Pirades 5 and biopsy didn’t find any cancer

Hi Taz87  - welcome to the club that no one wants to join.

However, we all try and help.

I have prostate cancer and, at the time I was diagnosed, was also told I had a Pirads 5 lesion. My biopsy found cancer.

The specialist nurse who did my biopsy told me that there was quite a low chance that my lesion was not a cancer - about 1 in 5 I seem to remember - and so I wasn't surprised when the biopsy showed cancer.

From what you have said, you have come out on the lucky side of the equation. My initial PSA was 7.3 but, unlike yours, it was showing a steady but gradual, rise. Yours got lower, and the recovered somewhat. 

Prostate cancer is quite slow growing, so you have time to make the right decision.

Given that the biopsy unusually showed no cancer, the October route may be the right one.

However, it obviously concerns you, and would concern me, that I didn't really know what is happening.

You are usually given a contact at the hospital if you have any problems, and I would phone them and ask for the rationale behind the wait, and what they think is happening. Take copious notes, and ask us again.

We may be able to help you work something out then.

Hello Taz87 

Well that's an interesting post - my views (not medically trained, just personal are):-

* The MRI saw a lesion and a Pirads score of 5 indicates a strong possibility of Prostate Cancer.

* Your PSA test results are all slightly elevated.

* Your Prostate is large - the average size is 25 - 30g.

* How many samples from your Prostate were taken at the biopsy in June - could the samples have "missed" any cancer due to the Prostate size?

The good news is you are being retested in October and Prostate Cancer is slow growing. I would be happy to wait and see what October brings.

(I have rising PSA and had a CT scan in May - no sign of cancer on the CT -so you aren't alone with this issue!, I am being retested in September!!).

Best wishes - Brian.

Hi, thanks for replying I had 6 samples taken and my report does say “attempted” to sample so I think there is doubt which is why I’m still concerned

Hello Taz87 

It's normally 10-12 samples taken on a biopsy, although if the Prostate is larger then they may take between 20 & 30.

If it's causing anxiety I would be calling your urology department - tell them of your issues and request they perform a second biopsy.

Best wishes - Brian.

Thanks for replying, I think I know that I should contact the urology nurse to discuss but wasn’t sure If I was being impatient/irrational and I’m also wondering if a second mri with contrast this time might give a different pirads score and if this is something they would consider if I asked.

Hello Taz87 

I don't think you are being impatient or irrational as this is your health and we all don't want to be kept in the dark about our condition.

A second MRI or a CT scan should find the little blighters, a PSMA-PET scan definitely would but these cost between £ 2000 and £ 2600 so the NHS is a little "tight fisted" in granting them.

You can only ask your urology team - every Health Authority in the UK works to it's own agenda so I've no idea what the reply would be.

Best wishes - Brian.

Hi

Bit puzzling that MRI shows a lesion of 1.8 cm but the biopsy shows nothing.

Also PSA not particularly high.

Others scans I suppose plus a transperineal biopsy could show something as opposed to the previous rectal biopsy.

Best wishes 

Steve