But man we are just novices on this but sharing our knowledge of our experiences not medical professionals giving advice. Did any of your providers recommended monitoring? What was your PSA?

On the PSA I am an example that the PSA is not definitive factor in having cancer or not. My PSA was still within normal range but I had cancer. It is why monitoring of PSA is important to see if rising on consistent basis as a indicator just as much as a high PSA level.

Yes I too found out the reading of biopsies and MRI scans is subjective and can be iterpreted differently. It seems the common type of prostrate cancer is hard to rate as degree is the difference between normal tissues and and cancer ones. I think you said you did the MRI without the barieum contrast. Did they put in a probe? Both of these are done to get a more accurate reading of your prostrate. Was there a reason they did not do the barieum and/or contrast with the MRI?

I am not sure but did I asked if you were offered the Decipher test. If not asked about it because it is what changed my reading and final diagnosis from intermediate to low.

The reason I'm getting second opinions from radiation oncologists (RO) is to narrow down my treatment options such as Viewray MRdian versus CyberKnife which each use Photon beams (xrays). The last RO advised against using Proton radiation because he said the machines had a history of frequently breaking down (not good if your treatments are interupted). Also, the patient can receive external burn/s like a bad sunburn. At this point I've had a MicroUltrasound Transperineal Biopsy which indicated 2 (3+3=6) tumors and one (3+4=7) tumor. Am not sure if this was fused with my 3T MRI though. The Gleason 7 tissue was sent for a Decipher test where it came back as 0.37 LOW RISK. My urologist said "good news" you are LOW RISK and then when asked if I should begin Active Surveilance (AS) he replied "well, you do have a fair amount of cancer in there". While the Decipher results at first were comforting they rely on a huge database of historical genetic info which is compared to your tumor's DNA so it can predict probable future outcomes. This brings to mind Dirty Harry's famous line "...you've got to ask yourself one question: 'Do I feel lucky?' Well, do you, punk?" We all know how that ended. https://youtu.be/abmULTYJJEg The second RO made some good points: 1. a biopsy is really a "blind biopsy" where the doctor may miss a tumor 2. waiting too long on (AS) could allow my (3+4=7) tumor to evolve into a (4+3=7) tumor. Then came the surprise info: I had thought that the radiation would be "targeted" to each tumor, but was told the entire prostate would be radiated!! Who knew? Please provide the link for the series on seeking opinions from radiologists who are experienced in reading prostate MRIs before making a decision on treatment and the link for your other online support group.

I saw that Viewray Mrdian filed for bankruptcy last month. Disappointing to see that. Looked like very promising technology. If you find out anything different please let me know, I'm interested in that, as well.
My doctor used the Oncotype DX decipher. Came back low/intermediate.
I had a guided Transperineal biopsy also, using the Precision Point system. It is certainly possible that the doctor may have missed a tumor but since the biopsy was guided by the MRI (assuming the MRI scan and read were correct) then, hopefully, the results were accurate.
The link to the youtube series is:

Thanks merwether for the valuable feedback. Actually Chapter 11 bankruptcy does not sound all that bad for the company. "Filing Chapter 11 bankruptcy allows businesses to stay open and continue operating while reworking their financial obligations. Filers are able to put forth a reorganization plan, which can include downsizing and plans to reduce their expenses" (Source- https://www.investopedia.com/ask/answers/061815/what-are-differences-between-chapter-11-and-chapter-13-bankruptcy.asp ) It appears that Viewray ,in fact, is taking these steps now so I would not write them off at this time. Their main asset is the future demand for what the MRdian machine can provide.
From what I've researched, the Gold Standard is to have an mpMRI guided biopsy rather than an MRI guided one. Definition: mpMRI means Multiparametric magnetic resonance imaging. This technique "is also claimed to allow more accurate diagnosis with higher detection rates, using fewer biopsies. It can pick up cancers with a Gleason score of 7 or above, and it is also better at detecting anterior tumors missed by a TRUS systematic biopsy. It is especially useful in patients undergoing repeat biopsies, with a 41% pick-up rate of cancers on mpMRI-guided biopsies, and with 87% of these being of clinical importance.
What is also important is that lesions detected on mpMRI are also more likely to be aggressive." (Source--https://www.news-medical.net/health/Types-of-Prostate-Biopsy.aspx) I am tilting toward MRdian since I don't think it requires fiducials to be inserted into the prostate like the CyberKnife approach. What are your thoughts?