PI RAD 5

Hi Pear Tree, my understanding as a non medic is that PIRAD is a scoring system to determine the likelihood of Prostate Cancer (PCa).  It ranges from 1 to 5 with 5 indicating it is significantly likely that PCa exists (but not definitely).  I imagine that your brother will be put forward for additional tests (probably depending on his PSA score).  Do you know what has been suggested for him?  Best wishes. David

Hi Pear tree ,

Welcome to the forum, I believe having an initial score of Pirads 5 means there is a strong indication that there is prostate cancer present . Though you need to know that you then need to have other investigations to find out more details and at what level . It’s an initial procedure . It doesn’t really tell you anything solid, just that something is possibly going on. Has your brother had other tests? CT scans, biopsy? Does he have a PSA score? Because these next procedures are more important at letting you know what’s happening. 
If you are googling the best places to get information will be- On this site- MacMillan cancer support . Prostate cancer uk and  Cancer research uk. 
Try not to worry at this stage, PC is very common and has a high cure rate. 
Best wishes L

Snap ! We replied at the same time. 
L

Hi PT

As has already been said No 5 indicates high likelihood of cancer.

He needs a biopsy to confirm

A PSA would be helpful and also do u know what the MRI says, that would give some more clues.

Best wishes

Steve 

Hello Pear Tree.

Sorry that you have found yourself here but hopefully we can help you with some information.

As a starter I have put this link to try and help you understand what the MRI does and the information it can give.

https://www.radiologyinfo.org/en/info/article-prostate-mri-report

A Pirad 5 score means that there is a high probability that prostate cancer is present, although it is not conclusive as sometimes a condition called BPH Benign Prostatic Hyperplasia, which is an enlarged prostate, can be given the same result. Your brother will be called for further tests, in particular a biopsy of the prostate which will then give a better idea of what the suspect cells look like, how widely they might have spread giving a Gleason staging and a TNM (Tumour Node Metastasis) score.  If your brother does have cancer then these results will help direct the course of action which can be anywhere from Active Surveillance to radiotherapy, hormone therapy, chemotherapy or prostate removal. There should be other information on the MRI scan which might indicate whether there are any odd looking areas in the body but if cancer is suspected then he will also be sent for a bone scan to rule out whether there is any spread there. Do you know if your brother has had a blood test and in particular for PSA. I would also add that all men over 50 should get themselves checked out with a PSA test.

Please come back with any questions .

Great minds think alike.

Here is the PI RADS scale for reference.

PI-RADS 1
Very low risk. Clinically significant cancer is highly unlikely to be present.
PI-RADS 2
Low risk. Clinically significant cancer is unlikely to be present.
PI-RADS 3
Intermediate risk. Clinically significant cancer may or may not be present.
PI-RADS 4
High risk. Clinically significant cancer is likely to be present.
PI-RADS 5
Very high risk. Clinically significant cancer is highly likely to be present.

Rob

 Pear Tree 

Welcome to the forum. I'm sorry you have had to find your way here but we are a friendly bunch and will help as much as possible. A good place for you to start is with the brochure "How Prostate Cancer is Diagnosed" from the Prostate Cancer UK website. You can download it here:

https://prostatecanceruk.org/media/2499098/how_prostate_cancer_is_diagnosed-ifm.pdf

Please come back with any questions you may have as someone on here will have an answer for you.

Don’t forget though:

“PI-RADS 5
Very high risk. Clinically significant cancer is highly likely to be present.”

BUT….

Biopsy result gives histology report and this will tell you the grade of cancer.  If the Gleason grade is 3-3 you will only need to keep an eye on it and will most likely die with it, not of it.  Also, if found at 3-3, you can monitor it and catch it (remove or kill) if it shows ANY sign of further growth to a higher grade (3-4, or 4-3).

AW