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PI-RADS 4 with ill defined margin and positive DEC
I received my MRI report and it doesn't look very encouraging. Peripheral lesion, ill defined margin, and positive DEC. From what I have researched this seems to indicate aggressive prostate cancer. The good news is that it is contained to my prostate so far.
Has anyone had similar MRI results and had a biopsy that turned out OK? Biopsy is scheduled for 6/2.
I was hoping that I would be able to have a focal treatment (TULSA or focal laser ablation) in order to minimize side effects but from my reading it looks like they are only effective in well defined lesions and that I may be looking at a radical prostatectomy.
Does anyone have any relevant experience with similar MRI reports and outcomes?
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@csbarry
New surgery technique’s can give immediate continence and with nerve sparing still enjoy erection’s and penetration. The old stories everyone has grown up about being incontinent and impotent after prostate surgery are giving way to the new technology. I even went home from surgery the same day. The sooner you address it makes recovery regarding these issues better. The stories everyone hears about how slow prostate cancer grows are stories too. Sure many prostate cancers are slow growing but as many are not. Not until you get a biopsy and Gleason score will you know whether yours is aggressive or not. Even Decipher testing gives you a better decision making tool
@wheel1
Wow! You never know what to expect.
@csbarry
I can understand the dilemma of choosing quality of life versus quantity. In my case I have co-morbidities which may influence my decision. In 2018 my cardiologist told me that within 5 years I was likely to have a major adverse cardiac event due to my severe coronary artery disease, yet here I am. I know the clock is still ticking so depending on my biopsy I may be tempted to just roll the dice.
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1 Reaction@wheel1
Good to hear. Did you have a radical prostatectomy?
@wheel1
Now a days you can diagnose through proteins in your urine. My doctor (University of Florida - Urologist) never heard of that. I met with the surgeon just three weeks ago and he laid out the side effects as I described. Dr Emberton lays it out the best for me - I go with that. So much info out there. Dr Emberton explains that the science of urology is currently in an explosion of “new” ideas and thoughts. Not holding my breath but waiting for the “new” to happen -
Peace
@keithl56
I did have a radical prostatectomy done by my surgeon using the newer DaVinci single port robotic model along with the nerve sparing and Retzius sparing that allows for the Puboprostatic ligament holding the bladder not to be cut by the surgeon coming in to remove the prostate from behind the bladder. Many patients are not aware of newer surgical techniques that are becoming available and this is a real need for patients to research and not just take what their surgeon says who they probably only went to because of a referral. Find and pick your surgeon
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1 Reaction@csbarry
Yes the ExDxo urine marker non invasive prostate marker test. This urine test is designed for people over 50 with a psa in the grey area that might have risen. It analyzes exosomal RNA to assess the risk of clinically significant cancer greater than Gleason 7. This test can sometimes help a person delay a biopsy if it comes back low while becoming more active surveillance while watching a lower questionable PSA. Just another tool in the tool box and so easy. It again is interesting how you hear so few urologists even discuss it.
@wheel1
That's why I am going to Johns Hopkins, a center of excellence, for my second opinion. I hope that they will be on top of all of the newer techniques versus my local urologist.
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