How can my risk be 50/50 but have high PSA & a high risk lesion?
Hello, I’m 64, been followed faithfully every 6 months. 3 previous negative biopsies, PSA range of 3.2 up to 7.9. Most recent 6.8 triggered a MRI. They only found one lesion but it’s a pirad 4. My doctor says it’s a 50/50 chance of cancer. I’m really confused how bad this could be. Dr said it’s contained. Also worried previous biopsy’s could have missed the tumor. Please help!
Hello Paul, I'm not that familiar with the pirad scale, but from what I read a 4 seems to suggest a higher probability of cancer. From my experience, I would think that the next logical step would be to do an MRI guided biopsy to determine if there's cancer present and, if there is, to establish a Gleason score. Those are the steps my doctor and I followed prior to further testing and discussion of treatment. Will Jones ProstateCancer.net Moderator
Hi Paul. AS Will said, an MRI guided biopsy seems the next logical step. The previous biopsies are kind of irrelevant now that they have found the lesion that they can test directly. Thought you would be interested in seeing this comment from our contributor Len on our Facebook page to your post:
"I’m curious why they found a lesion with the MRI but, now that they know where the actual lesion is, why aren’t they doing a biopsy of that lesion? If there’s a 50/50 chance of any major health problem in my body, I want to know exactly (100%) if it’s good or bad. 50/50 odds aren’t bad in a casino, but they’re terrible when it’s about my life expectancy. My PSA went from 0.6 to 2.7 in 2 years, and that growth is known as velocity, another strong indicator of the possibility of a high grade PCa. In my case, despite the low PSA, I had Gleason 9 PCa that we found out two years after my prostatectomy had just started to metastasize before they took it out. Radiation nailed it. I’m scared to even think where I’d be today if they had waited another 6 months, or God forbid another year, to do my prostatectomy. I’m hoping you’re too young to have gone to Vietnam in the 70’s, but if you did, fairly recent animal studies indicate Agent Orange probably doesn’t cause PCa but is an accelerant of it, i.e., it causes our PCa to grow much faster, which is most likely what caused my PCa’s very high velocity. (But high grade PCa can grow quite fast on its own). Take charge of your health, and our best to you. Len Smith ProstateCancer.net Moderator."
Hoping you get some answers soon and please feel free to keep us posted on how you are doing. Best, Richard (ProstateCancer.net Team)
