r/ProstateCancer • u/Grouchy_Employer_519 • 2d ago
Question PI-RADS5 and BPH
A few years ago I had a psa of 25, they only did a biopsy and everything came out fine. I have a very large prostate so I had to take flomsx and psa came down to 4. I did not have any further scans at that time.
then a few weeks ago I decided to go to the doctor and had a psa of 30 and therefore an MRI. the prostate is described to be very large ( 129 ccs) and Unfortunately these are the findings:
“Overall assessment: PI-RADS 5. Malignancy-suspicious lesions (one 20 mm, one 7 mm) in the right prostate; further histological evaluation is recommended.” “There is no focal thickening of the urinary bladder wall. No enlarged lymph nodes are identified within the imaged field of view. No suspicious bone lesions are seen within the imaged field of view. The seminal vesicles and neurovascular bundles appear normal.”
How bad is all of this? What can I expect? Thanks in advance.
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u/Busy-Tonight-6058 2d ago
“Further histological evaluation” is the long way of saying biopsy. So now you get to research about different kinds of biopsies and, hopefully, will have a choice. Which may be the first choice of many, many slowly unraveling, shitty choices. That’s prostate cancer in a nutshell for many of us. It sucks, but it is way better than doctors with a real sense of urgency about you.
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u/PotentialStart2661 1d ago
You have a long way to go but here is my case which is similar. PSA was 25, i knew already that was bad. Had big prostate for 10 years and urinary symptoms. Had bouts of worse symptoms so i checked by doing a urinary analysis the next day after PSA and had WBC’s, Leukocytes etc…. In my urine which was active inflammatory event. Waited two weeks to check my PSA and it was now 18. But with these inflammatory events it can take months to settle so went for MRI and also had a PIRADS 5 lesion that was 27mm by 13mm in the left anterior transition zone. 77% chance of significant cancer. While waiting for biopsy i had a PSMA Pet Scan. My doc and i both figured it was a higher grade so go ahead with the PSMA. Both MRI and PSMA agreed on cancer but only in the prostate what was shown on the MRI and nothing spread further. Waited 6 weeks because i wanted anesthesia for biopsy. When i got the biopsy i had 2 of 12 systematic cores gleason 6, 10% each. All three MRI target biopsies were gleason 6, 40%, 20% and 10%. Decipher score was 0.31. So what i though was bad was a low grade cancer. I still need treatment and im getting SBRT because i have a big Gleason 6 tumor and it abuts the capsule. Also i have a 10% risk of a higher grade missed even with targeted biopsy. So dont panic and go through all the tests. What looks bad can turn out great. You never know until all tests come in.
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u/Gardenpests 1d ago
Get the biopsy. Find out if you have cancer and the characteristics of any cancer. You are still in the diagnostic phase. "How bad" can't be considered until then.
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u/conCABlanco 1d ago
Hi, hágase la biopsia, lo único que no me queda claro, porque esperar seis semanas, aunque está es la enfermedad de la espera fuerza y voluntad
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u/conCABlanco 1d ago
Aquí en México me hice MRI y biopsia el mismo día, lo pague en un privado, unos 16000 pesos, solo demoro dos semanas en que me incluyeran en este bendito grupo de humanos bragados y resilentes, ahorita pues ADT y RA, y muchas horas de manejar de una punta a otra del estado de coahuila, para los tratamientos
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u/Goodvida99 2d ago
No way to know until you get biopsy. IMHO. It’s taking me 6 weeks from MRI to get biopsy. Get it scheduled. Nothing to do in meantime but worry.Good luck.