Hope ive got right info . could not see anything that said TNM
Thanks .
Mark.
Lesion 1 PC - Size Lesion 1: 16.5 mm (06/06/25)
Prostate Gland Volume: 35 (06/06/25)
PC - Likert Score Lesion 1: 5/5 (06/06/25)
Prostate PSA Density: 0.2971 (06/06/25) Prostate Region Lesion 1: Left sided T4 lesion (06/06/25) Prostate Lesion Present Lesion 1:
The prostate measures 35 ml. PSA density 0.3. T2 heterogeneity throughout the peripheral zone. There is a dominant area of low T2 signal centred at the 7 o'clock position measuring 16 mm (see key image), with mild capsular bulging. Towards the apex there is further ill-defined dominant low T2 signal extending from the 5-10 o'clock position (see key image). This latter component extends down towards and fractures the urethral sphincter. Matching restricted diffusion and early enhancement. Some haemorrhage within the left seminal vesicle. No pelvic adenopathy. Unremarkable bladder and distal colon. Right hip replacement. No bone lesion.
Greatest tumour length: 17mm Other Pathology High grade PIN: Yes Intraductal carcinoma: Yes Prostatitis : Yes, focal acute and chronic. Conclusion Tumour type: Acinar Adenocarcinoma Highest Tumour Grade Grade Group: 5, Gleason score 5+4 Overall Tumour Grade Grade Group: 5, Gleason score 4+5 Overall Gleason pattern 4 percentage= 50% Overall Gleason pattern 5 percentage= 30% Cribriform pattern 4: present in D Neuroendocrine expression: No morphological evidence on H\T\E assessment Maximum tumour length: 17mm Site: Target right posterior Number of cores involved: Total: 10/14 ; RT: 6/7 ; LT: 4/7 Lobes: Both Perineural invasion: Present (C1 C2) Lymphovascular invasion: Absent Extracapsular fat invasion: Absent Immunohistochemistry: Not done Suitable block for molecular tests: D2 (no necrosis, high cellularity, 80% tumour cells)
I'm sure you'll get more replies, think everyone out sunbathing at the moment, just hang on , and keep in touch cos there's plenty of help and advice on here for you
Nearly all of us have been where you are, and it is a hard place. Nonetheless, this thing can be beaten, or at least held at arm's length for a long time.
There are a number of people here who can do very well with sorting that lot out, but I will offer a couple of comments.
First off, my own Gleason Score is similar to your own. This really outlines the level of risk, but this risks suggests what will happen if the disease is untreated. Yours will be, so you can put side some of the concern.
You will see that a T4 lesion is mentioned in the results, and you can see from the page above that this could be called "locally advanced" which isn't as bad news as it sounds.
I couldn't find a great deal suggesting huge spread of the disease, but there will be others with a greater knowledge along soon.
I have to say that I was told when I started to locate good sources of information, and then read EVERYTHING.
One of our friends on here, Alwayshope has got a great way of explaining things, and will probably pick up this thread now I have taken her name in vain.
Hello Matk Hammer. and sorry for the delay in getting back to you but it was a busy evening here in a very sunny Greece, plus we have a 2 hour time difference.
That is a very detailed MRI and the good news is that it tells you where the cancer is but also what it is not.
Acinar Adenocarcinoma is the most common type of prostate cancer and is usually very receptive to treatment with curative intent. You have some elements such as cribriform and perineural invasion which means that it has a greater potential for recurrence in the future so the experts will usually suggest a more aggressive approach in treating it in order to try and prevent this from happening.
There is NO evidence of neuroendocrine elements which can make the cancer harder to treat.
The peripheral zone is situated at the back and sides of the prostate, surrounding the transition zone and extending from the apex to the base of the gland and is the most common site for prostate cancer - yours is bulging against the wall but is contained which is good.
No other cancer can be seen in the pelvic area,, bladder, colon or hip bones and there is no lymph node involvement.
PIN, or prostatic intraepithelial neoplasia, refers to abnormal cell growth within the prostate gland, specifically within the ducts and acini (small sacs). It is not cancer itself, but it is considered a precancerous condition because it can sometimes develop into prostate cancer. Part of your prostate is showing this and active surveillance is usually the recommended action but in your case I would ask whether they are going to treat it as well.
"Towards the apex there is further ill-defined dominant low T2 signal extending from the 5-10 o'clock position (see key image). This latter component extends down towards and fractures the urethral sphincter." Here is an explanation for this part -
Low T2 signal:
On an MRI scan, a low T2 signal typically indicates a structure with high cellularity or fibrosis, which can be seen in tumors or other abnormal tissues.
Apex:
This refers to the most inferior part of the prostate gland.
5-10 o'clock position:
This is a way of describing the location of the abnormal signal in relation to the prostate gland, as if viewed on a clock face.
Urethral sphincter:
This is a muscle that controls the flow of urine from the bladder. Its involvement suggests the lesion may be locally aggressive.
As the urethral sphincter is possibly going to be treated it is important that you start to train your external sphincters to help improve your urinary control and this is done with pelvic floor exercises starting today. There is an app you can download which tells you how to do them properly called the SQUEEZY APP - the easy way to think about it is using the muscles you need when you try to stop the flow mid pee.
The biopsy can cause hemorrhages in the seminal vesicles and is usually benign.
You will probably be offered a range of treatments so it is important that you speak to the experts about what they can offer but also about the risks of recurrence and side effects both short and long term from them. Once you have your full results from the scans you should be given your options - then is the time to take a breath and weigh up what you can live with but don't be rushed. Some health authorities do not have the facilities for all treatments and may not, therefore, offer them but this doesn't mean that you can't have them as you can be referred elsewhere for it. Come back here and we can help you with some questions to ask.
I hope this helps but if you have any further questions then please ask.
really sorry you find yourself in this position it’s a tough time I know
BUT
My husband was diagnosed Gleason 9 last year aged 58 his histology found the 16mm tumour one side and a further tumour on the other side very close to edge of capsule.
He has had a radical prostectomy and they managed to spare the nerves in one side only.
12 months on he has a PSA of <0.01
At the time we felt that life was never goi ng to be good again but it is and we live life fuller than we did before.
Take heart and know that life will get better and once you have a treatment plan I think most people would say you do start to feel better
