Posted , 19 users are following.
I recently had a 3T MRI and the score was 4. There is a 6mm lesion on the left apex. Of course they are pushing for a biopsy but I'm not going to have one due to my other health issues.
Does anyone have any good statistics on what percentage of subsequesnt biopsies are positive for PCA with a score of 4 , the numbers I've found are around 37%...which doesn't seem much better than a blind biopsy..
0 likes, 48 replies
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JktaPablo jwrhn1951
Posted
This has been quite a relevant discussion for me. About 6 months ago I had a MRI which identified a class 4 Pirads. My PSA was as high as 5.9 but has come down to below 5. I'm booked in for a biopsy in 3 weeks. Will definitely insist on a targeted one and hopefully transperrenial. Biopsy will be done in Australia. I live in Bali.
barney34567 JktaPablo
Posted
Have you identified a urological surgeon in Australia? Make sure you're very happy with him performing surgery if need be. Use him to do the biopsy.
Don't use one for he biopsy and swap o another for surgery as the latter will often not trust the former's biopsy results.
Triplets jwrhn1951
Posted
‘You need to understand that only by having a biopsy can you be certain that you have cancer and, if you have cancer , it is crucial to determine what grade of cancer you have . This grade is called your Gleason score . Depending on this result , future action will be decided. You MUST however take ownership of your own situation. It’s know good relying on your doctor or urologist. They are often very busy and may not necessarily give the best advice for you
As a matter of interest I have consulted no less than 5 urologists until I was happy with the experience and knowledge of the person I decided would be best for me
rolf61809 Triplets
Posted
My local radiologist read my 3T MRI P I rads scores as 4 and 5. And the urologist who did my Fusion biopsy there after found 0, even though he said that a score of 5 indicated and 80% chance of cancer being present. So I'm praying it was just the radiologist that was an idiot and not the Doctor Who did the biopsy. Oddly enough I had a second opinion of the 3T MRI by the Cleveland Clinic and they only found level 2, but that was below their protocol for doing the fusion biopsy, so I went ahead and had my local urologist do the fusion biopsy 3 weeks ago. But as biopsies can miss significant cancers up to 20% of the time I'm still a little nervous about it.
Triplets rolf61809
Posted
You are correct that biopsies can miss cancer but obviously a 0 result is great news. What is your PSA and age.
JktaPablo jwrhn1951
Posted
cjc99 JktaPablo
Posted
Hi JktaPablo,
My husband had a PIrad 4 MRI and recently underwent TRUS biopsy. Results have him at Gleason 7 now, and we are currently considering our options. We are scheduled to meet with an oncologist first to make sure we are informed of all possible options, but I suspect we will end up pursuing Robotic prostatectomy. My husband is 55. We feel that it is best to just "get it out," rather than take any chances of metastatic spread. Will check back and share any new info as I get it.
Best of luck to you.
JktaPablo
Posted
Further follow up. I had my prostate removed last week, robotically. Gleason 9 confirmed. They reckon they got it all, time will tell. Glad I didn't delay any longer. Now begins the kind recovery of bodily functions phase. Any tips?
pauljessee jwrhn1951
Posted
jwrhn1951 pauljessee
Posted
Well I'm probably not the best guy to ask whether you should be worried. Before I started on the finasteride my PSA was almost 3x yours for years and I still have not had a biopsy and I'm worry free...
The MRI can highlight areas of potential concern but it is not diagnostic. Since you have already had a biopsy with a 3+3 finding I personally would not be overly concerned but again that's just me. I have a buddy with a Pirads of 5. He has had two targeted and one saturation biopsies and every one has been negative.
The 3T MRI and Pirads scoring is an improvement over PSA alone but it cannot diagnose PCa or indicate the Gleason score. It seems most useful for the guys with a PIRADS of 1 or 2, the research shows they can safely avoid a biopsy.
pauljessee jwrhn1951
Posted
jwrhn1951
Posted
Well it's been four plus years since the last 3T MRI.
PSA has went from 10 to 20 while on finasteride thought I'd post results of the latest MRI on the off chance anyone is still following this old thread.
New report shows: two Pirads 5 lesions in the peripheral zone the Pirads 4 found on the left side before has grown and is now a 5 and there is a new lesion on the right side;
There is one Pirads 4 lesion in the transition zone and the transition zone also demonstrates multiple Pirads 3 lesions.
All of the lesions abut but do not appear to extend through the capsule, prostate volume 44ml which is about the same as last time.
So all in all fairly slow growing if there is cancer present.
I'm in my early 70's now and still not to keen on having a biopsy but told the urologist I'm thinking if cancer is present I'd probably just have it treated with seeds so that would not be to different from the biopsy.
My other medical issues have stabilized and I'm working 40-50 hours a week and plan to do that until I croak so I might get both the biopsy and treatment if needed but not in any hurry...