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User
Posted 08 Aug 2018 at 17:35

DH and I have just been to see the GP (sadly, not our normal one who is on holiday) for results of DH’s MP MRI scan conducted in late July 2018 (arranged after PSA of 8.3/DSE).  The GP told us basically nothing/didn’t want to commit when asked outright questions ie is it cancer/just wait for biopsy results etc.  Biopsy is still another 7 days away and GP said three weeks for results - really, three weeks?  He couldn’t even print off the results letter when I asked for a copy as printer wouldn’t work so I had to take a photograph on my iphone from his screen - what a farce.

Now at home trying to fathom things out from the pic of the letter.  Conclusion was Prostate volume 25ml - PIRADS of 5 in both sides - abnormality on both sides mid gland but with no suspicious abnormality seen in transitional zones.  Both areas show diffusion restriction - what is this?  Unfortunately, it has spread into the right seminal vehicle.  Measurements were 24mm x 14mm on right and 19mm x 7mm on left.  No enlarged nodes noted.   Can anyone give me any encouragement, feeling pretty low right now.  Last sentence mentioned T3b.  Sent for the Toolkit couple of weeks ago and left it in envelope unopened .... DH has decided it is time to open it as this is now real.

 

Liz😢

User
Posted 09 Aug 2018 at 09:51
With grey areas on both sides and of such dimensions, you don’t need a template biopsy for them to have a chance of spearing it; it would be hard for them to miss.

Also, keep in mind that the seminal vesicles actually travel inside the gland as well as outside; SVI does not necessarily rule out surgery. Much will depend on the biopsies and any other scans they recommend.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Aug 2018 at 20:10
I don't blame the GP for being reluctant to give you this information - GPs are not trained in urology or oncology and scans can predict but they are not foolproof so there will be no official diagnosis until a biopsy has been completed.

The PIRADS 5 means that they are predicting this is almost certainly cancer in both sides of the prostate. Diffusion restriction is an indicator that there may be cancer cells there; in that part of the scan the light reflects differently from healthy cells. The other bit of it is saying that the transitional zone is clear (this is the bit right in the middle of the gland) and the suspicious areas are in the peripheral zone which is where prostate cancer is most commonly found. The measurements suggest that the suspicious area is quite big on both sides. The T3 is just a different way of saying that it is already in the seminal vesicle.

So basically, it is probably cancer but no-one can confirm that until he has his biopsies. What the urologist will do is target the suspicious areas for the biopsy and take samples. It then takes a few days for the pathology to be done and a multi-disciplinary team then looks at all the results and recommends which treatments might be suitable. They may also send you an appointment for a bone scan but not all hospitals do that routinely.

It may seem horrendous right now but the 3 weeks will pass quite quickly.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Aug 2018 at 20:16
Just to add that when you know the results you will in all likelihood feel in a better place as you know what you are dealing with

Sounds bizarre now I know but trust me I’ve been there as have many others

Good luck

Bri

User
Posted 08 Aug 2018 at 20:42
Hi Liz, sorry you have to be here, but all the minutiae of scans and biopsies need not concern the lay observer or sufferer, such as yourself. They amuse lab technicians and really no-one else.

You will know more after his biopsy. Hopefully it will be a targeted template one.

The salient points after MRI and biopsy if cancer is found are:

Gleason score x+y=z

Grade T?N?M?

There is also now a ‘new’ grade number which in my case is three, the same as it was before in the old system.

Where do you live, I ask as there seems to be significant differences regarding prostate cancer treatment and diagnosis, depending on your local health authority.

Don’t despair, I am sure there is light at the end of the (MRI scanner?) tunnel. Come back here with any updates or queries.

Cheers, John

User
Posted 09 Aug 2018 at 09:15

Originally Posted by: Online Community Member
Just to add that when you know the results you will in all likelihood feel in a better place as you know what you are dealing with

Sounds bizarre now I know but trust me I’ve been there as have many others

Good luck

Bri

 

Absolutely right. I think most of us spend a lot of days at the beginning trying to dissect every bit of information and draw conclusions - and we are almost always wrong.

So please be patient, it really is better when we know our enemy and have it in our sights.

User
Posted 09 Aug 2018 at 13:37
There is a helpline on this site where you can phone a specialist prostate nurse to discuss such findings.
User
Posted 09 Aug 2018 at 15:42

Did they say anything else about the liver cyst?

I was told the MRI picked up "multiple simple cysts in my liver"

I was advised people can be born with these.

