New and uneducated

Hi Lonnie

Sorry to hear but there are plenty of people on here to give u good advice.

Yes PI RADS 4 means likely to be cancer but biopsy needed to confirm.

You don't give any PSA readings which would help  but assuming it is not to high then the likelihood is that any tumour is confined to the gland and therefore easily treatable.

Let us know when  you have more info and we can help u further.

I know it's a shock at the beginning but fingers crossed has been caught early and either surgery or RT should sort it

Best wishes

Steve 

Hi Lonnie88 and welcome to the prostate cancer forum, your PI-RADS score does indicate cancer is likely, but not certain. Lonnie please don't read Dr google use PCUK and Macmillan, your tests will be a prostate biopsy, ask for a transperineal one, a MRI  and a CT scan, They are usually done in weeks so you should have your results in about a month or so, I hope your results bring good news and you never have to be hear again, but if you do you will always be welcome, take care.

Eddie

Hi Lonnie88.

A very warm welcome but sorry that you have found yourself in this situation, just as you are about to retire. Firstly can I reassure you that most men die with prostate cancer and not of it. Also it is better to get get information from trusted sites like Prostate Cancer UK or Macmillan rather than Dr Google. As a starting point I have attached a link from PCUK.

https://prostatecanceruk.org/prostate-information-and-support/prostate-tests

PIRADS 4 does not necessarily mean that you have prostate cancer so the biopsy is the first procedure. I would ask whether it is a transperineal biopsy rather than a transrectal biopsy if possible as there is less risk of infection with this. If your results come back as positive then further investigation will probably be with a CT scan to check if there is any spread as well as a nuclear scan to check for any bone involvement. The biopsy gives the experts an idea of exactly where the cancer is, whether it is contained or has broken through the capsule and if so where to, if there is lymph node involvement, as well and giving an indication of how aggressive it is and the type of PCa. Once all your results are in then they will be reviewed by a multi discipline team to advise on the treatment pathway which would be tailored specifically to you. Your PSA is also an indication of prostate cancer but is not definitive, have you got it yet. Others can give you an idea of timescales for different tests. I would start making notes of all the people you talk to, date, name and content so that if you need to chase things up you know who to go to.

Please come back with any questions, no matter how small or silly you might think them as we have all asked them.

Hi Steve

Thank you so much for the prompt reply.

The strange thing is my PSA is normal (apparently 1 in 7 cases have normal PSA). It was only family history which prompted the urologist to send me for an MRI. I was expecting an “all clear” response.

I have a good idea of treatments for the Prostrate cancer which have a good chance of success, if contained within the troublesome gland. The concern I have is spreading, as that seems to be where the complications are. I was wondering how the medics go forward in detecting if that has occurred and to what extent.

Hope for the best, plan for the worse is my usual approach to life.

Regards

Lonnie.

Thank you for the detailed reply. I am going for the transperineal procedure. I now know what I will need to go through re-spreading. I will just have to wait for my Gleason score now. Hopefully, not too high. 

Sound like it will be a month for the Geason result and then more time after that for the CTs etc should they be needed. Worrying times ahead.

Hi Lonnie88,

I am so sorry for your pending diagnostic. The waiting time is the worse. What we did is chase the biopsy, the MRI and the bones can. In the first 2 weeks I was always on the phone saying we will accept any cancellation offered. My husband treatment started within a week of the diagnostic. From that day we knew we are fighting the ba...rd!

Everybody is so helpful on this from, so as they say forget Dr Google and go to info on Prostate cancer UK. 

As for your retirement, even if the diagnostic is not what you want, one of the most popular topic on the form is Travel Insurance. People with PC having holidays, having fun, enjoying their families and very active. 

Best wishes

Dafna 

Thanks Eddie. Time will tell.

Thank you for your positive reply. After all the friendly and helpful responses I now know I am not alone with facing the future.

Leave Dr Google and look at the Prostate Cancer UK website where you will find a really good selection of leaflets which you can download - the best at this present time is the "Prostate Cancer Toolkit"  Which will deal with tests, scans and diagnosis and introduces you to some of the acronyms and medical jargon used.  What is your PSA at the moment?  Or look on this site at advice about Prostate Cancer.   It is prefereable to have a MRI Scan before the biopsy but this doesn't always happen but it would mean that the biopsy can then be targeted to the area where the tumour can be seen on MRI.  It is also best to have a Multi practic MRI but these are not available all over the country.  I had my MRI after the biopsy and thought this was getting less common now.  Another thing to be kept in mind is that if you are having the MRI after the biopsy to wait at least 3 weeks to 6 weeks after the biopsy as the "trauma" and possible swelling from the biopsy area is likely to cloud the area. Once you have had your biopsy you will get a gleason score a d a staging so for instance my PSA was 13, Gleason Score was 7(3+4) and my staging was T2N0M0.  So stage 2 locally advanced (presumably) contained in the prostate and no spread to lymph nodes or else where.  At this stage I could have had brachytherapy with or without Hormone Treatment (HT),  Radiotherapy RT with HT or removal of the prostate.  However after having the MRI 3 weeks later it could be seen that the tumour was pressing on the back of the prostate so T3 disease could not be ruled out as both the urologist and radiologist were concerned that some cancer cells could have migrated into the local area.  At this stage the Oncologist suggested that HT followed by RT would be best as it would "mop up" any possibly microscopic spread which wouldn't be seen on scans.  I had 9 months of HT starting 14 weeks of RT starting at around the 6th month of HT.  This ended up to be absolutely the right thing to do as that was back in 2015/16 and since then my PSA has been undetectable.  I have had no lasting problems and was back to normal within 6-9 months of   finishing my treatment.   You may also have a bone scan and PET Scan but not everyone has these. 

As I think has already been said the worst part about this is the waiting - especially for the Multi Disciplinary Team (MDT) meetings to discuss progress from diagnosis to treatment options.  The best thing to do is to keep your self busy exercise and eat healthily so that you will be at your best when you start treatment.  I exercised all the way through my treatment and am sure it helped with the side effects of the HT - I only put on about 5 lbs and had a slight pouch of fat around my tummy,  had no noticeable mood swings and just a little fatigue.  I didn't have very many hot flushes with the HT but did notice as the effects of the RT were wearing off over the months after the treatment had finished that I noticed my thermostat was coping better with changes in temperature. 

All the best.  

Hello Lonnie88 

That's a cracking post by freefaller - The link to the publication he mentions is below. 

https://shop.prostatecanceruk.org/our-publications/all-publications/tool-kit

You will also find plenty of other decent publications there too.

If you require any further help or information please don't hesitate to contact me (I've been off over the weekend)

Best wishes - Brian.