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Pirad5 diagnosis for prostate

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User
Posted 13 May 2021 at 08:13

Hi everyone,


I had a call from my consultant on Monday with sad news that It’s possible That I may cancer of the Prostate as my 2nd MRI scan was Pirad 5. 


My first scan was 12 months ago I had My first scan because My psa was fluctuating from 4.3 to 5.5 . The first scan showed inflammation of the prostate. The advice was to have another scan 12 months later which looking back is a long time if they saw something in the first scan.


Now for my concern. I have had testicular pain mainly on my right side all this time another reason to have a mri scan in the first place. The conclusion from my consultant was sperm granulomas that we’re leaking so this is the path I have been taken down. My pain came and went so the next step was to remove the epididymis but first let’s see the 2nd scan and see the results then to my horror I was told you more than likely have cancer to my prostate. 
my biggest concern over all this time is I have suffered from leg, hip and neck pain. I have had lots of massages and take naproxen. My consultant doesn’t think it’s connected to my problem but I am not convinced as I am a healthy 54 year old. Yes, I am in my feet all day long as I am a builder but the leg and testicular pain never goes away which makes me concerned that if I do Have cancer that it may have got into my bones.


I don’t know if I am being over worried and I know most of you will say wait to have your biopsy which I hope will be next week yet I just fear the worst.


its great get this off my chest and I look forward to hear your thoughts. Just one last question do I have general or local anaesthetic? Take care all.

Edited by member 13 May 2021 at 10:57  | Reason: Not specified

User
Posted 13 May 2021 at 15:47

I had an MRI scan on 21/04 following a psa reading of 5.76. I have a lesion of 15mm on a 55ml prostate and believe my Pirad reading is 4. My understanding is that although a lesion showing up on the MRI scan suggests that there is a good chance that you will have prostate cancer (though it could be benign), the fact that your psa reading is fairly low (less than 10) probably suggests that the cancer is localized (i.e. has not spread) and is highly treatable.  The trouble with being told that you may have prostate cancer is that the mind goes into overdrive and all the everyday aches and pains start to make you believe that they are caused by cancer. In your case they are probably not.


As you have said, you really need to await the results of the biopsy which will tell you exactly what the state of play is.


Hopefully, you will have your biopsy next week, but if you using the NHS I think you may well find that it will be later. In my case, my scan was on 21/04, the findings were reported back to me  by telephone call on 30/04 and my biopsy has just been scheduled for 04/06. I had a letter from Addenbrookes, Cambridge on Monday (10/05) advising that they were going to miss the 3 week treatment window (MRI to biopsy should take no more than 3 weeks) and upon receipt was contacting private clinics to find out the cost (around £1700) and waiting times of having a biopsy. I was just about to push the button to go private when I received a letter today furnishing me with my biopsy date. I may well go private for treatment if the NHS cannot offer the best treatment for my condition.


Re your question about the type of anaesthetic, most biopsies are carried out under local anaesthetic. My TP one certainly is.


Good luck with your biopsy and if you do get diagnosed with prostate cancer bear in mind that for most people it is highly treatable and is not a death sentence.


 


 

User
Posted 13 May 2021 at 16:52
Is the next slot not till June because you are going private? If so, it will be quicker to have it done on the NHS.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 May 2021 at 17:06

You are not on your own; there are more people with prostate cancer than you think and some are probably people you know. As soon as you mention prostate cancer to them they open up and tell you about their own diagnosis etc.


Interestingly enough, Japanese medical research has found that a number of prostate cancers start when the person is in their 20/30's and most are so slow growing (one slow growing cancer cell takes over 400 days to form) that a 10 mm lesion may have taken over 40 years to form. Now, not many people know that, to misquote Michael Caine.


The NHS biopsies, unless you are a high risk case, are presently taking around 6 weeks from the MRI scan (it should be 3 weeks) so your private biopsy date, though longer than you would like, is not out of kilter. No doubt the consultant would have slotted in an earlier date if your psa reading and scan showed an urgent need for it to be so.


It is difficult to be focused on other things when you are told you may have cancer, but as Chris has said in his message, your situation based on your results is not one to be overly concerned about.It is a bugger to be diagnosed but if you have to get cancer prostate cancer is one of the "better" ones to have.


