MRI of Prostate... Lesions

Shelly, I agree with Rob, with a rising PSA a biopsy might answer your question. What does your urologist suggest? If you are having urinary problems due to your high BPH, he might recommend a TURP operation to help. However, in my case that made taking out the prostate a little more tricky. It also may eliminate some treatments should Prostate Cancer be found.

I had 2 MRI's that showed nothing when biopsy confirmed gleason 6. I think the gleason 6 is harder for the MRI to pick up. My third MRI just before my surgery showed PIRAD-4 lesion. Pathology after surgery was 3+4. If you dig around on this site, I think people have had PIRAD-4 lesions that are benign so, I don't know how much to let the MRI influence your thought process. We want as much info as possible to make most informed decisions but, not all info is the same.

Do nodules and Lesions "go away"?

Hi again,

The interpretation of the MRI film into nodules and lesions depends on the experience of the radiologist, and the way in reporting the results are not standard.

When taking the second MRI, the radiologist commonly uses the results of the previous scan and adds only what is new. They do not get a second look on the first film to compare.

If worried about the last results, you can try requesting second opinions on the films from the three scans at an independent radiologist.

I am curious about your history. I wonder what led your #1 urologist be concerned with your age and family history. How old are you? Do you have family members with PCa diagnosis?

The size of your gland is about 5 times bigger than the normal of 25cc (up to 55 years old), ou 40cc for a 70 years old. The traditional biopsy template of 12 needles could easily miss regions of concern. It is, therefore, wise to discuss with the urologist in advance on the method he will adopt in your next biopsy. Probably deviating some needles to other regions of the gland or using the 14 needles template.

There is no doubt that AS is the best option if the status of the person/patient so permits it, however, AS is not a walk in the park. One must be strong mentally to live with the bandit under the same roof.

I think it better for you to keep your inquiries/reporting in one same thread if interested if getting better concise opinions.

Best wishes

VGama

It definitely is capable of explaining the PSA increase.

I have a 140cc prostate with BPH symptoms, and a 3+4=7 biopsy. In talking with the uro, he mentioned how big prostates and bad cancers don’t usually go together. It’s the smaller prostates that throw the curves. I found that anti+correlation to be nice to hear.

I also had the genomics test on my biopsy result, which indicated reduced probability of mets. Additional good info.