3 lesions PI-RADS 5

combtmedic

I am 46 years old with 3 maternal uncles with prostate cancer. My PSA was high for 18 months. The doctor decided to do an MRI. Monday, 2/5/24, I received a call that I had 3 lesions within my prostate. 2 of the lesions were protruding in the a capsule wall into the fat tissue. All three lesions were rated PI-RADS 5. The radiology reports stated there was no evidence of anything in my lymp nodes, bones, or seminal vessels. I’M 46 YEARS OLD. I saw the doctor on Wednesday. She would not give me a diagnosis until I have a biopsy. She kept stating “Remember, these are rated a 5. All 3 lesions are a 5.” I am scared at this point. I asked about treatment and even though she had refused to diagnose, she started talking to me about treatment. Removal or leave it in and see what happens. Both with the possibility of chemo and/or radiation. Now I am in a waiting pattern. Wednesday will never get here. Then, she told me the pathology report would take 7-10 days. I have done so much research and it only confuses me and scares me. The first 3 days I was numb. I didn’t know how to feel. Day 4 I accepted I had cancer. Day 5 I read that 29% of those with a 5 and protruding dies. So then I thought I was dying. Today, I am holding onto the glimmer of hope that it is benign. I don’t know if the doctor told me this (I am sure it was her) or I read it. With a PI-RADS 5 lesion, it is 95% or higher probability of cancer. Can someone please walk me through this? If you have something similiar, what were your experiences? Thank you.

Old Salt

Very sorry to read about your prostate problems at such an early age. We do understand your anxiety and we will try to provide support.

Unfortunately, most sources do indicate that with a PIRADS 5 score cancer is likely, but only a biopsy can prove that you do have prostate cancer.

I hope that the biopsy will be an MRI-guided one so that the PI-RADS 5 lesions can be analyzed. It is too early, for me at least, to write about treatment scenarios. They do depend on the information from the biopsy. You wrote that your PSA was high; can you provide some details please?

combtmedic

I just know that it was high for 18 months before they decided to do an MRI. It was over 5 in December but was even higher, up and down, throughout time. I am having a guided MRI biopsy. I don’t know what all that means right now. I was told they would take samples directly from the lesions. Have you ever heard of someone getting a PI-RADS 5 and it not being cancer? I have 3 of them. Like I said, 2 are protruding out. My friend is a surgeon and told me that a benign tumor would not protrude out of sac. Good thing is, the MRI showed it was not in other areas yet.

oldspice

https://csn.cancer.org/discussion/comment/1713153#Comment_1713153

I wish you well on your journey it’s unfortunate at such a young age but more testing must be done before final determination. My Urologist told me a few stories how a PIRAD 5 turned out to be negative via the biopsy. Mine was a PIRAD5 and it was indeed cancer. The biopsy is where the facts are as the MRI is the picture and the biopsy is the actual data. If the biopsy is positive then you most likely will be scheduled for a PSMA scan which highlights any other areas from your pelvic area to your neck. That test is specific to prostate cancer and is relatively new but a big break through in prostate cancer research because of its accuracy. Best to focus one step at a time and not get ahead of yourself as anything is possible. Good luck and wishing you the best.