Hi everyone, just after some advice as my 78 year old father has just recently had his mri letter as just after some help with the findings.
My father is a very fit for his age and says he feels fine, he just recently put a 12 panel 6ft fence up all by himself with out me knowing 
he is quite worried about this but really don't like to talk about it or ask questions. We went through this in 2021 where he had a high psa test then mri and thankfully a biopsy came back as benign.
This time seems worse though and the area before that was benin seems to have grown. Any advice on the reading would be helper as my father had a telephone call and said he really couldn't understand what was being said. Thank you everyone.
PSA 12
PREVIOUS Aug 2021 prostate biopsy
No PIN or invasive malignancy is found.
MRI prostate 17/10/25:
Comparison made with the previous MRI prostate 27/06/2022.
Prostate spans 5.4 cm cc x 3.5 cm AP x 5.2 cm in width giving a total estimated prostatic volume of 51 ml with a PSA density of
0.23ng/mL/cc.
No T1 hyperintensity to suggest haemorrhage.
The prostatic nodule within the left transition zone demonstrates interval enlargement and now contains T2 intermediate signal
material, which restricts and his suspicious, PIRADS for (2 o'clock to the 4 o'clock position).
Elsewhere within the right gland base, is a restricting focus at the 9 o'clock position of the right posterior transition zone, also
PIRADS 4.
Small focus of diffusion restriction within the anterior left transition zone of the mid gland (12 o'clock position) in keeping with a
PIRADS 4 lesion.
No enlarged pelvic lymph nodes.
There is a focally restricting lesion within the right pubic tubercle, concerning for metastatic deposit.
Small anterior diverticulum within the bladder. Otherwise unremarkable appearances of the bladder and anorectal junction.
Hello Moke275727c283
A warm welcome to the group although I am so sorry to find you joining us.
This is a peer to peer support group and none of us are medically trained and we all work from our own journey through this cancer so from my "limited knowledge" I can tell you:
* A PSA of 12 is high for dad's age - it should be around 6/6.5 maximum.
* A PIRADS-4 score on a prostate MRI shows the MRI has a clear view of the prostate and that the chance of there being cancer present is high.
The transition zone is where you find BPH (Benign enlargement) but my reading of the scan is that the scan now shows that this is now potentially a T2 cancer.
I would anticipate the next step to be another prostate biopsy.
Personally with dad being as fit as you say and the cancer being possibly low grade and contained within the Prostate I wonder if Active Surveillance would be better for him where he is checked every few months (I am not a fan of this but it would give him a better quality of life than invasive or medication treatment with side effects).
Only my personal thoughts but something to consider. I hope my ramblings help.
Best wishes - Brian.
Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
I am a Macmillan volunteer.
Hello Moke275727c283
Personally another biopsy and aim for the sections of the prostate where the MRI was showing the PIRADS 4 readings.
If they can't easily get to these with a TP biopsy (Tran-perennial) then it should be a biopsy under general anesthetic. I think they need to find out if there is some cancer in the gland.
Best wishes - Brian.
Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
I am a Macmillan volunteer.
