Post MRI report seems bad.

larbud

Had my first MRI after PSA jumped from 3.1 on April 2021 to 13.6 on Feb 2024 then a week later to 15.6. Was tested for possible infection but came back negative so the MRI was scheduled.

The Report Impression: Highly suspicious lesion of the anterior right apex as above marked for possible fusion biopsy. The lesion demonstrates definite extracapsular extension anterioly.

Pi-RADS CATEGORY 5, PROSTATE VOLUME 53.8ml

Follow up with Urologist was scheduled for April 1 but they called today and want to see me tomorrow. (Will post update) Thus my interpretation of bad. My guess for the next step is a biopsy.

Any thoughts are appreciated.

I have a feeling I'm now a member of the not so sought after but very popular club.

Clevelandguy

Hi,

The biopsy will grade your cancer with a Gleason score. Your Prostate volume is about twice the normal volume of about 25ml. Some of your higher PSA scores might be related to Benign prostate hyperplasia(BPH) which will inflate your PSA. Good luck and pray for the best………

Dave 3+4

larbud

Will have my fusion biopsy April1 and receive a Geason Score shortly after.

Old Salt

Many have reported their biopsy experience as a relatively minor inconvenience. Others not so much.

I hope that your overall experience will fall in the first category.

With a PSA that high, a PSMA scan may be in your future after the biopsy.

larbud

Does extracapsular extension most often mean the cancer has metastasized or can cancer still just be local? Can BPH be ruled out?

Clevelandguy

Hi,

Yes, extracapsular extension means the cancer has spread outside of the Prostate. Your Urologist should be able to determine if you have BPH.

Dave 3+4

centralPA

Extracapsular extension does not mean it has metastasized (spread throughout the body) it does mean it has expanded its way out of the boundary of the prostate. It could still be localized to the prostate area. But obviously the odds that it has or will further spread are greatly increased. Smart that your care team bumped up the schedule for you.

larbud

https://csn.cancer.org/discussion/comment/1714202#Comment_1714202

Will my Urologist be able to determine BPH from my MRI or only after Biopsy.

Larry

larbud

Sorry if I am not fully understanding, but does extracapsular extension always mean cancer or can the EPE be BPH or a benign cyst?

Larry

larbud

Not sure if I got the abbreviation for extracapsular extension correct. Is it EPE or ECE?

centralPA

https://csn.cancer.org/discussion/comment/1714205#Comment_1714205

Your prostate is bigger than average (prostate hyperplasia). The “benign” part requires a biopsy to determine.

I think EPE and ECE are the same thing.

https://radiopaedia.org/articles/extraprostatic-extension-of-prostate-cancer?lang=us

Does the EPE always mean cancer…I think anything is possible, but it does correlate strongly with cancer, unfortunately. Let’s hope you are the exception to the rule.

Clevelandguy

https://csn.cancer.org/discussion/comment/1714205#Comment_1714205

Hi,

The Urologist should measure the size of the Prostate from the MRI data.