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Advice on this very much appreciated

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User
Posted 06 Mar 2025 at 17:32

Hi there 


I am 57 and after experiencing increased urges to urinate, my doctor wanted to check my Serum Prostate Specific Antigen Level and do a physical check of my prostate. Although the blood result was 1.37, he discovered abnormalities in the prostate.


My consultant confirmed this and I had an MRI scan two weeks ago.


I have just been told that I have a Pi-Rads 3 diagnosis. The consultant has said he wants to monitor my blood over the coming months and not do a biopsy.


Doing research online it appears that usually having a 3 grade means having a biopsy.


He said the biopsy would be very unpleasant and to be avoided at the moment. It slightly felt like I was being fobbed off. But that might have been my high level of anxiety.


Has anyone else experienced this? Should I push for a biopsy? Any words of advice gratefully received.


Thanks so much  


 

User
Posted 06 Mar 2025 at 20:33

I'm not too sure that Pirads3 is usually a biopsy. It probably is if accompanied by a high PSA.


One PSA test is not very useful, but two or more tests several months apart are useful, because then you can see which way the PSA is moving. I think the consultant is right to do more blood tests rather than do a biopsy.


Prostate cancer is very slow, you have hardly any signs of (except the prostate abnormalities). Waiting a few months will make no difference to the disease if it is present.

Edited by member 07 Mar 2025 at 00:12  | Reason: Not specified

Dave

User
Posted 06 Mar 2025 at 20:52
Seems reasonable TBH. Just make sure you get the follow up.
User
Posted 06 Mar 2025 at 22:33

I'm with Dave and francij1.

User
Posted 07 Mar 2025 at 10:49

Hi Richie


I can only agree with my other fellow club members. PIRADS 3 is 50/50 chance at best, of anything sinister being present, and your PSA level is very low. I would go with the recommended waiting, and put off having a biopsy unless things change. They aren't much fun to be fair 👍


Ian.

Edited by member 07 Mar 2025 at 10:50  | Reason: Not specified

User
Posted 08 Mar 2025 at 11:35

Hi Richie,


Score another one in favour of following the doctors advice.


My MRI came back a 4 and that triggered a biopsy, which, although I wouldn't have one as a hobby, wasn't as bad as I thought.


The biopsy came back negative for cancer cells. 


The 3 score your MRI gave you means it's not necessary to have the invasive biopsy at this time. 


I know how hard it is when you think there is something going wrong inside you, but you have to be realistic and appreciate that sometimes watchful waiting is the best option.


As previously said just keep on top of future tests. My GP has been fantastic and pencilled a reminder in my medical notes to call me in for a psa test at the appropriate time so I don't forget.


Mick

User
Posted 08 Mar 2025 at 12:48
It is unfortunate that it was not mentioned what the irregularity was in the Prostate. It could be that it is rather large which is known as BPH. The Prostates of some men grow more quickly than in others and this of itself does not signify cancer. Agree that regular monitoring by PSA should be done.
Barry
User
Posted 08 Mar 2025 at 23:28

The urinary symptoms are normally symptoms of an enlarged prostate.
Prostate cancer doesn't usually have symptoms (until it spreads elsewhere, in which case the symptoms are wherever it's spread to).


Do you know how large your prostate is? (This will be in the MRI report.)


If you are not having a biopsy, I would insist on 3-monthly PSA tests for a year to get the rate of change, and then maybe another MRI to compare with the current one (which is a bit like Active Surveillance, although that can only strictly be offered after a biopsy).

 
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