 


All the best and let us know how you get on


 


Ivan


 


 

Edited by member 13 May 2021 at 17:09  | Reason: Not specified

User
Posted 13 May 2021 at 17:20

Hi Lindo,


I had a PSA of 5.8 prior to the biopsy. The biopsy came back with 2 cores where PCa was detected but at less than 5%. It was a further 2 years before I elected for any treatment, prior to that it was just active surveillance. Chances are that if they find any PCa it is likely to be at a very early stage. Its very easy to over think things. Just try to put it to the back of your mind and see what if anything the biopsy throws up. Good luck

User
Posted 14 May 2021 at 04:53

Originally Posted by: Online Community Member
...I had a call from the The consultant secretary who will be potentially doing my biopsy...



Try and get the Consultant himself to carry out your biopsy, rather than his secretary...😉


Best of luck.


Cheers, John.

User
Posted 18 May 2021 at 11:35

My lesion is 15mm on a prostate of 55 ml in size and as I have previously said I want a biopsy for peace of mind and so that if it is cancer the right treatment can be given. I must admit, like Chris, I am confused why the consultant thinks that a lesion could be prostatitis. Still, he is more qualified than us so should know the difference.


Obviously, your pain issues and possible inflammation does add another level to your decision making process and only you can decide how to proceed. If it was me, I would still want the prostate checked as early treatment for prostate cancer can make a real difference.

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User
Posted 13 May 2021 at 15:47

I had an MRI scan on 21/04 following a psa reading of 5.76. I have a lesion of 15mm on a 55ml prostate and believe my Pirad reading is 4. My understanding is that although a lesion showing up on the MRI scan suggests that there is a good chance that you will have prostate cancer (though it could be benign), the fact that your psa reading is fairly low (less than 10) probably suggests that the cancer is localized (i.e. has not spread) and is highly treatable.  The trouble with being told that you may have prostate cancer is that the mind goes into overdrive and all the everyday aches and pains start to make you believe that they are caused by cancer. In your case they are probably not.


As you have said, you really need to await the results of the biopsy which will tell you exactly what the state of play is.


Hopefully, you will have your biopsy next week, but if you using the NHS I think you may well find that it will be later. In my case, my scan was on 21/04, the findings were reported back to me  by telephone call on 30/04 and my biopsy has just been scheduled for 04/06. I had a letter from Addenbrookes, Cambridge on Monday (10/05) advising that they were going to miss the 3 week treatment window (MRI to biopsy should take no more than 3 weeks) and upon receipt was contacting private clinics to find out the cost (around £1700) and waiting times of having a biopsy. I was just about to push the button to go private when I received a letter today furnishing me with my biopsy date. I may well go private for treatment if the NHS cannot offer the best treatment for my condition.


Re your question about the type of anaesthetic, most biopsies are carried out under local anaesthetic. My TP one certainly is.


Good luck with your biopsy and if you do get diagnosed with prostate cancer bear in mind that for most people it is highly treatable and is not a death sentence.


 


 

User
Posted 13 May 2021 at 16:23

Hi thank you for that,


its good to know I am not on my own with this.


I have private health and since my post this morning I had a call from the The consultant secretary who will be potentially doing my biopsy . She told me the next step is to have a consultation with him on Monday and that the next slot for biopsy is the 17th of June which shocked me to be honest especially as I have private health. So now it’s a case of discussing the biopsy with him and deciding to go ahead which I have no doubt in my mind that I will because I need to know.


so it’s a waiting game. I am trying to get in a state of mind of thinking of the best as apposed to thinking of the worse.


hopefully all goes well with your biopsy and if I can offer any support I will do willingly.


 


take care.

User
Posted 13 May 2021 at 16:48
With a PSA of 5 you are EXTREMELY unlikely to have prostate cancer that's spread to your bones. Yes, it can happen, but only with rare and exotic forms of prostate cancer that are very, very unusual. With the ordinary type of prostate cancer which is called adenocarcinoma, bone spread would be associated with a PSA in the hundreds or even thousands.

It really is just a matter of waiting for the diagnostic process to take its course, I'm afraid. This is the most stressful part of the whole thing for many men. Just take it a day at a time, and DON'T consult "Dr Google"! Once all the diagnostic tests are complete you'll know where you stand. If you do have localised prostate cancer it's not the end of the world; it's a condition for which treatment is highly effective.

I was diagnosed in May 2018 at the age of 56, so not too dissimilar to you, and started treatment later that year. Three years on and (touch wood) it's all sorted and life is good.

Best wishes,

Chris


User
Posted 13 May 2021 at 16:52
Is the next slot not till June because you are going private? If so, it will be quicker to have it done on the NHS.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 May 2021 at 17:06

You are not on your own; there are more people with prostate cancer than you think and some are probably people you know. As soon as you mention prostate cancer to them they open up and tell you about their own diagnosis etc.


