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Received MRI Results Today

Posted by stew80 @stew80, Nov 30 10:30am

Hi Brothers,
My high PSA numbers (~ 12) led to me getting an MRI last week. Today I have the results and they are concerning. The highlights are:
One large lesion 2.7 x 1.7 x 2.5 cm in left peripheral zone.
One smaller lesion (0.8 cm) in right anterior mid-gland.
No lymphadenopathy.
No suspicious bone lesions.
PSA density is 0.45.
I'm not sure what this all means and I'm in a bit of a shock. I just wonder if anyone has had a similar diagnosis. I would appreciate any comments or opinions. I haven't had a medical consultation yet so the grading is not identified. I'm 84 and otherwise very healthy and active.

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mulberry | @mulberry | 4 days ago
In reply to @stew80 "Thanks for your message. I called my GP today and updated her. She said that the..." + (show)
@stew80

Thanks for your message. I called my GP today and updated her. She said that the main info they need is on the current MRI. Two lesions (PIRADS 5 AND 4). There is also an indication that one lesion may have encroached the edge of the prostate and the worry is it may have spread locally. I am pushing to get the biopsy sooner than what is booked (20 Feb 2025) by getting on a short list. I don't think there is a 'pay' option to get it sooner. On the transrectal versus perineal biopsy issue, the Cancer Center here doesn't do perineal. My GP said that despite the infection potential, there are fewer layers to punch through rectally and the results are more accurate. I also asked about a povidone iodine suppository and she said she hadn't heard about using it for a biopsy, but it made sense. Apparently it's available over the counter. Finally, my GP said that, sad but true, they look at 84 and have the tendency to be less in tune to the urgency.
Merry Christmas and Happy New Year to you as well.

Jump to this post

I had the transrectal, transpereneal wasn't available at my provider. It was much easier and less painful than I had feared. I had read some descriptions of bad experiences here and on other postings. My urologist had done a lot of them and I think his experience was probably the most important factor.
As for infection risk, in addition to thorough prep cleansing (think pre-colonoscopy), they gave me an antibiotic pill to take the night before the procedure plus a shot in my buttock just before the procedure. That shot actually hurt more than the biopsy!
The biopsy itself included a local anesthetic which I believe was applied with the same tool that contains the ultrasound head and that fires the needles. That numbed the area where the needles penetrated. Then he warned me each time before he "fired" them so I wasn't surprised. There were pauses as he studied the ultrasound image to target specific zones. He had the benefit of several MRI's but the actual procedure was not fusion guided.
The "firings" felt like a strange, snap sensation but no pain. The procedure was over in 15 or 20 minutes including talk time, undressing and getting situated on the table. Easy-peasy!
I had actually postponed the biopsy quite a few months out of unwarranted fear.
One thought I had that got me over the hurtle of fear was to ask myself, why wouldn't I accept a biopsy of a likely cancerous tumor if it was anywhere else on my body? That forced me to face the fact that all I had to fear was fear itself.
Just my two-bits worth. I hope it helps and all goes well with whatever you choose.

REPLY
stew80 | @stew80 | 4 days ago

Thank you for sharing this. It sounds like you didn't have an infection which for me and many is the most concerning.

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1 reply
mulberry | @mulberry | 4 days ago
In reply to @stew80 "Thank you for sharing this. It sounds like you didn't have an infection which for me..." + (show)
@stew80

Thank you for sharing this. It sounds like you didn't have an infection which for me and many is the most concerning.

Jump to this post

You're welcome! No, no infection. The biopsy pathology was (3+4)7 , favorable intermediate and my subsequent RARP surgery pathology was the same i.e. wasn't upgraded to an 8 or 9. So the biopsy was very similar to actual conditions. I know the needles can miss the cancer.

By the way, I am 78 and surgery was 7 months ago, PSA 0.009 (3 mo) and 0.006 (6mo). No regrets, here.
Best

REPLY
stew80 | @stew80 | 4 days ago

Good to hear. I don't think surgery will be offered because of my age (84). I'll look at other options once the biopsy is done (right now scheduled for 20 Feb).

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