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Pirads 4

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User
Posted 14 Sep 2019 at 17:35

My husband has just had an MRI scan Monday evening and was called 36 hours later to advice it showed a Pirads score if 4. The Dr said this indicates cancer is highly likely 


A Trans Perineal Biopsy is scheduled for Monday morning.   His PSA was 4 having jumped from 2 over 6 months.  His PSA has been tested regularly for the last 3 years as he was having regular night time toilet visits   DRE did not reveal anything suspicious other than a slightly enlarged prostate. 


We are both reeling at how quick this had moved. 


Any help or advice would be welcome as we feel sick with worry.  Thank you.

User
Posted 14 Sep 2019 at 19:46

Hi, diagnosis is a very worrying time. There's nothing much you can do until the biopsy results. There's an enormous amount of information about and trying to take it all in can be depressing as well as helpful. There are lots of good threads on this site and lots of people here who have been where you are and know what you are going through.


Stay strong, we're with you all the way.

User
Posted 14 Sep 2019 at 20:18

Diane,


As Phil said, you will be worrying, and there's nothing much we can say to quench that until you get more test results. Prostate cancer is usually much slower moving that many better known cancers, so if you are diagnosed with it, you will usually get some different options to pick and plenty of time to make up your minds what you want to do. It's also good that you were being closely monitored, which means it will have been caught earlier than is the case for many people.


You got the MRI result very quickly, which is very impressive. Usually it takes 3 weeks.


Do you know if the biopsy is a template biopsy (a theatre procedure under general anesthetic), or an outpatient procedure (local anesthetic)?


You will probably be asked to have a bone scan after the biopsy - that's perfectly normal too.

User
Posted 14 Sep 2019 at 20:25
Try not to worry too much. The low PSA makes it overwhelmingly likely that the cancer has been caught at an early stage, and localised prostate cancer is an eminently treatable condition. Waiting for all the tests that are required for diagnosis is the worse part of the process for many people. You’ll probably have to wait a couple of weeks for the biopsy results. If they do show cancer, he’ll probably be sent for a bone scan. Don’t worry about that - it’s a routine test which is vanishingly unlikely to show any spread with such a low PSA. Only when all the facts are known can treatment be recommended.

Easier to say than do, I know, but try to put it out of your mind and get on with life.

Best wishes,

Chris
User
Posted 15 Sep 2019 at 03:19
You may like to order or download the “Tool Kit” comprehensive information pack from this charity:

https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit

Best of luck.

Cheers, John.
User
Posted 19 Sep 2019 at 22:00
There's absolutely no reason to expect "dreadful news" with the information you've provided. The overwhelmingly probable outcome is a diagnosis of localised prostate cancer which has been caught at an early stage and is eminently treatable. Don't crucify yourself! Wait for the results and don't go down the "but what if..." road. There's absolutely no benefit in doing so. You'll know where you stand soon enough.

Best wishes,

Chris
User
Posted 20 Sep 2019 at 16:00

Hi I completely understand how your both feeling - my husband and I have been on the emotional rollercoaster of positive biopsy and Gleason - 4+4 and he’s just had his bone scan today which will give results in a week. Like you I’m preparing for bad news whilst trying to get on with ‘normal life’ it's hard. Good luck and let us know how he gets on. 

User
Posted 26 Sep 2019 at 19:38
Well, happy days. I just read that only 25% men with a potential problem only turn out to have cancer in the end.

Good to know he is being actively monitored, and I hope whatever is causing the MRI shadow is resolved soon.

Best of luck,

Cheers, John.
User
Posted 26 Sep 2019 at 20:14
Good news 😀
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User
Posted 14 Sep 2019 at 19:46

Hi, diagnosis is a very worrying time. There's nothing much you can do until the biopsy results. There's an enormous amount of information about and trying to take it all in can be depressing as well as helpful. There are lots of good threads on this site and lots of people here who have been where you are and know what you are going through.


Stay strong, we're with you all the way.

User
Posted 14 Sep 2019 at 20:18

Diane,


As Phil said, you will be worrying, and there's nothing much we can say to quench that until you get more test results. Prostate cancer is usually much slower moving that many better known cancers, so if you are diagnosed with it, you will usually get some different options to pick and plenty of time to make up your minds what you want to do. It's also good that you were being closely monitored, which means it will have been caught earlier than is the case for many people.


You got the MRI result very quickly, which is very impressive. Usually it takes 3 weeks.


Do you know if the biopsy is a template biopsy (a theatre procedure under general anesthetic), or an outpatient procedure (local anesthetic)?


You will probably be asked to have a bone scan after the biopsy - that's perfectly normal too.