Interestingly enough, Japanese medical research has found that a number of prostate cancers start when the person is in their 20/30's and most are so slow growing (one slow growing cancer cell takes over 400 days to form) that a 10 mm lesion may have taken over 40 years to form. Now, not many people know that, to misquote Michael Caine.


The NHS biopsies, unless you are a high risk case, are presently taking around 6 weeks from the MRI scan (it should be 3 weeks) so your private biopsy date, though longer than you would like, is not out of kilter. No doubt the consultant would have slotted in an earlier date if your psa reading and scan showed an urgent need for it to be so.


It is difficult to be focused on other things when you are told you may have cancer, but as Chris has said in his message, your situation based on your results is not one to be overly concerned about.It is a bugger to be diagnosed but if you have to get cancer prostate cancer is one of the "better" ones to have.


 


All the best and let us know how you get on


 


Ivan


 


 

Edited by member 13 May 2021 at 17:09  | Reason: Not specified

User
Posted 13 May 2021 at 17:20

Hi Lindo,


I had a PSA of 5.8 prior to the biopsy. The biopsy came back with 2 cores where PCa was detected but at less than 5%. It was a further 2 years before I elected for any treatment, prior to that it was just active surveillance. Chances are that if they find any PCa it is likely to be at a very early stage. Its very easy to over think things. Just try to put it to the back of your mind and see what if anything the biopsy throws up. Good luck

User
Posted 13 May 2021 at 17:29

Thank you for all your positive comments I’m feeling better already (Dr Google (: made me laugh.

User
Posted 14 May 2021 at 04:53

Originally Posted by: Online Community Member
...I had a call from the The consultant secretary who will be potentially doing my biopsy...



Try and get the Consultant himself to carry out your biopsy, rather than his secretary...😉


Best of luck.


Cheers, John.

User
Posted 14 May 2021 at 10:51
I found the biopsy to be highly uncomfortable, but in part that may have been due to the operator of the instrument being a trainee. Local anaesthetic where they take the samples so that only the popping sound indicates when it happens (I had 6 samples). Some discomfort for two days and blood in stools and urine but I soon recovered. I drove to and from the hospital without any problem.
User
Posted 18 May 2021 at 08:02

Just and update from my consultation with the consultant who will be responsible for my biopsy.


 


I was told the result of my scan can be one of two things Prostate cancer or inflammation of the prostate “prostatitis’ we decided to go ahead with the Biopsy.


we discussed many scenarios about my condition unfortunately as I was trying to take in everything he had to say I forgot to discuss one very important concern of mine and would really appreciate feedback if anyone else has had similar problems.

 

For the last 12 months I have had really bad leg, hip, neck and back pain.  Over the last 3 months the pain has been quite chronic and debilitating to the point I go for massages to try and relieve my pain and to be honest the massages give me only temporary relief before my pain  returns as I am writing to you I have have really bad leg pain particularly around my groin, thighs and neck I often get tingling sensations around my abdomen. I have mentioned my leg pain in the past to other consultants but they kind of avoided my concern ‘worryingly.

 

 My Mri  scan result could be cancer but it could also be An infection of the prostate “Prostatitis” one of the symptoms of prostatitis is CPPS chronic pelvic pain syndrome.

 

I have the tell take signs of this condition this is why I want to discuss this with The Professor because it may make him have second thoughts of the biopsy? Then again  It may not ? nonetheless, I need to discuss it ASAP just in case the narrative has changed and we should look at my condition in a different way.

 

In the very beginning my doctor thought I had prostatitis because of my psa level after taking antibiotics on several occasions my psa did come down after a long course but then returned which was why I was referred to a specialist. I stopped taking antibiotics because I kept coming out in Hives “urticaria” 

 

I understand the reasons of having My biopsy because we need to rule out cancer yet I can’t help thinking it maybe prostatitis and having the biopsy may cause other implications that could be avoided.

 

I have sent an email to the consultant to discuss my concern and hope to hear from him soon.

 

I just wanted to voice my concerns to you guys out there and get your opinions.

 

thank you.

 

User
Posted 18 May 2021 at 10:43

Did the MRI scan show a lesion? If it did, I am not sure that could be caused by prostatitis. Though a lesion in itself could be benign. My limited understanding is that a biopsy does not cause long term damage (though like all things there are exceptions to the rule), but could cause local swelling and bleeding for up to 6 weeks. Because my biopsy is scheduled for 04/06 I have undertaken a deal of research and for peace of mind have no issues having a biopsy performed.

