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MRI - staging - is biopsy just confirming or can MRI be wrong?

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User
Posted 07 Oct 2023 at 01:27

Letter says Pirads 5 bilateral peripheral zone  T2N0/T3N0

 

that lead to biopsy. Does the letter inferring a stage mean they’re certain it’s cancer and biopsy confirms the stage, or can MRI be wrong? 

Apologies for many questions 

 

User
Posted 07 Oct 2023 at 13:23

MRI shows suspicious areas but is subject to interpretation. Also, there have been cases where MRI has not shown suspected cancer where in fact there is some but imaging has improved so this is less likely now but still possible. These days they tend to concentrate biopsy on the suspicious area seen on MRI and from these samples it is possible to determine the type of PCa you have and give a Gleason score. Only by examining a Prostate in the lab after Prostatectomy can a more definitive appraisal be made on grade and extent of cancer.

Edited by member 07 Oct 2023 at 15:02  | Reason: spelling

Barry
User
Posted 07 Oct 2023 at 13:35
Barry is spot on! The MRI indicates areas of interest and the biopsy, which uses a predefined plan of where to extract the cores and how many, is based on the MRI. These cores are then examined and an interim diagnosis provided which guides the next stage of treatment. But even the biopsy is based on samples of the gland and does not investigate the seminal vessels etc and so only when the prostate (and lymph nodes) are sliced and examined on the lab table can they be definitive.

For example, my MRI showed a single lesion and a G7(3+4) but the lab changed this to G9(4+5) after examining it.

However, they are experienced in what they do and even though the diagnosis are 'guesstimates' they are pretty accurate in most cases.

User
Posted 08 Oct 2023 at 04:19

Nearly all of us gone through the same trauma of extreme anxiety, fear, night less sleep but eventually learn to get use to it. You too will eventually overcome this ordeal, and I hope sooner than later. On the bright side of it, is good to know you are not alone and this group with lots of humanly, caring, helpful,  knowledgeable members takes most of the burden off your shoulder and help you to go through this hard times.  

Good luck

 

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User
Posted 07 Oct 2023 at 13:23

MRI shows suspicious areas but is subject to interpretation. Also, there have been cases where MRI has not shown suspected cancer where in fact there is some but imaging has improved so this is less likely now but still possible. These days they tend to concentrate biopsy on the suspicious area seen on MRI and from these samples it is possible to determine the type of PCa you have and give a Gleason score. Only by examining a Prostate in the lab after Prostatectomy can a more definitive appraisal be made on grade and extent of cancer.

Edited by member 07 Oct 2023 at 15:02  | Reason: spelling

Barry
User
Posted 07 Oct 2023 at 13:35
Barry is spot on! The MRI indicates areas of interest and the biopsy, which uses a predefined plan of where to extract the cores and how many, is based on the MRI. These cores are then examined and an interim diagnosis provided which guides the next stage of treatment. But even the biopsy is based on samples of the gland and does not investigate the seminal vessels etc and so only when the prostate (and lymph nodes) are sliced and examined on the lab table can they be definitive.

For example, my MRI showed a single lesion and a G7(3+4) but the lab changed this to G9(4+5) after examining it.

However, they are experienced in what they do and even though the diagnosis are 'guesstimates' they are pretty accurate in most cases.

User
Posted 07 Oct 2023 at 16:47

Thank you, I understand. Hoping the radiologist guesstimate is wrong.

 

people on this forum seem so helpful and relaxed - yet I’m full of fear and dread. Hopefully I’ll learn to relax about this. 

User
Posted 07 Oct 2023 at 20:58

Turkey2222,

Most of us were stressed out in the beginning, but have had time to adjust to the diagnosis.  Don't be hard on yourself.  Allow yourself time to adjust.  I know it's easier said than done, but try to distract yourself with pleasant activities during this 'waiting' period for clarification of your situation.

Good luck.

JedSee.

User
Posted 08 Oct 2023 at 04:19

Nearly all of us gone through the same trauma of extreme anxiety, fear, night less sleep but eventually learn to get use to it. You too will eventually overcome this ordeal, and I hope sooner than later. On the bright side of it, is good to know you are not alone and this group with lots of humanly, caring, helpful,  knowledgeable members takes most of the burden off your shoulder and help you to go through this hard times.  

Good luck

 

User
Posted 08 Oct 2023 at 08:11

Hi Turkey222,

As I’ve said many times on this forum, I think you would benefit from joining a support group such as Maggies. If it’s a good one (like mine😊) it will almost certainly help you come to terms with this disease. I was at my Maggies Mens Cancer Support Group on Friday morning and it was intense, I can’t go into detail because it’s confidential, but the support and advice offered by the group to a new member was inspiring.

I always feel so much better coming out of the meetings.

Derek

User
Posted 08 Oct 2023 at 08:22

Hi decho glad you are doing well you are very lucky Maggie's near you is a very good group the one I went too which I won't name wasn't luckily I met a group off local guys we meet on a regular basis and help one another glad your group is good but not all are 

User
Posted 08 Oct 2023 at 09:29

Hi Gaz,

Yes I know I am lucky and they are not all as good. We are also fortunate that one of the Support Specialist was previously head CNS in Urology. We have a general Cancer support group every Friday and also a Prostate Cancer Networking Group once a month.

TBH though a lot of support comes outside of the group meetings, we regularly go out for coffee, lunch etc, and we also have a WhatsApp group. The important thing is to be able open up about your feelings and worries and an informal group like you have found would be JUST as good.

I was having a ‘Why Me?’ Week last week but they guys and the Specialists were able to help me address my emotions and I came away feeling completely different…for the better😊

All the best

Derek

User
Posted 08 Oct 2023 at 17:25

Good to hear decho the support around you it really helps as you know.i find this forum invaluable 👍

 
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