User
Posted 14 Sep 2019 at 20:25
Try not to worry too much. The low PSA makes it overwhelmingly likely that the cancer has been caught at an early stage, and localised prostate cancer is an eminently treatable condition. Waiting for all the tests that are required for diagnosis is the worse part of the process for many people. You’ll probably have to wait a couple of weeks for the biopsy results. If they do show cancer, he’ll probably be sent for a bone scan. Don’t worry about that - it’s a routine test which is vanishingly unlikely to show any spread with such a low PSA. Only when all the facts are known can treatment be recommended.

Easier to say than do, I know, but try to put it out of your mind and get on with life.

Best wishes,

Chris
User
Posted 14 Sep 2019 at 21:15

Hi Andy2


Thank you for your quick reply.  The procedure is the Trans Pireneal Biopsy and it's being done via local anaesthetic.


I'm finding this community so supportive 


I'll keep the post updated.


 

User
Posted 14 Sep 2019 at 21:27

Diane,


This means you're in one of the more advanced hospitals. The procedure you are having is relatively new and is replacing the TRUS procedure (trans rectal ultrasound guided biopsy).

User
Posted 14 Sep 2019 at 21:50

We are at Maidstone and Tunbridge Wells NHS trust hospital . They do have a very good oncology department.  Fingers crossed if it is cancer it had been caught early.    We focussed on the Pirad 4 result from the MRI, but I now understand that the biopsy will give us more accurate answers.


Thank you. 


 


 


 


 

User
Posted 15 Sep 2019 at 01:03

The biopsy is the only way to confirm that it is actually cancer but the PIRADS score is usually a reliable indicator. If it is cancer, the biopsy will also determine what type of prostate cancer it is, and what stage.

Edited by member 19 Sep 2019 at 22:04  | Reason: typo

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 15 Sep 2019 at 03:19
You may like to order or download the “Tool Kit” comprehensive information pack from this charity:

https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit

Best of luck.

Cheers, John.
User
Posted 19 Sep 2019 at 21:05

Just an update in my husband.  We went for the biopsy on Monday.  It was the targeted biopsy Trans Perineal which he had done via local anaesthetic.   Around 40 targeted samples were taken and following the 30 minute procedure he had to wait until he had urinated before leaving.    The consultant said the MRI scan didn't show anything surrounding the prostate .     Apart from a little blood in his tribe for 24 hours and being very tender he has recovered well.


We see the consultant a week today, Thursday 26th September.  I have to say we are dreading the appointment and fear hearing dreadful news.  


We feel we should have some questions prepared although of course depending on the results I guess determines on what questions we will have.  My husband says that I need to have a clear head as if it is the worse possible news he won't take in anything.


PSA was 4.8 , up from 2 just 3 months earlier. DRE revealed a soft smooth prostate slightly enlarged. MRI showed 'highly likely on the Pirad score.


We go from feeling quite positive to very anxious and fearful and playing the 'what if' game. .  I have spoke to Macmillan for emotional support and thus forum helps too.  The waiting is awful . 


 

Edited by member 19 Sep 2019 at 21:07  | Reason: Spelling

User
Posted 19 Sep 2019 at 22:00
There's absolutely no reason to expect "dreadful news" with the information you've provided. The overwhelmingly probable outcome is a diagnosis of localised prostate cancer which has been caught at an early stage and is eminently treatable. Don't crucify yourself! Wait for the results and don't go down the "but what if..." road. There's absolutely no benefit in doing so. You'll know where you stand soon enough.

Best wishes,

Chris
User
Posted 20 Sep 2019 at 16:00

Hi I completely understand how your both feeling - my husband and I have been on the emotional rollercoaster of positive biopsy and Gleason - 4+4 and he’s just had his bone scan today which will give results in a week. Like you I’m preparing for bad news whilst trying to get on with ‘normal life’ it's hard. Good luck and let us know how he gets on. 

User
Posted 26 Sep 2019 at 19:14

Update on husband's biopsy .


So today we received the best possible news.  Following an MRI that showed 'highly likely' cancer cells and the Trans Perineal biopsy last week. ..results are back and show no cancerous cells.  Husband will be seen again for PSA testing in 4 months and possibly another scan and biopsy.


I know not everyone has the same outcome and we are grateful for all the support on this forum.  It has been so helpful when we were fearing the worse.


Wishing everyone a healthy future and thank you for your support and guidance .


 


 

User
Posted 26 Sep 2019 at 19:38
Well, happy days. I just read that only 25% men with a potential problem only turn out to have cancer in the end.

Good to know he is being actively monitored, and I hope whatever is causing the MRI shadow is resolved soon.

Best of luck,

Cheers, John.
User
Posted 26 Sep 2019 at 20:14
Good news 😀
User
Posted 26 Sep 2019 at 22:03
Super news - you will be well aware of the need for regular monitoring in future, not just in 3 months time!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
 
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