Confused after MRI

I am not a doctor, but I think the main thing is whether it is all in the prostate or not. If it is, it doesn't matter how much is in there. It all gets either zapped with radiation or removed with surgery.

I don't think where your MRI indicates extraprostatic extension is where the biopsy penetrated the prostate, so you didn't get a sample of that exact spot. That lesion on the right that showed up in the MRI definitely got sampled by the biopsy, though. I am betting that the doctor will presume it's in the bed? I'd be prepared for either diagnosis from the doc. Know what the options are that he might present.

Now is the time to become a lay expert in your condition. Anxiety stems from uncertainty and loss of control. Knowledge is power, power is control. Read up all you can and walk into the doctor's office knowing what he is likely to say, and being prepared to talk about it.

The NCCN patient guidelines are an excellent place to start. Written in plain English, but follow the detailed guidelines for the docs.

https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459

https://www.nccn.org/patients/guidelines/content/PDF/prostate-early-patient.pdf

@REB72 I'm a 68-yr old who was asymptomatic aside from elevated PSA in a March 23 blood test and was eventually diagnosed with PCa in December. Sounds like we share the emotional roller coaster of this disease and I share the anxiety of the what ifs and unknowns. I have my surgery scheduled for July 9 with the DaVinci Xl. It took a long time, lots of information gathering, more than a few tears and many conversations with my wife. I met with and discussed my diagnosis with two radiation oncologists and two surgeons before making my decision. For me, the tipping point in favor of surgery were the discussions around hormone treatments in conjunction with radiation therapy. The possible side effects don't work well with my emotional conditions and I couldn't get past the limited treatment options via surgery should the PCa return post radiology.

I'm only a few steps ahead of you on this path but I'm more than happy to share my experiences if that's something you think might be helpful. If you're anything like me, it's hard to shut off the brain from worry and anxiety sometimes.

I don't think anyone can plan for this and PCa is hardly as straightforward as I thought it was. My doctor recommended I start doing Kegel exercises now, pre-surgery, as it's supposed to help with the incontinence issues post surgery. This may be helpful for you https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074

The thing that helped me the most was when I met my surgeon, he opened the conversation with, "We're not here to treat your cancer. We're here to cure you." I hope you have or find that confidence. You're far from being on this journey alone.

Hang tough.

Ron

I recommend that, once you know more, you set up an appointment with a 'center of excellence' to discuss what your options REALLY are.

https://www.cancer.gov/research/infrastructure/cancer-centers

I wonder if you couldn't get a prescription for Ozempic and get your weight moving in the desired direction?

There's just no positive to being overweight when dealing with this. Makes surgery more difficult, more body for any beam to travel through to get to the cancer.

The sleep apnea thing is my big worry.

While you're sitting around staring at your navel, waiting for the medical system gears to ever-so-slowing (too slowly!) turn, try reading the book Breath. Super interesting, and talks about using your breath to cope with anxiety and also apnea. Just a good read too.

https://www.mrjamesnestor.com/breath-book

RonB Your diagnosis, age and decision process are almost identical to mine. 3+4=7 , 68 years old and went through the exact same thought process and conclusion. I am having DaVinci surgery on July 17th and start Kegel PT this week.

REB72 I empathize with your worry. I get totally consumed with worry and anxiety on situations I can't control. I could not focus or think for 2-3 weeks after my diagnosis. My day to day life was on hold…I couldn't do anything. But then I started get educated, I kept getting reassurance from multiple Drs. Once I got educated and my options and direction were clear to me, my anxiety went way because I now had a plan.

I know that our PCa and circumstances are different and that you may have more hurdles than me. But I wanted to let you know that there are many people that have issues controlling anxiety and worry. I still have plenty to worry about, but I now have a plan and I feel that I have taken some control over my situation.

Old Salt and centralPA have had sage advice. Especially on controlling anxiety with knowledge and education. I know it is easier said than done, especially when facing uncetrtainty. But I hope that you can get control of your anxiety once you get more information and direction.

Best of wishes. I will be thinking of you.

I am dealing with a similar situation. I had my MRI on April 4th and a Biopsy schedule for May 8th. On April 17th the Dr that was doing the Biopsy cancelled my appointment (ins reason). I have been reaching out to doctor twice a week for direction on the next step or to see if he has rescheduled me at a different clinic, but he has been radio silent until this morning.

The nurse that called this morning suggested having the procedure done by my doctor with ultrasound (transrectal instead of the targeted fusion biopsy, (transperineal). This is all very new for me, so I appreciate being part of this group, and hearing advice from others that have had the misfortune of dealing with this decease. I will be checking out the links posted by swl195

If your MRI detected something of interest to sample, it’d be nuts not to do a fusion guided biopsy. If it came back as nothing seen, then your biopsy will be random anyway.

So it depends on what was seen in the MRI.

The 'tech' suggested there MIGHT be a patient portal. Why not try to find it?

Waiting two weeks will be hard; try to focus on something more pleasant…