Pi-Rad 5, PSA 8.4, (last year, 5.3)

I appreciate your input. 

Looking on the net PI RAD 5 appears to have a rather grim prognosis, but maybe I'm not looking at all the variables. 

I read somewhere that with PI RAD 5, even after prostatectomy, re occurence is highly likely. Can you comment on that?

Thank you Sir. 

It's like driving your car and it starts making a weird noise. We can have a good guess whether it is engine, gearbox or suspension from the way it sounds but further diagnosis needs a visit to the mechanic, further examination and tests and maybe a strip down of the offending part.

Good luck and try not to worry - it is what it is, it's not going to change over the next day/week/month and the treatments are well proven and highly successful in the vast majority of cases.

my husband had pirads 5 on MRI but Gleason 6 after biopsy, apparently he had asymptomatic infection that can look bad on MRI. Maybe prepare for the worst and hope for the best.

good luck 

Quote from a post on quora which I read today.

(start quote): "I'm not a surgeon, but heard this story from a family friend who used to work at the NIH with a highly successful and recognized surgical oncologist (I'll call him Dr. S) who told this story.

I heard it secondhand, so don't have all the details, but think it's a pretty amazing story regardless (apologize in advance for my clear lack of medical terminology).

Anyway, Dr. S gets a patient with late stage cancer, who had a good sized tumor somewhere in his midsection. It's believed to potentially be operable on, so the man is prepped for surgery and Dr. S begins by opening up the patient's abdomen.

To go off on a quick tangent, do you know why cancer is called cancer? It's no coincidence it has the same name as the crab in the zodiac. Tumors are rarely one self contained sphere — they have "legs" that branch out in all different directions, and kinda sorta resemble a crab. I encourage you to look it up, and it's one of the reasons it's so much easier to treat cancer when you catch it early…usually the small "lump" is only the visible portion of the tumor"

Back to the story, as Dr. S described it, it was one of the worst tumors he had ever seen, and the cancer was so developed that surgery was going to be impossible. So, the good surgeon had no other choice but to sew the patient back up and give him the prognosis. There was no further treatment that could be done.

About two or three years go by, and Dr. S sees a patient's file with a familiar name come across his desk. Dr. S recognized it as the man he operated on a few years prior, but no way it could be the same guy, right?

The man had come back in for something unrelated to his cancer (though I think something that involved a CT scan). When Dr. S went to see him, he saw none other than the patient he sewed up two years prior, standing there in good health. Despite having had treated thousands of patients, Dr. S was in shock. They talked for a few minutes, and I wanna say Dr. S got permission to look at the man's most recent scans, and there was no sign of the cancer. Zero. It was completely gone.

No, the guy hadn't found another surgeon nor underwent chemo, in fact, Dr. S was the last person to have even operated on him. The only explanation was that the immune system had recognized the tumor as a foreign body / threat and destroyed it.

____

With parents in the medical field, I have heard several other similar-ish stories, but this one by far is the most amazing one I've heard.

As a disclaimer, this is very much a true story (though I don't remember the type of cancer or the name of the doctor). Although what happened is extremely rare, it's not impossible — the human body and immune system are capable of extraordinary things. It's no surprise there are several cancer treatments that focus on simply getting the immune system to recognize and fight the cancer." (end quote)

I'm realising that the typical western diet with a surplus of dairy probably strongly correlates with prostate Cancer. Countries with low dairy intake have very low incidence of prostate Cancer. Had I twigged this years ago I would have seriously curbed or ditched dairy from my diet. We don't need it. 

Edited by member 22 Dec 2023 at 09:29  | Reason: Not specified

I know. I was only being light hearted. I'm on AS and currently waiting for my PSA test results from Monday, so trying to lift my mood a bit. I think people should approach this disease with any and every trick in the book that works for them.

I'm still in my 50s (just) so a bit apprehensive about progression...

Hope all goes well for you.

Ian.

you have misunderstood what you have read online. I think you are confusing PI-RADS 5 with G(5+5) or with pattern 5 distortion. 

PI-RADS 5 tells you nothing about prognosis, recurrence, etc. As another member has already posted, Pi-RADS 5 just indicates that, based on the MRI images, there is a very strong likelihood that there are cancerous cells. 

What you have been reading about recurrence, prognosis, etc., relates to biopsy samples that have clinically significant Gleason patterns of 5  

Thank you for the clarification and apologies for jumping the gun, as it were. Your points have been noted. 

The way the scale of PI-Rads are presented online, make it look very serious to a neophyte in this game. Hence my error in judgement, possibly premature. 

Thank you, Sir.