PIRADS 5 lesion.

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Hi, my husband had just recently suffered a heart attack and is on blood thinners and aspirin etc. Complaining of abdominal pain and doctor discovered that his prostate was slightly enlarged, she couldn’t feel around the back of it and referred him to Urologist. His PSA came back 0.8 and his bloods were good. We paid for a private abdominal scan which showed a fatty liver and a slightly enlarged prostate., everything else was normal. The margins of the prostate were 3.4cm x 3.4cm x4.0 cm. Spoke to Urologist on phone who wanted to do an MRI to be on safe side as my husband’s sister died of breast cancer and his uncle has had prostate cancer. Urologist phoned today to say that MRI (not mpMRI) showed a 17mm lesion rated PIRADS 5 on left side and he wants my husband to come in for a biopsy. The measurements that MRI is that the prostate is 3.5mmx3.7x4.0mm. Can lesion have grown so quickly in 6 weeks? Cardio team do not want him to have biopsy at moment as it would involve coming off blood thinners for 10 days. I’m very worried for him. I’m worried that as lesion is larger and PSA is so low that his cancer will fall into the aggressive category. Has anyone had any similar experiences? Thanks you in advance.

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10 Replies

  • Edited

    Mary,

    The difference in prostate size between Ultrasound and MRI is within the accuracy limits of the measurements. The MRI is more accurate than the ultrasound. Why you are saying "Can lesion have grown so quickly in 6 weeks?". It seems like you should have more discussions with the doctors and get better information about the situation. If he has a biopsy, it could be an image guided biopsy, that would use one needle versus the 12 or 16 needles of the usual biopsy. There would be less bleeding.

    Best wishes,

    Thomas

    • Posted

      Thank you Thomas . My hubby's biopsy is scheduled for tomorrow and he can possibly speak with the surgeon performing the procedure. His next consultation in about three weeks time will be to discuss the findings. As he is being treated under the NHS its not as easy to access the doctors than it would be if we were paying for care privately. Thank you for replying.

    • Posted

      Hi Barney, my husband had a trans perineal biopsy on 1st April and was told he will have his results in 2-3 weeks. Professor Leung who carried out the biopsy took 4 cores and explained to my husband that, though they rate the lesion as Pirads 5, as his psa is so low that they could be looking for inflammation, infection or indeed cancer. If it's cancer the biopsy will tell them if it's a snail, a tortoise or a hare, which I think is a great way of explaining it. The NHS hospital that carried out the biopsy is a teaching hospital and is a centre of excellence within the NHS, so I'm sure they will have done a good job. The minus point is the wait time fir results, and as soon as I have them I'll update my post.

    • Posted

      What I like reading is that it was a trans perineal biopsy. That's the way to go. I assume it was guided by ultrasound or MRI.

      Also I looked up Prof Hing. Quite impressive indeed.

      You mention "low PSA". What were his most recent readings and how far apart were they?

    • Posted

      Hi Barney, hubby's psa was 0.8 in February, he has had no prior blood tests that we could use for a comparison. Results day is 29 April!

    • Posted

      Let's hope for the best for 29/04.

      The reason I asked about earlier PSA tests is because the trend in numbers is important more than just the raw number.

      For instance, a man can have PCa with a PSA of 1 and another man with a PSA of 10 may not have PCa.

    • Posted

      Hi Barney, we received notification of an earlier appointment which took place today . My hubby's lesion is benign, they think it's inflammation His PSA will be retested in a few months and he will be scanned again in a year. its a great outcome for him. I would like to thank all of you for your support and wish those on the journey the very best. Kind regards x

    • Posted

      As I understand you, the scan showed PIRADS 5 but the follow up transperenial biopsy showed benign? True?

      If so, then that's wonderful news because only 10% of PIRADS 5 scans are found to be false positives.

    • Edited

      Yes, delighted to say that though it was a Pirads 5 rating, the lesion was classed as benign , so he was very lucky!

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