Edited by member 18 May 2021 at 10:43  | Reason: Not specified

User
Posted 18 May 2021 at 11:15

Hi, yes my scan showed a lesion 1.5 cm the consultant did say it could be inflammation or it could be cancer so thats why he wants me to have a biopsy. He told me he has found a number of times that the cause is prostatitis and not cancer The dilemma  and where the confusion is with my pain which leads me towards inflammation. He told me doing a biopsy on a inflammatory prostate can hold its own complications by way of infection or even sepsis . “nightmare”

User
Posted 18 May 2021 at 11:25
You said that your MRI was assessed as PIRADS 5. That means that there's the strongest level of evidence of a tumour. You need a biopsy. Prostatitis doesn't look like a tumour on an MRI scan!

Best wishes,

Chris
User
Posted 18 May 2021 at 11:33

Hi Lindo,


Interesting. Welcome. My immediate reaction is, in not in any particular order.


Are you penicillin allergic ? 


Builder, general wear and tear, or have you ever had a bad injury ?


A good qualified sports injury physio would probably be a wise move for your £.  From ..Personal experience.  You need to get a proper DX for ongoing pain. Ie Joints, muscle or nerves.  


Re. Biopsy, only way to know for sure. However see my note re. Penicillin.. and derivatives. 


Hope this gives food for thought.  If you haven't already, try and define triggers,  does pain improve with rest etc  . Worst getting up in morning


Are you on any other medication ?


Regards Gordon


 


 

User
Posted 18 May 2021 at 11:35

My lesion is 15mm on a prostate of 55 ml in size and as I have previously said I want a biopsy for peace of mind and so that if it is cancer the right treatment can be given. I must admit, like Chris, I am confused why the consultant thinks that a lesion could be prostatitis. Still, he is more qualified than us so should know the difference.


Obviously, your pain issues and possible inflammation does add another level to your decision making process and only you can decide how to proceed. If it was me, I would still want the prostate checked as early treatment for prostate cancer can make a real difference.

User
Posted 18 May 2021 at 13:16

Originally Posted by: Online Community Member
You said that your MRI was assessed as PIRADS 5. That means that there's the strongest level of evidence of a tumour. You need a biopsy. Prostatitis doesn't look like a tumour on an MRI scan!

Best wishes,

Chris


I don't think that is correct Chris - the consultant has seen the scan and advised the patient that there is a suspicious area which could be infection / inflammation or cancer. As he is the qualified professional with the benefit of having seen the images, I think we have to assume that he knows what he is talking about?  

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 18 May 2021 at 13:19
Lindo, your symptoms could be caused by prostatitis or another infection / inflammation - they could equally be as a result of advanced prostate cancer in the bones. The only way to find out for sure is to have the biopsy.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 18 May 2021 at 13:21

Hi Gordon,


 


it’s funny you should mention penicillin Gordon I hadn’t been allergic to it in the past until I had a tooth implant in January  and was give amoxicillin in case I had infection I had a terrible reaction/hives and ended up in hospital on a drip.


im interested to know why you ask the question Gordon.


thank you


 


I am a property developer so I am on my feet most days. I do all the work myself. I have been doing this kind of physical work in the past but never had constant pain like I have for the last 3 months.

User
Posted 18 May 2021 at 22:30

Lindo,


Just a gut feel, I have 3 family members penicillin allergic.


Have you been tested for pen.allergy? Did you have a specific rash ?  A drip of what and how long in hospital ?  Have you had any other blood tests ?


 


Gordon

User
Posted 19 May 2021 at 10:20

Hi Gordon,


I was just in for a couple of hours had a injection in my buttock and arm. I’m not sure what the drip was for? I had hives, first started on my hands and my thumbs specifically and behind my ears I had really trouble breathing that’s when I seemed medical attention. The only blood tests I had recently was for psa levels and thyroid.

User
Posted 19 May 2021 at 10:27

Hi,


 


I was told I didn’t have any cancer if the bones just a 1.5 cm lesion inside my prostate The Professor said I had a very small prostate which made the lesion look bigger. My big worry is obviously it may be cancer the other worry is if it is inflammation they will be taking sample from an inflamed prostate. I forgot to mention mist if this started with pain in my testies the diagnosis was spermicide granulomas due to past vasectomy so I was taken down this pathway to eventually have the epididymis removed that is now in the back burner because they found a lesion in my prostate after having mri scan because my psa had increased from 4.2 to 5.4 

 
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