Results of Prostate MRI

Hi Adey , sorry to hear.

Actually the main part to look at is the T4 Mx,

Generally T4 would indicate that any tumour has escaped the prostate gland . obviously not helpful to receive this at start of BH as you can't query anything.

You need a biopsy to confirm it is cancer and after the BH phone the cancer centre and ask for a copy of the MRI report which will tell u a bit more about where the potential cancer actually is.

PSA not too high so hopefully although escaped  the gland has gone to no major organs, a bone scan may be also needed to clarify.

But most important at this stage query what  the MRI says and come back on here 

Best wishes

Steve 

Thank you Steve, for taking the time to reply. BH is a nightmare.  

Hello AdeyJ and I am sorry to hear about your husband.

At the moment you have been given an indication that your dad has a cancer which is spreading outside the prostate but not necessarily into the seminal vesicles - this is the T4 bit.

T4: The tumor has spread to tissues next to the prostate other than the seminal vesicles. For example, the cancer may be growing in the rectum, bladder, urethral sphincter (muscle that controls urination) and/or pelvic wall.

The rest of the TNM staging is yet to be determined with further scans, usually a bone scan as well as a CT scan to see if there is any wider spread.

The PSA density is the relationship between the PSA and the volume of the prostate but a value of greater than 0.15 is usually indicative of prostate cancer. 

The biopsy will determine whether the cancer is aggressive and this, along with the results from the scans will determine the type of treatment offered.

There is a book which you can download for free which explains the diagnosis process and what the results mean. It also gives an idea of treatments available. Surgery is usually discounted once the cancer has breached the capsule but hormone therapy will be the first line of treatment to halt the cancer in its tracks.

https://issuu.com/magazineproduction/docs/js_prostate_cancer_guide_for_patients_ezine

Thank you for this and the link to the book. So much to take in

Hi AdeyJ - unusually, I’m going to disagree with my friends Grundo and Alwayshope .  I can’t make sense of “T4 0Mx” at this stage of diagnosis. You would normally expect to see T2 or 3, then N (for nodes) either 0 or 1  and M (for metastasis) with an x (as no CT or bone scan yet).  I think there’s been a typo. I’ll explain in my next comment.    AW

Hi again AdeyJ 

AdeyJ said:

The results of your MRI scan shows 57cc prostate with a PSA density of 0.38 with areas of abnormality (T4 0Mx) which would require further investigation in the form of prostate biopsies

Thank you! I am pretty clued up to a lot of this and medical terminology and something doesn't seem quite right with the letter and it certainly has not been written for a patient to understand. I appreciate your input.

• So, the PSA  density is his PSA of 21.8 divided by 57 cc gland = 0.38.  His PSA isn’t terribly high and the density of 0.38 isn’t either (mine was 0.52).  So you can forget about that for now.  
  
  The crux of the matter is the statement about areas of abnormality requiring “prostate biopsies”.  By definition, these biopsies are taken from the gland itself, so clearly they can’t say for sure that he is T4. so don’t go googling T4, as I don’t think they can say that at this stage!
• in my experience, they will give a Gleason grade after the biopsies are taken, then he will have a CT scan to look at soft tissue and bone scan to look at bones - both full body scans.  These are the ones that will ascertain if there is spread leading to a T4 diagnosis. 
  AW

So AdeyJ - in summary, I think there’s a typo.  It’s too early to say T4 from just the MRI, with the only areas of abnormality being subject to prostate biopsy.  I would hope that he will be on a curative pathway.  Please try to calm things down and stay away from Dr Google. Have a good long weekend and try to put things to the back of your minds.  Really.  Let us know how things progress.   AW

Thank you for understanding where we're at and for your insight. Unfortunately, we all did the Dr Google thing, and it now makes sense why we were all coming up with different perspectives. Thank you so much AW.