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PI-RADS 5, PSA 67

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User
Posted 24 Nov 2024 at 14:26

Hi, i am writing because of my husband. 

Basically he mentioned symptoms to his internist this August - burning sensation when passing urine, having to pee often in the night, and the internist got his PSA tested. 

It was 54 ng/ml at the end of August so the urologist gave him a number of other swabs etc and put him on antibiotics and said he should test again in October. 

In October it was 50 ng/ml  so the urologist said he should get an MRI. 

In the meantime, he did more bloodwork and the PSA was 67 ng/ml(!). 

The scan came back as extensive PI-RADS 5 lesionin tZ and pZ on both sides - as far as I understand it, he has not seen a doctor about it yet. They mention areas with maximum 39mm and 14mm with a long connection to the pseudo capsule. It also mentions no sure signs of growth outside the capsule. 

And the prostate itself if 50x48x47mm, so very big. 

My husband is in his 50s and he has a brother and had an uncle with Prostate Cancer. 

I guess this all means it is very likely he has it too and the doctor will probably recommend a biopsy. 

Do any of you have any insight if the jump in PSA from 54ng/ml. then 50 ng/ml and then 67 ng/ml from August to October is concerning? 

User
Posted 24 Nov 2024 at 20:10

It very well maybe cancer with the PSA numbers and PIRADS 5 lesions, but be aware until the biopsy gleason scores come back it is difficult to say whether the cancer is low, intermediate or advanced grade. I have seen high PIRADS come back benign. Regardless the diagnosis of prostate cancer is a long journey with years and years typically. I feel blessed it was the cancer I was diagnosed with as you can read over and over of all the patients diagnosed with pancreatic cancer, or stomach, esophageal, brain, colon, etc. and pass very quickly. Get the biopsy, hopefully obtain an MRI fusion biopsy to target the lesions and research the treatment options. I hope the best for your husband!

User
Posted 24 Nov 2024 at 23:00

I know someone on active surveillance his PSA bounces around between about 8 and 17 so your husband's PSA may be just bouncing around rather than rising. With a prostate that size his PSA relative to the size of his prostate is not quite as alarming as it first appears. Until all the tests are done you don't know where you are. If the MRI shows no growth beyond the prostate that suggests if it is cancer it will be very treatable.

Dave

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User
Posted 24 Nov 2024 at 20:10

It very well maybe cancer with the PSA numbers and PIRADS 5 lesions, but be aware until the biopsy gleason scores come back it is difficult to say whether the cancer is low, intermediate or advanced grade. I have seen high PIRADS come back benign. Regardless the diagnosis of prostate cancer is a long journey with years and years typically. I feel blessed it was the cancer I was diagnosed with as you can read over and over of all the patients diagnosed with pancreatic cancer, or stomach, esophageal, brain, colon, etc. and pass very quickly. Get the biopsy, hopefully obtain an MRI fusion biopsy to target the lesions and research the treatment options. I hope the best for your husband!

User
Posted 24 Nov 2024 at 23:00

I know someone on active surveillance his PSA bounces around between about 8 and 17 so your husband's PSA may be just bouncing around rather than rising. With a prostate that size his PSA relative to the size of his prostate is not quite as alarming as it first appears. Until all the tests are done you don't know where you are. If the MRI shows no growth beyond the prostate that suggests if it is cancer it will be very treatable.

Dave

User
Posted 25 Nov 2024 at 14:13
We keep having to remember that we don't know anything yet, it is only very likely PCa but not necessarily. So have not told the kids of course (youngest is 8yo) but we are a bit stressed. I hope he can see a doctor soon and find out how the next steps work.

And of course even if it is PCa, I realise it can be very manageable.

User
Posted 29 Nov 2024 at 06:22

So he saw the urologist and he gave him a referral for a fusion biopsie (extensive pi rads v lesion both sides, psa 67).

Now we are trying to find a hospital to do it. The main one he recommended said to call back next week as the person making appointments is not there this week. 

 
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