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MRI - PIRADS 4 and waiting for Biopsy

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User
Posted 17 Jun 2023 at 16:50

Hi all,

I am 53 years old, in2019 I went to GP following some slight urine flow issues and regularity of needing to go.  At that time PSA was 6, a week later PSA was 3.7. GP decided to put me on Finasteride and to keep an eye on things going forward.

3 weeks ago went back to GP(different one) slight changes in urine flow. Had DRE and bloods and referred to Urology. MRI taken and 10 days ago told that I have a lesion on my Prostate that is PIRADS 4. Now waiting for a biopsy.

I am sure they said my prostate was not large, 16ml and the lesion was 10mm.

I asked if the lesion was contained  and was told by the nurse that they think it is contained but are not sure.

I am waiting a call back as I did phone and ask why they were not sure.

My question is why would they not know as I thought MRI  showed the growth and if it has spread ?

Thanks .

User
Posted 21 Aug 2023 at 12:31
Hi Craig

I have updated my profile with most of the story so far but overall recovery has been very straightforward. RARP was on 12th May and today I am down to a single Tena pad for the odd dribble when I strain or sneeze and occasionally the pad is clean after a whole day. I will always have ED as mine was non-nerve sparing but we still have a lot of fun in the bedroom and I swear I enjoy my dry orgasms much more than pre-RARP - but maybe that's just me and the missus :)

Zero regrets on the RARP - I have PSA <0.01 6 weeks afterwards and 6 monthly checks with the urologist.

User
Posted 17 Jun 2023 at 21:54

They can't always be sure with MRI and better to say so. Hopefully, biopsy will throw more light in your case but there are sometimes situations  until a removed Prostate is later examined in the lab that it is more certainly established if there were clear margins.

Edited by member 17 Jun 2023 at 21:58  | Reason: Not specified

Barry
User
Posted 21 Aug 2023 at 10:52

Hi C Mac

 

I see from your profile that you have updated your current status. How are you getting on? I am 59, Pirads 4 on MRI, and 3 weeks into waiting for my biopsy result, so would be interested to hear how things are going mate.

User
Posted 21 Aug 2023 at 11:18
I think I was in the same situation given that I was Pirads 4 at MRI and Gleason 3+4 after the biopsy. The urologist agreed to the RARP on this basis but after the surgery, when the prostate was examined in the lab, it was upgraded to Gleason 4+5=9 and T3aN0M0 - so the MRI and even the biopsy is only a guesstimate as it is based on samples (albeit scientific ones that are designed to give as accurate a prognosis as possible).
User
Posted 21 Aug 2023 at 12:16

Hi Harty,

still waiting on bone scan results, hopefully get this week. I think if clear then it will be treatment decision time. Hope it goes well for you.

thanks Craig 

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User
Posted 17 Jun 2023 at 21:54

They can't always be sure with MRI and better to say so. Hopefully, biopsy will throw more light in your case but there are sometimes situations  until a removed Prostate is later examined in the lab that it is more certainly established if there were clear margins.

Edited by member 17 Jun 2023 at 21:58  | Reason: Not specified

Barry
User
Posted 18 Jun 2023 at 14:35
Barry,

Thanks for the reply and information. Waiting on contact for date for Trans Perenial Biopsy, believed likely late July.

Thanks

Craig

User
Posted 21 Aug 2023 at 10:52

Hi C Mac

 

I see from your profile that you have updated your current status. How are you getting on? I am 59, Pirads 4 on MRI, and 3 weeks into waiting for my biopsy result, so would be interested to hear how things are going mate.

User
Posted 21 Aug 2023 at 11:18
I think I was in the same situation given that I was Pirads 4 at MRI and Gleason 3+4 after the biopsy. The urologist agreed to the RARP on this basis but after the surgery, when the prostate was examined in the lab, it was upgraded to Gleason 4+5=9 and T3aN0M0 - so the MRI and even the biopsy is only a guesstimate as it is based on samples (albeit scientific ones that are designed to give as accurate a prognosis as possible).
User
Posted 21 Aug 2023 at 12:16

Hi Harty,

still waiting on bone scan results, hopefully get this week. I think if clear then it will be treatment decision time. Hope it goes well for you.

thanks Craig 

User
Posted 21 Aug 2023 at 12:19

Hi Steve,

thanks for the update. Like you say MRI and biopsy could well change post RARP. It is something I am thinking about. The 2 of 14 cores that showed cancer in my Biopsy were at the location /area where MRI showed the lump. Fingers crossed.

Out of interest how is your recovery post RARP, hope you are doing well.
Thanks Craig

User
Posted 21 Aug 2023 at 12:31
Hi Craig

I have updated my profile with most of the story so far but overall recovery has been very straightforward. RARP was on 12th May and today I am down to a single Tena pad for the odd dribble when I strain or sneeze and occasionally the pad is clean after a whole day. I will always have ED as mine was non-nerve sparing but we still have a lot of fun in the bedroom and I swear I enjoy my dry orgasms much more than pre-RARP - but maybe that's just me and the missus :)

Zero regrets on the RARP - I have PSA <0.01 6 weeks afterwards and 6 monthly checks with the urologist.

 
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