PI-RADS 5 but PSA very low and prostate small

Hi CB

I presume that u are waiting for the biopsy result?

Is PSA of 1 the only PSA u have had?

Does the MRI show anything and if so any idea of  tumor size although I realise PIRADS 5 and of course biopsy needed to confirm if cancer

Best wishes 

Steve 

Hi thank you. Yes biopsy was today. The lesion is apparently in the capsule only and not all of it but how much I don’t know. 

I had a second PSA blood test today as GP wanted to double check as it was so low but exam didn’t feel right. I scored 1 about three years ago as well.

So it’s wait 3-4 weeks for results on the biopsy and a few days for the PSA but I bet it’s still really low.

Ok,  so it's in capsule only but not sure on size.

Worth asking that at some point, if cancer then hopefully a low Gleeson with a smallish tumour size going along with the low PSA.

Doesn't sound a big problem at this stage, if cancer probably easy to treat and curable.

Let us know when u know more

Steve 

Hi Steve thank you for the support. Second PSA is 1.1, a few weeks ago it was 1.0. I’m going to assume that’s natural variance.

Having done some more reading I’m a little concerned that I only had 7 cores taken in the biopsy - unless the surgeon was using the MRI image as the guide and sampling just the lesion not the whole prostate. I wish I’d done more pre biopsy reading beyond the leaflet they sent me about bringing a dressing gown and blood in my pee :-) so I had some more questions to be prepared with.

I’m also surprised I was told by the urologist that a PIRADS 5 is only a 1 in 3 chance of cancer. I’ve not seen any articles or reputable web pages say it’s less than 70% unless my really low PSA was factored in. Which was not part of the explanation. Also he said my prostate was small. It’s 34ml - I found that on my recent ultrasound report which I can access. Can’t see the MRI report though. 34ml is average for my age of 59. Semantics I know but I’d have a little less angst about the team if they have a little more detail and accuracy. 

To add to my worries I dug into PIRADS 5 and low PSA and noted some journal articles suggesting aggressive poorly differentiated cancers can mean the PSA level doesn’t get raised. 

My apologies to anyone reading this who has a diagnosis and thinks what’s he worrying about when he knows nothing yet, it is both the uncertainty inherent in waiting and the annoyance with myself for not asking better questions to the team that compels me to write it down here.

Hi CB

Does sound a bit puzzling with a PSA of 1 ISH.

Perhaps not cancer, biopsy result needed, wouldn't worry too much about cores taken.

Biggest thing that's missing is what the MRI actually says in terms of any potential tumour size,  not prostate size.

Pi rads doesn't  mean that much , just an indication, biopsy tells what it really is.

When possible try and look into tumour size in mm, the cancer centre should be able to tell you. Possibly/hopefully quite small with that PSA 

Yes, you're right, some aggressive cancers have a low PSA, quite rare though.

With tumour size and Gleeson that should tell u everything.

Best wishes

Steve 

I was told 2-3 weeks for biopsy results but I have been given an appt next week which seems very efficient, only 7 working days from biopsy so I’m thinking they found nothing and want me off the books.

I Chairboy1d4982 ,

Your position is interesting.

It does seem to be that the cancer is contained within the gland, if it is cancer at all.

That being the case you may be overwhelmed with options.

I think that, if you want help on this, you might be well adviser to call Macmillan's support team on 0808 8080000, or contact them in some other way. Details are on this page:

https://www.macmillan.org.uk/cancer-information-and-support/get-help/macmillan-nurses

I had to wait for ALL the results to come in before any treatment plan was to be offered, and it was a long hard wait.

You may get a discussion where the oncologist says, "Well, we could do this, or this, or that!"

If you do, more people here can explain and help.

I wish you very well indeed.