PIRADS 5 on MRI
I’m 57 and my most recent PSA level was 1.6 in June 2022.
I had an out of pocket full body scan Monday. This is what was reported:
Prostate gland: Mildly enlarged prostate gland. 1.5 cm PIRADS 5 lesion is located at the right posterior and lateral peripheral zone at the base. There may be involvement of the right seminal vesicles. Urologic consultation is advised.
PIRADSTM v2.1 Assessment Category: PIRADS 5 - Very high (clinically significant cancer is highly likely to be present).
Recommendation: Aggressive findings or >15 mm in size. Biopsy recommended.
I have no symptoms, and this was totally unexpected. I’m waiting to hear back from my Primary Care Physician for a urologist consultation. I’m wondering if anyone has had a similar experience.
: Know you are not alone with this diagnosis. Many men, including myself, never expected to hear that they were dealing with prostate cancer. Many were led to believe that some minor annoyances, like a slower urine stream, etc., were explained away by a well-meaning GP suggesting it was due to " a slightly enlarged prostate." These days, I advise men in my support group to skip the GP route and visit a urologist for any prostate exam.
A scan and targeted biopsy should offer insight into the next steps: watch and wait, surgery, radiation, etc. Prostate cancer is slow-growing, and when caught early, it can be successfully addressed. Ask the urologist about the treatment outcomes if you need to treat it. You will want to ask for information on future treatment options should the cancer return, which happens for about 30% of men.
I was diagnosed in 2012 and have been treated for a reoccurrence several times. Fortunately, I chose to do surgery first, which allowed me to be re-treated with radiation at a later date. I understand that the reverse order does not produce the best outcome. That said, I am not an MD or offering medical advice.
Please do keep us informed as you continue on your journey. Dennis, patient leaderThank you Dennis. I've had a specific dull pain in my lower left back since mid 2023. It hasn't gotten worse, and I ignored it. I'm not sure if it's related. I don't think my scan covered that area, but it wasn't brought up in the report. I've heard similar stories where RARP is the way to go, and I'm hoping I will be a candidate for the RARP surgery + chemo, since I'd like to at least avoid radiation for as long as possible. Seems like testosterone blocker makes a big difference, too.
Low back pain is often but not always associated with more advanced Prostate Cancer. If your scans suggest cancer has spread — surgery alone may not be offered. Best to see the results of additional testing. YES the T blockers can slow things down (put cancer to sleep for a while)but are not curative.
I was unsure of radiation after my surgery but was surprised how easily it was done. So far all is well. If interested go to one of my websites where I describe my experience with Radiation —it can be found at www.TheProstateCancerCoach.com
I did not tolerate Lupron well while other men in my support group had little to no side effects— you just don’t know how you will react until given the meds. All of this is a step by step process like many other treatable diseases. Dennis
