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Psa 5, 68 t2. One .8cm lesion peripheral zone 2
Well my psa history at 65 4.1 then retest 2.2, next year 3.85 then 3.75 then this year 5.09 retest 4.99 doctor noted slightly enlarged non nodular prostate, mri performed pirads 4, t2, one .8cm lesion zone 2 perifial zone, confined to prostate, follow up on June 17th then schedule biopsy. Any thoughts?
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With the Pirads 4 MRI finding a biopsy is probably a good next step. If there is a significant delay in getting in for the biopsy, you could request a newer blood test than the PSA test and which uses different technology than the PSA test to screen for probability of prostate cancer. @jeffmarc will probably be along soon to comment on your post and he has a chart that shows the various types and their respective accuracy. I think the best one currently is an IsoPSA test; another one is the ExoDx test.
As you probably know already, not all Pirads 4 lesions turn out to be prostate cancer so don't necessarily assume anything at this point. All the best to you as you go through further diagnostic steps.
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1 Reaction.8cm is the size of a pea, how the heck do they get 12 samples out of that, I guess I will find out.
With a PIRADS 4 you definitely need to get a biopsy unless something else shows you don’t need it. The PSE test seems to be the most accurate when it comes to figuring out whether a biopsy is truly needed. If that comes back saying yes, then you really want to get one.
I suspect your doctors probably going to want to do that anyway. The thing is, They frequently find problems in spots that aren’t lit up in the MRI. So that’s just a good reason to do a biopsy.
@rider51 Was telling you about the tests you could take, Like the PSE test. I included the chart that shows all of the ones that were available at the time the chart was made.
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4 ReactionsIt is certainly possible that the PIRADS 4 lesion is benign. Mine was and it was the reason then for the fusion biopsy. Fortunately the additional grid random bites of the apple found my cancer.
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1 ReactionThey will probably use the MRI imaging to target 3 or 4 biopsy samples from the Pirads lesion, and then they will almost certainly take about 12 additional samples in a standard pattern that covers the entire gland. The goal is to make sure they determine what is going on with the lesion, and also look for anything that did not show up on the MRI. In my case and ExoDx test indicated an elevated risk of prostate cancer but an MRI did not show anything suspicious. I went ahead with a saturation biopsy (24 samples) just to be sure and that did reveal a small amount of prostate cancer which needed to be treated.
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1 ReactionHopefully it will be a low grade cancer.
@ginge38314
The PSE test, produced, by Oxford Biodynamics, is a 5 biomarker blood test with 94% accuracy. The report will say that you are likely, or unlikely, to have prostate cancer. Here is a link to their product page. It takes about 2-3 weeks to get the results back.
https://www.94percent.com/
At 65y (which was my age when I had proton radiation treatment for a localized, 7(4+3), w/PSA of 7.976), I would get a 2nd opinion on the MRI results, and then check both PSA Density and % Free PSA in time to review during your June 17th follow-up.
> Yes, schedule biopsy.
(Mayo Clinic utilizes age-adjusted reference ranges for PSA blood tests because normal PSA levels naturally increase as a man ages. Age-specific standards are critical for accurately detecting potential cancer in younger men while avoiding potentially unnecessary biopsies in older men.)
My psa density was .15, but I noticed at the beginning they noted findings most consistent with with prostatitis with tiny focus of decreased accuracy signal in the right peripheral zone. Thanks