Finally happened.
First post here in a loong time.
I was diagnosed in 2010 when my my PSA was 4.5 ( I had honeymoon cystitis, and after a round of antibiotics it dropped to 2.5). My urologist was very alert and we went a head with a biopsy, and I had one core, gleason 6 (3+3), less than 5%.
I hadn't had children yet, so we started early active surveillance. PSA every 3 months, annual to 18 month biopsies. 2011 clean biopsy, 2013 clean biopsy, 2014 clean biopsy, 2015 clean biopsy, 2016 1 core gleason 6, less than 5% ( 2nd opinion gleason 6), 2017 clean biopsy.
2017 went on, and I had rectal pain and issues... this went on and on, and in 2018 I had a perianal abscess removed right over my prostate. That was not pleasant. 2019 I had a biopsy again, 1 core, gleason 3+3, 5%. I also had a MRI in 2019, which showed Pi-Rads 2.
By this time, my psa had slowly gone from 2 to 6ish. Doubling rate was in the 6 to 7 year range. I have a large prostate, and lots of BPH. My wife and I had twin girls in 2017. Still doing PSA 3 to 4 times a year, plus yearly MRI's. 2020 Pirads 2, 2021, Pirads 2, 2022 Pirads 2, 2023 Pirads 2, 2024 Pirads 2. There weren't even any spots that we could do a targeted biopsy and with the risk of infection we depended on MRI's.
2025 comes along and BAM, MRI Pirads 5, in transition zone, wedge shape, no clear boundaries. No sign of any extraprostatic invasion. To say I'm freaked out is a understatement. PSA density is .14, PSA doubling time is 144 months, PSA is 10.8, with a low of 8.1 in the last 6 months. What makes this really hard for me is I have lumbar stenosis, so my back and pelvis are constantly aching and have been for the last 4 years, and i also have BPH and I think a case of prostatitis. Transperineal fusion biopsy is scheduled for May 1. Anyone with a similar case?
Hi
. It is certainly understandable that this sudden finding would throw you for loop. I can't personally speak to an issue like this, but I do know that a one time PI-RADs 5 finding is not necessarily definitive. There is a certain percentage who end up not having significant cancer. It is also noteworthy that a history of inflammation may cause some high PI-RADs abnormalities. I want to share with you this article that discusses high PI-RADs abnormalities (where a subsequent biopsy does not find cancer): https://pubmed.ncbi.nlm.nih.gov/33080145/. It is discussing what such a finding might mean and potential steps, but is also significant in that this research is necessary because it happens. In this study 18% of men with a PI-RADs 4 or 5 didn't have cancer in the subsequent biopsy. I certainly can't say this will be the case for you, but your history certainly didn't point to a sudden PI-RADs 5 finding. Only the further testing will give you answers. Has your doctor had any thoughts on the surprise finding? I see you have the biopsy scheduled for May 1st. Wishing you the best and please feel free to keep us posted on how you are doing - this community is here for you. Richard (Team Member)
