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User
Posted 08 Jun 2023 at 13:46

Hi, I received a letter from hospital regarding MRI and bone scan


Letter states prostate classified as category 3 in both peripheral zones. High PDA density is elevated g 0.24


Could someone explain what this means

User
Posted 08 Jun 2023 at 21:25

"Interesting that they are going straight to biopsy. In my case I first had a simple echo to determine the prostate size and then an MRI to look for lesions which then guided the biopsy."


The person has already had his MRI and bone scan Steve. The biopsy is going to be a targeted biopsy based on the MRI images

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Jun 2023 at 17:22

There is not too much information to go on there. I am going to take a guess the category 3 means a PIRADS score of 3. This is a scale which runs from 1 to 5. A score of 5 would mean cancer quite likely, and a score of 1 means cancer unlikely. So 3 is about the middle.


I'm going to assume you meant PSA not PDA. 


PSA is not a very good test of cancer, and people with big prostates can have a high PSA just because the prostate is big. By taking the blood PSA and dividing by the prostate volume, you can get the PSA density. A value of 0.1 would be quite healthy 0.24 is a little high.


I presume the next action is to decide whether a biopsy is needed.


 

Dave

User
Posted 08 Jun 2023 at 21:19
Interesting that they are going straight to biopsy. In my case I first had a simple echo to determine the prostate size and then an MRI to look for lesions which then guided the biopsy.

However, the biopsy isn't pleasant but not that bad. You get gowned up and the surgeon does a quick finger check and then you lie on your side. They push a well lubricated tube up your rectum and then give you a couple of painkiller injections. After a minute or so you can feel them fire a device into the prostate - it's uncomfortable as they fire it each time but not major pain - in my case they did 13 of them. They then clean you up and you walk back to get dressed - I drove home afterwards.

I went to lie down on the bed for a couple of hours when i got home with a couple of paracetamol and I was fine. For your next dozen or so ejaculations you will have bloody semen which can freak you out a bit and you may have small amounts of blood in your stools and urine but that's perfectly normal.

From the histology results they will give you a Gleason score which looks something like 3+4=7 which indicates the size and scope of the cancer lesion(s). From that point you can decide one what steps to take next.

Hope that helps
Steve
User
Posted 08 Jun 2023 at 21:29

You might get a Transperinial biopsy where they go in through the perinium. You lie on your back with your legs up in stirrups and the needle goes in through the perinium. I had this and no real issues …I think it’s less prone to infection for obvious reasons.

User
Posted 08 Jun 2023 at 21:56
Sorry, that was by bad as I misread your OP so yes that all makes sense.

It sounds as though the MRI has found some suspect areas on the prostate that deserve further investigation. Fairly normal.

I have been lucky in so much as having direct and immediate access to the MRI/Bone scan results - they even give me a CD with the images as well as online access - not that I can read scans but they supply the technicians notes in advance of the consultation with the urologist - I guess that's both good and bad LOL
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User
Posted 08 Jun 2023 at 17:22

There is not too much information to go on there. I am going to take a guess the category 3 means a PIRADS score of 3. This is a scale which runs from 1 to 5. A score of 5 would mean cancer quite likely, and a score of 1 means cancer unlikely. So 3 is about the middle.


I'm going to assume you meant PSA not PDA. 


PSA is not a very good test of cancer, and people with big prostates can have a high PSA just because the prostate is big. By taking the blood PSA and dividing by the prostate volume, you can get the PSA density. A value of 0.1 would be quite healthy 0.24 is a little high.


I presume the next action is to decide whether a biopsy is needed.


 

Dave

User
Posted 08 Jun 2023 at 18:42

Thanks for the reply, received a phone call to go next Thursday to discuss the procedure of Artemis targeted biopsies.


 

User
Posted 08 Jun 2023 at 21:19
Interesting that they are going straight to biopsy. In my case I first had a simple echo to determine the prostate size and then an MRI to look for lesions which then guided the biopsy.

However, the biopsy isn't pleasant but not that bad. You get gowned up and the surgeon does a quick finger check and then you lie on your side. They push a well lubricated tube up your rectum and then give you a couple of painkiller injections. After a minute or so you can feel them fire a device into the prostate - it's uncomfortable as they fire it each time but not major pain - in my case they did 13 of them. They then clean you up and you walk back to get dressed - I drove home afterwards.

I went to lie down on the bed for a couple of hours when i got home with a couple of paracetamol and I was fine. For your next dozen or so ejaculations you will have bloody semen which can freak you out a bit and you may have small amounts of blood in your stools and urine but that's perfectly normal.

From the histology results they will give you a Gleason score which looks something like 3+4=7 which indicates the size and scope of the cancer lesion(s). From that point you can decide one what steps to take next.

Hope that helps
Steve
User
Posted 08 Jun 2023 at 21:25

"Interesting that they are going straight to biopsy. In my case I first had a simple echo to determine the prostate size and then an MRI to look for lesions which then guided the biopsy."


The person has already had his MRI and bone scan Steve. The biopsy is going to be a targeted biopsy based on the MRI images

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Jun 2023 at 21:29

You might get a Transperinial biopsy where they go in through the perinium. You lie on your back with your legs up in stirrups and the needle goes in through the perinium. I had this and no real issues …I think it’s less prone to infection for obvious reasons.

User
Posted 08 Jun 2023 at 21:30
Thanks, I had 1st hospital appointment 24th April bone scan followed by MRI 12th May I have not seen a Dr since 24th so it was a bit of a shock when I received the letter this morning followed with telephone call to arrange appointment for Thursday to discuss biopsies.

Thanks information

Arthur
User
Posted 08 Jun 2023 at 21:56
Sorry, that was by bad as I misread your OP so yes that all makes sense.

It sounds as though the MRI has found some suspect areas on the prostate that deserve further investigation. Fairly normal.

I have been lucky in so much as having direct and immediate access to the MRI/Bone scan results - they even give me a CD with the images as well as online access - not that I can read scans but they supply the technicians notes in advance of the consultation with the urologist - I guess that's both good and bad LOL
 
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