Ido4

Ido4

User
Posted 09 Aug 2018 at 17:58
Cysts in the liver and kidneys are commonplace and completely benign. Nothing to worry about. MRI scans often pick up this kind of thing.

Chris

User
Posted 09 Aug 2018 at 18:48

Originally Posted by: Online Community Member
Cysts in the liver and kidneys are commonplace and completely benign. Nothing to worry about. 

Chris

I’ve got a ‘fatty‘ liver which may or not be related to alcohol consumption, but thanks for your assurance Chris, that I have nothing to worry about!

Cheers, John

Show Most Thanked Posts
User
Posted 08 Aug 2018 at 20:10
I don't blame the GP for being reluctant to give you this information - GPs are not trained in urology or oncology and scans can predict but they are not foolproof so there will be no official diagnosis until a biopsy has been completed.

The PIRADS 5 means that they are predicting this is almost certainly cancer in both sides of the prostate. Diffusion restriction is an indicator that there may be cancer cells there; in that part of the scan the light reflects differently from healthy cells. The other bit of it is saying that the transitional zone is clear (this is the bit right in the middle of the gland) and the suspicious areas are in the peripheral zone which is where prostate cancer is most commonly found. The measurements suggest that the suspicious area is quite big on both sides. The T3 is just a different way of saying that it is already in the seminal vesicle.

So basically, it is probably cancer but no-one can confirm that until he has his biopsies. What the urologist will do is target the suspicious areas for the biopsy and take samples. It then takes a few days for the pathology to be done and a multi-disciplinary team then looks at all the results and recommends which treatments might be suitable. They may also send you an appointment for a bone scan but not all hospitals do that routinely.

It may seem horrendous right now but the 3 weeks will pass quite quickly.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Aug 2018 at 20:16
Just to add that when you know the results you will in all likelihood feel in a better place as you know what you are dealing with

Sounds bizarre now I know but trust me I’ve been there as have many others

Good luck

Bri

User
Posted 08 Aug 2018 at 20:42
Hi Liz, sorry you have to be here, but all the minutiae of scans and biopsies need not concern the lay observer or sufferer, such as yourself. They amuse lab technicians and really no-one else.

You will know more after his biopsy. Hopefully it will be a targeted template one.

The salient points after MRI and biopsy if cancer is found are:

Gleason score x+y=z

Grade T?N?M?

There is also now a ‘new’ grade number which in my case is three, the same as it was before in the old system.

Where do you live, I ask as there seems to be significant differences regarding prostate cancer treatment and diagnosis, depending on your local health authority.

Don’t despair, I am sure there is light at the end of the (MRI scanner?) tunnel. Come back here with any updates or queries.

Cheers, John

User
Posted 09 Aug 2018 at 09:15

Originally Posted by: Online Community Member
Just to add that when you know the results you will in all likelihood feel in a better place as you know what you are dealing with

Sounds bizarre now I know but trust me I’ve been there as have many others

Good luck

Bri

 

Absolutely right. I think most of us spend a lot of days at the beginning trying to dissect every bit of information and draw conclusions - and we are almost always wrong.

So please be patient, it really is better when we know our enemy and have it in our sights.

User
Posted 09 Aug 2018 at 09:51
With grey areas on both sides and of such dimensions, you don’t need a template biopsy for them to have a chance of spearing it; it would be hard for them to miss.

Also, keep in mind that the seminal vesicles actually travel inside the gland as well as outside; SVI does not necessarily rule out surgery. Much will depend on the biopsies and any other scans they recommend.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Aug 2018 at 13:37
There is a helpline on this site where you can phone a specialist prostate nurse to discuss such findings.
User
Posted 09 Aug 2018 at 15:42

Did they say anything else about the liver cyst?

I was told the MRI picked up "multiple simple cysts in my liver"

I was advised people can be born with these.

Ido4

Ido4

User
Posted 09 Aug 2018 at 17:58
Cysts in the liver and kidneys are commonplace and completely benign. Nothing to worry about. MRI scans often pick up this kind of thing.

Chris

User
Posted 09 Aug 2018 at 18:48

Originally Posted by: Online Community Member
Cysts in the liver and kidneys are commonplace and completely benign. Nothing to worry about. 

Chris

I’ve got a ‘fatty‘ liver which may or not be related to alcohol consumption, but thanks for your assurance Chris, that I have nothing to worry about!

Cheers, John

 
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