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PI-RADS 5

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kim2424
kim2424

I am trying to understand my husbands MRI, done by the cancer center of his prostate. He just had surgery last Friday and did a second biopsy to see what was going on and his PSA was 20.3. I am trying to prepare myself for these results. Here is what his MRI information says.

There is more mild, segmental low T2 signal intensity in the right

peripheral gland extending from 6:00-11:00 with early contrast

enhancement. There is no clear diffusion restriction.

Capsule: There is broad based attachment with the capsule, which is

bulging anteriorly, indicative of likely invasion.

Neurovascular bundle: Unremarkable .

Seminal vesicles: Unremarkable .

Lymph nodes: No pelvic lymphadenopathy .

Osseous structures: No suspicious lesions identified .

Urinary bladder: Unremarkable.

Miscellaneous: None.

Impression

IMPRESSION:

2.3 cm lesion in the anterior aspect of the prostate near the mid

gland with diffusion restriction and early contrast enhancement.

(PI-RADS 5).

0 likes, 7 replies

7 Replies

  • anthony70342
    anthony70342 kim2424

    Posted

    Hi Kim,  

    We just went through the same thing here in Reno, NV.  After 8 mos. of running around to useless doctors, we finally decided to go to the Cancer Treatment Center of Phoenix, AZ.  What a difference!  We knew exactly what all this ??? MRI meant in less than 2 hours and yes, my husband does have prostate cancer.  But with Hormone Therapy shots and upcoming 40 radiation treatments, he will hopefully be in remmission.  His PSA level was at 49.0 and with 1 Hormone Therapy shot his level has gone down to 6.4.  He gets these shots every 3 months. The center wants his PSA to be 0 before starting radiation.  He goes down to Phoenix next month for his 2nd hormone shot and for the doctor to place "markers" in the prostate so they know every time where to shoot the radiation. We have a lot of confidence in them.  So depending on your insurance, Cancer Treatment Centers of America is the place to go!  They have multiple locations across the country.  Visit their website to kind of put your mind at ease.  I too was a total BASKET CASE when the Reno doctors gave us the news that they could not take out his prostate as they originally told us they would do. I'm still a little unnerved by the cancer in general, but like I said, we have HOPE now because the doctors there CARE!!!  Take good care & God Bless you and your husband.  Also FYI, CCTA will fly you guys in and will fly your husband in for treatment FREE to you.  If you are his Caretaker and you are needed at any interval, they will also fly you in for free as well.  Lodging is available at the center for a very small fee.  Check with your insurance.

    • richard98806
      richard98806 anthony70342

      Posted

      Kim has excellent advice to get cancer specialists involved.  #1 did your Dr not explain the MRI?  If you can't communicate with your DR it is time to find a new one.  You said he had surgery.  What kind?  What was done? Second biopsy?

      The important thing is to communicate with DR get the correct diagnosis and information.  Do your research.  YOU make the decision on what treatment is performed.  The good thing about prostate cancer is that you have TIME to evaluate AND there are numerous OPTIONS for treatment and most are very effective in having excellent results.  The National Cancer Institute (NCI), The American Cancer Society (ACS) and John Hopkins Brady Urological Institute are EXCELLENT resources for information and OPTIONS for treatment.

      My personal experience:  67 yrs old, overall healthy.  Increased PSA of 8.0 in October 16.  Referred to Urologist had follow up PSA  which increased to 8.8 had biopsy which indicated cancer with a Gleason score of 4/3 and 30% of gland with cancer. Had Bone PET scan to see if I had other cancers or if prostae cancer spread, MRI. I councelled with the Urologist (surgeon). Radiology oncologist, primary care physician. I researched all the previously mentioned websites.  Became involved with blogs like this and spoke with people I knew and discovered there are a lot of men out there with PC and discussed their experience.  All options have side effects and though it was a very difficult decision I felt I made my decision based on a lot of different information that is available.  Remember, it is YOUR decision and fortunately there is time to make it.  Take your time and research.

      I ultimately decided to have a Robot Assisted Radical Prostatectomy in March 17 and I am satisfied with my decision.  A thing to remember is to investigate the provider of your treatment whether it be a surgeon or a radiation oncologist that they are experienced and have a great track record.

    • kim2424
      kim2424 richard98806

      Posted

      My husband 52 and last year had the rectum biopsy and a PSA of 16.8 and 15.3, this year his PSA is 20.3 and they did the MRI and a month later last Friday did a surgery for a second biopsy going in between the rectum and testicles. The doctor said the MRI showed a spot( reason for this type of biopsy, but nothing else). Husband is on Medicare due to an accident at work disabled him in 2013. So we are limited on funds for treatments until we settle his workers Comp case.
    • kim2424
      kim2424 anthony70342

      Posted

      My husband 52 and last year had the rectum biopsy and a PSA of 16.8 and 15.3, this year his PSA is 20.3 and they did the MRI and a month later last Friday did a surgery for a second biopsy going in between the rectum and testicles. The doctor said the MRI showed a spot( reason for this type of biopsy, but nothing else). Husband is on Medicare due to an accident at work disabled him in 2013. So we are limited on funds for treatments until we settle his workers Comp case.
  • richard98806
    richard98806 kim2424

    Posted

    fortunately I have Medicare  supplement.  So what has the Dr said about the MRI and SUGGESTED next steps?

    In the meantime start looking into the suggested treatments, their pros and cons and short and long term side effects

  • barney34567
    barney34567 kim2424

    Posted

    Like others, I am wondering if he had surgery and if so what type? Or was it just a biopsy. Either way the pathology results trumps the MRI PIRADS report.

    On the topic of PIRADS, note a 5 means there is wrong evidence for a cancer in the prostate. The MRI also does a  good job of identifying areas outside the prostate that may be cancer.

    Mention is made of "likely invasion" by the prostate breaking the capsule and entering surrounding areas. This will be confirmed at surgery. Knowing what the MRI reveals is likely helps the urologist determine the most suitable path eg do nothing, surgery, radiation or hormone.

    • barney34567
      barney34567

      Posted

      sorry, my up autocorrect program made a mistake. I meant to say "on the topic of PIRADS, note a "5" means there is strong evidence ..."

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