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Pi-rads of 5's on prostate MRI

Birddog7071
Posts: 2
Joined: Sep 2018

My PSA went from 5.4 to 11.4 in a year.  I have lower back pain and pain in kidney areas.  A MRI of prostate was ordered.  There are 3 areas with pi-rad scores of 5 and 1 area with a pi-rad score of 4.  I won't have a biopsy done until Oct. 25.  What are the chances they won't find cancerous cells ?  

MudMan's picture
MudMan
Posts: 23
Joined: Jul 2018

Birddog,

Anything is possible at this point and your pending biopsy will confirm if you have PCa.  PI-RADS of 4 is "Probably Malignant" and PI-RADS of 5 is "Most Probably Malignant."  There are those on this forum that have done a great amount of reseaching that probably will explain the lower back or Flank Pain you are experiencing.  In my opinion, the biopsy is the next step and welcome to the club you didn't really want to join.  There is a lot of good information available here.

Old Salt
Posts: 720
Joined: Aug 2014

What are the chances that they won't find cancerous cells? 

Based on the data you provided, I personally think (!) that those chances are fairly low, but really, why speculate? You need to focus on the biopsy, as MudMan stated.  

Please consider the following:

Most older men have cancerous cells in their prostate

In many cases no therapy is necessary when low-grade cancer is identified, at least initially

And when higher grade (more aggressive) cancerous lesions are identified, many therapies are available

Let's hope for a negative outcome of the biopsy. If not, please respond and we will try to help.

lighterwood67's picture
lighterwood67
Posts: 219
Joined: Feb 2018

On my MRI I had a 2 lesions.  One a PI-RAD 5 and one PI-RAD 4.  Biopsy showed the PI-RAD 5 lesion was cancerous.  Gleason 4+3=7 in 5/5 cores.  The PI-RAD 4 was not.  I had a UroNav biopsy.  In my opinion, knowing your chances are not going to answer your question.  A biopsy will.  Good luck on your journey.  The folks on this site have helped me a lot.  

Sw1218's picture
Sw1218
Posts: 55
Joined: Jan 2016

there are other illnesses of the prostate that has symptoms similar to prostate cancer. BPH {non-cancerous growth of the prostate} and another one i know of is prostatitis {inflammation or infection of the prostate}. Symptoms include:

1. freguent trips to the bathroom

2. lower back pain

so, when the brothers above suggests a biopsy, they're not trying to play "hard to get" it's just that they understand a biopsy will determine which of the illnesses if not all three illnesses of the prostate you have. IF the results of your biopsy turns about to be cancer, the results would determine how aggresive. This way you would be able to more accurately decide the best treatment.

Georges Calvez
Posts: 305
Joined: Sep 2018

You can often rule out prosatitis and BPH by urine analysis and ultrasound, MRI before going for the invasive needle stick to be sure in a minority of cases.

SantaZia
Posts: 64
Joined: Apr 2018

Hi Bird, sorry you have to go through this, but that is a long time to wait for a biopsy. After I had a second PSA test confirming my results I was scheduled for a biopsy the following week.  You may also want a second opinion of the pathology report once you get your results. Also, the biopsy slides can be used to run genetic tests.  There is no rush with all this, however, the biopsy results may help reduce the worrying and provide you some direction.  I would suspect your lower back pain is similar to everyone else and is not related to PC. If you have a kidney infection you would have a fever and other symptoms. I started this process in January 2018.  Generally, PC is a slow growth cancer.  I also had a PI Rad 5 and prior to my last pre-hormone shot my PSA was 12.7 on Finasteride for 22 years some said I should double the score.  I ended up with an unfavorable intermediate PC that required 6 months of hormone treatment prior to radiation. There is a lot of testing, research, and preparation that you will want to do too. Good Luck!  

Birddog7071
Posts: 2
Joined: Sep 2018

I'm a Vietnam combat veteran that spent 10 months in 8 man recon teams.  Main source of water were streams and pot holes.  My twin brother was there too but a clerk in a hospital.  Illnesses I have that he doesn't, ulcerative colitis, diabetes, cataracts, glaucoma and now possibly prostate cancer. I receive 100% of my healthcare through the VA and have received excellent care.  I tried to get an earlier bioposy at the University of Minnesota.  Because I'm on 2 immune system suppressants for my UC, the VA wants the biopsy done in the radiology department using the MRI and ultrasound to get samples from the suspicious areas to minimize the number of needle pokes due to high risk of infection.  I certainly wish it were earlier. 

ASAdvocate
Posts: 117
Joined: Apr 2017

As others have stated, a PIRADS 5 lesion is serious. Could it be from a non-cancerous anomaly? Yes, but not likely.

Why can’t you schedule a biopsy sooner? The worrying could be a major distraction for you.

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