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MRI scan results indications

User
Posted 05 Jul 2023 at 20:08

Hi, your experience and advice would be appreciated please!

my husband (he’s 61) had raised psa after a recent health check, he was tested again after 4 weeks and as it was higher again, referred to urologist, who sent him for MRI scan. This showed the prostate to be twice normal size and the urologist said showed ‘areas of concern’ so 4 days later he had a trans perineal biopsy and we now await the results.

I cope with things by devouring all of the information I can and like to be ‘prepared’ and although we are talking about it, my husband prefers not to waste a worry until we have all the facts (I am pleased he is able to do that) but I wish he had asked the urologist what he meant by ‘areas of concern’.

my question is, is an MRI an indication of definite cancer and the biopsy just to show the type, growth rate and likely spread,….or could the raised psa, enlarged prostate and ‘areas of concern’ all be non cancerous?

thanks

Debbie

User
Posted 06 Jul 2023 at 11:52
When I had my first echo, the technician informed me that mine was 35cc and 'slightly enlarged' - I asked him if this was exceptional and he said no, he had seen prostates 70,80 and some over 100cc.

The MRI might identify suspicious areas, but as Andy said, only the biopsy can confirm or deny.

Good luck!

User
Posted 06 Jul 2023 at 12:29

25-30cc is normal size, but given a large proportion of men have large prostates, "normal" is a strange concept.

Mine was variously given as 93cc or 97cc on scans, but wasn't giving me any symptoms at all. Although enlarged prostates often do give symptoms, the symptoms don't seem to be proportional to prostate size, although for any given prostate, they only get worse as the prostate grows.

Someone in a support group yesterday has a 500cc prostate, which only recently started giving problems. That's by far the largest I've heard of (and it doesn't have prostate cancer).

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User
Posted 05 Jul 2023 at 21:42

The enlarged prostate is not normally anything to do with prostate cancer. It's just that many men's prostates never stop growing, so by the time you reach age 50,60,70, they can be quite large. It is this which causes urinary symptoms of getting up to pee at night, peeing slowly, etc. although some enlarged prostates don't cause any symptoms. An enlarged prostate will also mean that his normal PSA level will be higher because he has more prostate tissue.

Areas of concern, or lesions, are areas of abnormal tissue, but an MRI scan can't identify them as cancer, and they could be areas of inflammation. Also, cancer can exist in areas which look normal on the MRI. It is only the biopsy which can identify if there's cancer there, so you are just going to have to wait for the biopsy results. This is an anxious time, we know.

User
Posted 05 Jul 2023 at 22:00
Thanks for that…that’s what I understood but wanted to make sure I hadn’t got it wrong!
User
Posted 06 Jul 2023 at 11:52
When I had my first echo, the technician informed me that mine was 35cc and 'slightly enlarged' - I asked him if this was exceptional and he said no, he had seen prostates 70,80 and some over 100cc.

The MRI might identify suspicious areas, but as Andy said, only the biopsy can confirm or deny.

Good luck!

User
Posted 06 Jul 2023 at 12:29

25-30cc is normal size, but given a large proportion of men have large prostates, "normal" is a strange concept.

Mine was variously given as 93cc or 97cc on scans, but wasn't giving me any symptoms at all. Although enlarged prostates often do give symptoms, the symptoms don't seem to be proportional to prostate size, although for any given prostate, they only get worse as the prostate grows.

Someone in a support group yesterday has a 500cc prostate, which only recently started giving problems. That's by far the largest I've heard of (and it doesn't have prostate cancer).

User
Posted 12 Jul 2023 at 22:54
Just an update on our journey….8 days since husbands biopsy so still awaiting results of that (as you all know, anxious times) but then yesterday we received a copy of a letter sent to GP with results listed of examinations so far and quoted on rectal examination cT2 felt; and that at consultation practitioner had explained the results of this and of MRI, both appearing to be cancer but obvs the biopsy would give more info. (My husband wasn’t aware that cancer was mentioned at that appointment). We also have in the letter that MRI is Likert 5.

So at the moment it’s hard not to believe that it’s not PC and we hope for good news at the biopsy appointment that it is as contained as possible.

I guess it would be foolish that the biopsy would show no cancer now!?

User
Posted 13 Jul 2023 at 00:41
We have seen a few men recently who were PIRADS 5 at MRI and subsequently given the all clear. However, the fact that the urologist could feel it in the DRE is fairly conclusive - I think you are probably being realistic about the results.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 Jul 2023 at 00:42
How high was his PSA?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 Jul 2023 at 00:51

thanks for that Lyn… psa results 6.2 and second 4 weeks later at 6.39

 

User
Posted 26 Jul 2023 at 09:06

Update: just over 3 weeks since OH TP biopsy and things taken a bit longer due to strikes but results appointment is tomorrow.

Thanks to all of you who have taken time to share on this site as it has helped us to feel so much more prepared for the meeting with our questions and potential outcomes.  That of course May all go out the proverbial window when emotions kick in but we will see!


I will update when I can over next few days…we have the distraction of twin granddaughters third birthday shenanigans over next couple of days so quite a bit of family time!

User
Posted 26 Jul 2023 at 10:09
The emotions are the hardest part as we naturally always think the worst is going to happen.

If the results do show that he has PC then he will have caught it early and the prognosis is likely very favourable - I was pretty much in the same situation with a slightly higher PSA and I opted for the RARP which was performed on May 12. It was far less dramatic than I ever anticipated - I was literally shaking like a leaf beforehand - but it was very straightforward. My histology results were not as good as I had hoped for but I still have the option of RT later on - but my surgeon doesn't want to see me for 6 months.

My incontinence has all but stopped - ED I can live with but can affect others psychologically. You will find lots of others on the forum in the same or similar situation so it really is far better than your imaginations are probably creating for yourselves :)

Best of luck moving forward!

User
Posted 26 Jul 2023 at 10:36

Thanks Steve! Yes I share your views and the waiting will be over tomorrow! (My husband is a Steve too!)

 
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