MRI diagnosis shows prostrate cancer

@carjcapt
I have not read any medical reports that show cancer being spread by taking biopsies for prostate cancer.

Your biopsies can be done through rectal or transperineally. If you have rectal it has a higher rate of infection but small (1-2%). You are also awake. I had mine done transperineally and felt nothing (anesthesia) before, during, after.

There are many many treatments now for prostate cancer. Depending on your Gleason Score it will help your urologist and or R/O determine best treatment for you. There are also several tests after a biopsy that can fine tune your diagnosis and a more precise risk level that will help define treatment.

Without the Gleason Score really not much we can pass on from our experiences other than I have not heard of any medical information about prostate cancer being spread when doing biopsies. You can always to a search on Mayo, Cleveland Clinic, WEBMD, John Hopkins, etc. to give you medical information on this subject to help you.
Good luck

I've read things about a biopsy possibly spreading cancer cells.
Possible... but not a given.
Crossing the road also carries a risk of getting run over.

The biopsy is the definitive way of knowing for certain that cancer is present. They can only tell by grabbing samples & looking under a microscope.
I also had PI-RADS 4 & the biopsy confirmed cancer.

A year & 2 surgeries later & the urologist says I'm "cured".
So the biopsy is worth any small risk.
One thing that you'll find the more you read.... all sort of things *may* happen, *could* happen & have happened to others.
But unless you're living in their body, it's not certain that these things will happen to you.

Spoiler alert: you may end up with surgery anyway. I did.
But it's better than the alternative.

Listen to JC76- he s spot on with accurate information.

Check out this video about over treatment of people in their 80s. Can give you a clue about directions.

For your age (80y), your PSA is low.

> but, with your younger brother having had prostate cancer, have you had a genetic (germline) test?

An MRI PIRADS score only provides a likelihood (risk) of clinically significant prostate cancer being present.

> PI-RADS 4: High (clinically significant cancer is likely to be present).

However, there is more information you can collect to help make the biopsy decision:

> PSA Doubling Time – the number of months it takes for PSA to double. If the PSADT was < 10 months, patients tend to do worse.

> PSA Velocity – the change in PSA levels over time. A rapid rise in PSA may indicate the presence of cancer or and aggressive cancer.

> % Free PSA – PSA circulates in the blood in two forms – either attached to certain blood proteins or unattached (“free”). If the % of Free PSA is low (< 25%), it may indicate a higher risk of prostate cancer.

> PSA Density: The larger the prostate volume (due to an enlarged prostate), the more PSA can be produced. PSA Density is the ratio of PSA to prostate volume.

> Liquid biopsy results: There are blood-based and urine-based tests that will tell more about the possible need for a tissue biopsy.

Your concerns regarding a biopsy to “potentially cause cancer cells to enter blood stream” are not supported by the data. What’s called “needle track seeding” is extremely rare. Though not a zero chance, this paper from 2015 points out how rare it is: https://pubmed.ncbi.nlm.nih.gov/24958224/

And even if you do have a Gleason score, what you do with that information is totally your call.

@carjcapt you might want to take a PSE test which they say is 94% accurate, even though you had a an MRI. The company is Oxford Biodynamics that makes the biomarker test. The results will either say: you are unlikely to have prostate cancer or likely to have prostate cancer.

If you do have a biopsy, ask to be put out, as I was with the twilight drug. Also, ask about a fusion biopsy which provides some additional image safety in its process.

If you do have a biopsy, have them include a Decipher test to give you a feel for aggressiveness. Doctors do use it to decide treatment.

Finally, get a Telehealth second opinion from a center of excellence. Doctors are dedicated but not infallible.

One step at a time.
You had the MRI because of some concern about family history of prostate cancer.
The next step is a more definitive biopsy.
And then you will have more information about whether you have a condition that is benign or whether active surveillance or other treatment is appropriate.
And as noted above, there are many treatment choices. If treatment is necessary and advisable, the important thing is to know what you're dealing with. Again, that is why you had the MRI.
I had my MRI and biopsy at age 72 (now 75), found high risk cancer in the prostate and received treatment at a center of excellence (COE).
Because of our age, please have confidence in whatever facility and surgeon are going to perform the biopsy.
I traveled to a center of excellence for my care, and the effort was worth it for me.
Best wishes.

When you have the biopsy make sure it is MRI guided. I'm 79 and I had the perineal version last year and I found it uncomfortable (not as bad as a root canal) but would not term it "invasive." Take it step by step. The MRI that prompted my biopsy identified a lesion smaller than y9ours. The guided biopsy took two needle samples from the lesion and they both came back benign. Some 3+4 and 3+3 in two other samples (out of 12).
Good luck.

Good news everyone. Went to see my urologist's PA who scheduled my biopsy with a 8 minute visit. After getting information from all of you and you tube videos and a bit of written information I left a message with my urologist (Never met Him). Didn't hear from him for two days. Next day went to see my family doctor (he ordered the MRI) told him my reservations of the MRI results and my past 10 year PSA numbers and the fact that I haven't talked to my urologist at all.

Yesterday about 5:30pm my urologist called and short story is he cancelled the biopsy with a PSA test in 6 months. He indicated that the MRI is not a good tool especially with normal PSAs.

Woohoo....maybe I can get old enough to not worry about prostrate cancer.

@carjcapt
You will see from posters and urologist that the PSA number is not the real issue it is if it continues to rise. I had a normal PSA but was diagnosed with prostate cancer.

I am not sure about relunctance to have a MRI. They are painless. I had a normal PSA but was contiuing to rise so a MRI/conrast was ordered. That MRI showed suspicious areas (may be wrong but a MRI cannot diagnosis cancer just suspiciousl areas or tumors) and a biopsy was ordered. That biopsy found prostate cancer and I was treated with radiation to treat it.