Can anyone help me understand my results?

Hi John,

Others are going to come back with better replies than I have for you, but I will make a start and hope to help.

It does rather read as it only one core was involved, and they have stated that this was Gleason 6, which is quite low risk and moves very slowly.

There also seems to me to be a suggestion that no cores in the target area were positive. Yet other results, possibly from an MRI scan, indicate a Pirads 5 lesion which often indicates prostate cancer.

I am going to assume that's why the second biopsy?

You might find this helpful -

https://prostatecanceruk.org/prostate-information-and-support/prostate-tests/prostate-biopsy

Your are in the worst time for this - waiting for diagnosis and a plan for treatment. We all always think that valuable time is being wasted. This video, from a non-profit organisation in America call the Prostate Cancer Research Institute, might provide same comfort -

 https://youtu.be/aotF2SPzCmU?si=SrjEVOpC5toiznyl

I hope that others will supply more information.

Hello John (Anxiousdad) 

From what you have said the MRI (PI-RADS 5/Likert 4) would indicate a strong possibility of Prostate Cancer. It would appear to me the biopsy hasn't taken samples from the affected area (hence the 2nd biopsy). In the first biopsy they have taken 14 samples with one positive.

Here's our guide to the staging of Prostate Cancer:

Staging and grading of Prostate Cancer

With a low PSA and Gleason 6, at the moment there's no need to panic - the second biopsy will hopefully bring the diagnosis to a conclusion.

i hope the above helps.

Best wishes - Brian.

Hi Anxiousdad . You are correct that only one of the cores showed adenocarcinoma which is the most common type of prostate cancer.

The index lesion is usually the main lesion with the highest grade. 20mm is considered a higher risk volume and that, along with the Pirads 5, Likert 4 is why you have had the second biopsy. The posterior peripheral zone is the area closer to the rectum but it is this area which can be associated with a higher risk of recurrence further down the line compared to the transitional zone and why the experts want to confirm whether the lesion is cancerous or not.

Index lesions are representative of PCa grade in low-risk patients, but the other foci of tumour, the satellite lesions, gain relevance in higher risk patients. 

The posterior subcapsular region of the prostate is often undersampled. The close proximity of these lesions to the posterior capsular wall of the prostate makes them difficult to localize while increasing the need for early detection because of their increased risk for extracapsular extension.

I hope you get a definitive diagnosis soon so that you can go forward.