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What can I expect after my biopsy?
51 year old and was diagnosed two weeks ago via MRI with a Gleason 7+ cancer.
MRI results below. Nothing was found in the lymph nodes or seminal sack. I have BPH on the Right side and that has been effecting me for several years.
LEFT PERIPHERAL ZONE: Ovoid focus at the lower 3rd peripheral zone measures up to 5 x 3 x 7 mm in largest AP, transverse and craniocaudal dimensions. This demonstrates diffusion restriction and low ADC signal. This does not enhance asymmetrically from the adjacent central gland. No other similar-appearing focus identified.
Prostate volume: The prostate measures 4.0 x 5.4 x 4.4 cm in largest AP, transverse and craniocaudal dimensions. This corresponds to a volume of 49.76 cc. Calculated maximum expected PSA of 5.97 ng/mL
IMPRESSION:
Suspicious diffusion restricting nodule in the left-sided peripheral zone at the apex. PI-RADS 4
I’ve been through multiple Urologists trying to get help with my enlarged prostate. The urologist I’ve had for 20+ years due to kidney stones wouldn’t give me a PSA because I was too young. He said to wait until I was 50 even though my father has prostate issues and he was my father’s urologist. My dad has had a PSA of 15 with multiple biopsy’s but no cancer found.
The second urologist did run my PSA and it was a 5. He did set me up for PSA screenings every six months but the only treatment he would do was prostate massages anytime I came into the office. That didn’t help and truthfully made my problem worse.
Went to my third urologist last July. My PSA was still a 5. February of this year my PSA jumped to 7.25 and they did the MRI where they found the issue.
My biopsy is next Thursday and I was accepted into the Brown Cancer Center in Louisville, KY. I meet with that team later in April. My only concern is looking through all the doctors profiles on the team none have prostate issues as their main focus.
I’m right now assuming with my age and no signs of spread that removal will be the recommendation. With my enlarged prostate issues causing me so much pain and affecting my daily life I’m thinking that might be the right direction.
Has anyone had experience with the Brown Cancer Center in Louisville, KY? Any other recommended paths?
I did submit for the “Color” genetics testing that was recommended on another post.
I’ve lived a good life and I’m not complaining. This is just part of life but I don’t want to leave my wife alone. That is my biggest concern.
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HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
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Also I’ve been on Flowmax for almost 25 years, not long after it came out. I’ve had diagnosed BPH for 10+ years and have tried anything and everything and the pain/symptoms are worse than ever. It’s changed my life for the worse and I avoid leaving my house or doing anything social because of it. I have a high pain tolerance and have passed 30+ kidney stones and had 12+ removed via basket retrieval, laser and lithotripsy. My BPH pain is constant and has mentally wore me down.
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1 ReactionThe Prostate Cancer Research Institute for one. I can’t post links as a new member but search YouTube for: “ MRI vs. Random Needle Biopsies” from @ThePCRI
My MRI detected a PI-RADS 4 spot.
@ericp502 Have you researched with your Urologist the many , many options to treat your BHP . For eaxmple : TURP , HoLEP , TUIP , RECUM and others .
Prostate cancer suffers can have many of these treatments withour removing the prostate .
From “healthline.com”
Medically reviewed by Roger Bielinski, MD FACS, Urology — Written by Tim Jewell on March 17, 2023
When Looking for Prostate Cancer, Which Is Best, MRI or Biopsy?
Is an MRI better than a biopsy? An MRI is often considered a more accurate way to confirm a diagnosis of prostate cancer than a biopsy. A 2019 article in the Canadian Medical Association Journal suggests that MRIs are accurate in diagnosing prostate cancer 93% of the time — compared with only 48% for biopsies.
Source: The New England Journal of Medicine
MRI-Targeted or Standard Biopsy in Prostate Cancer Screening
Authors: Martin Eklund, Ph.D., Fredrik Jäderling, M.D., Ph.D., Andrea Discacciati, Ph.D., Martin Bergman, M.D., Magnus Annerstedt, M.D., Markus Aly, M.D., Ph.D., Axel Glaessgen, M.D., Ph.D., Stefan Carlsson, M.D., Ph.D., Henrik Grönberg, M.D., Ph.D., and Tobias Nordström, M.D., Ph.D., for the STHLM3 consortium
MRI with targeted and standard biopsy in men with MRI results suggestive of prostate cancer was noninferior to standard biopsy for detecting clinically significant prostate cancer in a population-based screening-by-invitation trial and resulted in less detection of clinically insignificant cancer.
My biopsy was not a big deal at all. They had a giant scary needle for the numbing - I joked they should take that out on Halloween - but there was very little pain through the whole procedure. They use a gun-like device to shoot in and retrieve samples. You will have bloody ejaculate for about a month or so. Definitely a mood killer. All that I've read says that a biopsy is the ONLY way to diagnose cancer. All of the other methods are best guesses. Even a biopsy can miss cancer tissue, but if it finds cancer, you have cancer.
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1 ReactionI have my transperineal biopsy scheduled for this Thursday.
Read the articles I posted. Most of the articles written recently are saying the MRI is just as good if not better than a biopsy for detecting Gleason 7 or above prostate cancers.
ericp502 This report confirms an MRI Guideed Biopsy is superior to a standard Biopsy . i.e Going in blind and performing the old " OFTEN DESCRIBED PINCUSHION BIOPSY " or
" Swiss Cheese Biopsy " -- take lots of random sample cores and hope you hit something .
The latest and ONLY REAL TIME MRI BIOPSY IS " " An In - Bore or Gantry Biopsy . These are rare because of the equipmennt costs . Australia is even using A TESLA T 7 MRI Machine .
The most common worldwide is the Tesla 3T MRI which replaced the 1.5 .
I repeat : An MRI CANNOT CONFIRM OR GRADE PROSTATE CANCER -- ONLY A BIOPSY CAN .
I know Canadian report very well . I live in Canada - I personally know many of the top Urologists and Oncologists at The Princess Margaret Hospital in Toronto - Ranked in the top 5 Research and Cancer Treatment Centers in the World . Also Sunnybrook in Toronnto where the TULSA-PRO Focal therapy was invented by Dr. Gupta , who I know and now practices in the USA . Dr. Laurence Klotz performs the TULSA- PRO at Sunnybrook and was on the original research team .
Sir , I respecctfully request you personally consult with several senior PROSTATE CANCER UROLOGISTS .
Ask the question " Can you determine for certain a patient has prostate cancer and it's grade ( Gleason Score ) from an MRI " ?
I look forward to their names and answer .
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1 Reaction@jeffmarc Am I missing something . @ ericp502 on this forum insists .
" YOU CAN CONFIRM A PATIENT HAS PROSTATE CANCER AND CAN TELL IT'S GRADE FROM AN MRI ALONE " --- I respectfully disagree .
Your thoughts .
The biopsy report I have and was read by two radiologist say I have a high likelihood of a Gleason 7+ spot and PI-RADS 4. I understand that this is not 100% but it is more likely than not.
I uploaded the MRI images to Copilot and Grok AI and they both had the same analysis.
I’m hoping they are incorrect but it’s unlikely. My biopsy on Thursday with the MRI should be enough. I have scheduled a second opinion with Brown Cancer Center and I’m having the urologist doing the biopsy submit the samples to Mayo Clinic in Florida for another opinion.