prostate MRI

psa went from 5 to 3.79 and back up to 5 over 2 years

Also I am 58 and my psa has always run a little high since my 20's

PSA falling is good. It may indicate that you had an infection and was treated with antibiotics that lower the PSA.

I

Don't look at the raw PSA numbers. Look at the change over time.

A good guide is to be worried if the number doubles in a year.

Guided mri biopsy in Novemeber due to pi rads 3

Ultra sound guided MRI is the way to go. It is the most definitive biopsy.

Just ensure that:

(a) You are happy with your choice of physician to perform the biopsy because if you need surgery following the biopsy, other surgeons may not trust the result of the this physician's biopsy; and

(b) The biopsy will be TRANSPERINEAL and not TRANS RECTAL as the former has a FAR LOWER risk of infection.

Best wishes.

is psa screening accurate I been told it can give false reading I had one it came back 3.5 I'm 52 yes old

1. PSA tests should be performed by the same lab all the time as different labs have small differences in their measurements;
2. I have not heard of false readings but I can say that I never consider one PSA reading in isolation. One needs several over time to establish a trend.
3. The PSA number per se doesn't mean much. You need to see readings over time

Thanks for the reassurance Twig

May I ask a question? Was the radiologist who diagnosed "no cancer" a person with a high reputation? That is, is he/she well regarded AND one who focuses ONLY on prostate imaging?

The MRI showed Pirads 4 and was red flagged for potential prostate cancer, so a template prostate biopsy was scheduled. The biopsy results showed no cancer from 15 cores taken not the MRI imaging.

Good news.

What I was trying to indicate was that it's best to have prostate images analysed by a radiologist who specialises in prostate as opposed to a "generalist" radiologist.

I am hoping for a good result also. starting to get anxious

That is good to hear.

PiRADS 4 on the MRI is what I had. If cancer is detected in a biopsy then it's a pretty nasty one. But then again, cancer may be absent with a PiRADS 4 diagnosis.

If I were you I would check PSA levels say in 3 mths time and compare it to the last two PSA readings.

Thanks for the advice, i have my PSA done every 6 months. i had one done in Dec 2020 at 2.98, then one in Jun 2021 at 12, Jul 2021 at 7.8, it was the PSA of 12 that got me the MRI and then the biopsy.

Did you have the PSA tests done in the same lab? I ask because different labs have slightly different ways of measuring. A general rule is that one should consider cancer if the PSA doubles in a year.

i dont know as it is done by the UK NHS some by my GP and others by the hospital phlebotomy dept. My PSA went from 2.98 to 12.00 in 6 months hence the biopsy to check for prostate cancer. They found none this time but the PSA monitoring will continue every 6 months, next teat is in December

Interesting.

It is said that MRIs should be read by experts in prostate imaging to best understand if what looks like PIRADS 4 is indeed PCa. Many radiologists miss he PCa, if it's there.

It now doesn't matter how good or bad the radiologist was because you had the biopsy which showed no PCa.

If I were you by all means monitor the PSA every six mths, ideally at the same place.

Also ask a urologist, your one or another one, what could elevate the PSA so much in such a short time but not impact on the PSA. That is raise the PSA but is -ve for PCa

just had another 6 monthly PSA test, came back at 3.14 so not bad after a 12.0 in June and showas how much PSA can jump

around.

PSA should not jump around. It is influenced by meds including antibiotics. Have you been on meds prior to the DEC PSA test?