Just Got Diagnosed

Hi,

The only time you can get a definite cancer diagnosis id with a biopsy. MRI’s detect suspicious areas that an experienced diagnostician might determine is cancer but not definite without the biopsy. After the biopsy your Urologist will grade your cancer as to it’s aggressive nature. 3 being not very aggressive and 5 being really aggressive. BPH(Prostate inflammation) can raise your PSA number if you have that condition. Time to wait until after you have your biopsy before you start discussing treatment protocols. If you do have cancer you will want to also consult a radiation Oncologist for their prospective. Second opinions from a different doctor and hospital network is a good idea depending on your trust in your current doctors.

Dave 3+4

Agree with Dave, MRI is not confirmation. See what your biopsy says. If results are positive, get second opinions, investigate your options.

I second the above opinions.

Please tell us once you have the biopsy result; hopefully we will be able to give advice at that time.

bloom,

Welcome to you Sir,

As all have noted above, an MRI cannot confirm PCa, but the results and the way the radiologist summarized things, it is HIGHLY LIKELY that it is PCa. The vector rate of the PSA results agrees with this likelihood also. The biopsy will inform the doctor of your Gleason Score, as well as the extend of the tumor(s) ("volumetric involvement"). You will need all of this information to make an informed decision on curative therapy, but in most cases without likely escape from the gland, Cyberknife is usually a good and popular choice. If there is likely glandular escape, the choices then become IMRT/IGRT, which is a different type of radiation delivery from Cyberknife. Cyberknife itself is the brand name for radiation delivered as 'SBRT,' so if the urologist mentions SBRT, know that he is discussing CK, or an alternative brand of it (by 'brand,' I mean manufacturer of the radiation device employed).

As to how fast PCa advances, the truest answer is 'it varies' (based upon Gleason score), but in most cases, it moves quite slowly, and almost always, there is ample time to sit back and study the options.

max

I'm about a couple of weeks ahead of you... I just had my biopsy last Monday.. I also had a MRI that showed I had a Pi Rad 4 lesion.. My biopsy was targeted transperineal ultrasound guided and they took 24 core samples .. The procedure itself (which I was worried about) was painless... 2 out of 24 were graded as 4+3... Another 3 were 3+3 and the rest were benign.. I will see my urologist on June 27th for consultation and treatment options... I have no idea at this point what to expect... Best of luck to you...

Dale: You can expect that your urologist will recommend treatment.

We don't know your age, but it is likely that he will mention, if not recommend, surgical removal of your prostate; it is probably his specialty. Perhaps he will discuss radiation treatments as well, but he may not be up-to-date and sufficiently knowledgeable about those. Let's see what happens, but make sure you evaluate all pertinent options before making a decision that is best for you.

Based on the biopsy results, it appears that you have time to do this.

Ok.. I also am very active.. My concern with the biopsy is that it would prohibit me from biking, etc for a prolonged period of time… I was “lucky’ in that I was able to bike 5 days after my procedure.. I didn’t have that much of a problem urinating, but I do have an enlarged prostate as well.. So I now know that I have cancer… 4+3 graded cores are not good… The question now is how aggressive is it and what do I do treatment wise… I hope your biopsy comes back negative for PCa… Best of luck to you..

Great news Bloomschool , I have a similar condition with a Pirads4. Going for a MRI guided biopsy next week. PSA was 5.1 2 years ago then dropped to 4 for a year then jumped to 6.1 now its 5.1. Can only hope for results as good as yours. My 4/K says 27% chance of clinically significant cancer, nurse says 60% overall chance of PCA. Spending my time studying and hoping for no cancer or grade 6 cancer. Radiation? prostatectomy? Can't know treatment until diagnosis is in. However it is not in my hands! We will see, I am 66 so I am in the risk zone....