Transrectal Ultrasonography picks up small mass in the prostate

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New Member

Date Joined Sep 2009
Total Posts : 2
   Posted 9/18/2009 5:02 PM (GMT -6)   
Hi there, very pleased to find such a well educated group of people.

I have been reading for a few days before deciding to post.

Well today my father came back from the urologist after performing an ultrasound that has shown a mass in one lobe. Theres not much info accompanying the report, father was just told to undergo biopsy next week.

His PSA kept rising suddenly since last month from 5.1 to 5.7 in one month and within one week to 6.1

Percent Free PSA was 12% when PSA was 5.7.

His age is 59. He has not had any health problems apart from irritable bowel syndrome and doesnt smoke,drink or do anything apart from work really. His job is very stressful. My grandfather also had some problem with prostate not sure however what but he had radical prostatectomy. That was 35 some years ago. He eventually died of something else some 6-7 years later (amyloidosis was the disease that hit him)

Question: Is it typical to find a mass in the prostate gland under ultrasound?? What is the possibility that this mass could be malignant or something else?? I am asking because from the info i have been reading here there is not much about ultrasound of prostate and findings. Most people seem to go from PSA/free PSA and DRE to biopsy.

DRE was also negative, doctor said prostate was very smooth and soft
Size of mass if not mistaken (i see some D1 and D2 readings on the ultrasound film that are saying 10.9 mm and 13.5 mm)

Post Edited (Solon) : 9/18/2009 5:15:25 PM (GMT-6)

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4170
   Posted 9/18/2009 5:13 PM (GMT -6)   
It's impossible to imply anything without a biopsy. An ultrasound wll pick up suspicious areas, but they have to be sampled with a biopsy.
The rise in psa is also a concern.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


New Member

Date Joined Sep 2009
Total Posts : 2
   Posted 9/18/2009 5:21 PM (GMT -6)   
Offcourse i understand that biopsy is needed.
Just wondering whether other type of masses (of benign form) exist commonly in the prostate gland apart from the malignant ones.

Have many people in this forum undergone ultrasound with detectable masses in their prostate ?? Because i havent stumbled on such a post all this time im reading

Veteran Member

Date Joined Jul 2009
Total Posts : 1267
   Posted 9/18/2009 8:41 PM (GMT -6)   
Hi Solon, I can't answer your question except to say that when I was having my biopsy the doc was doing an ultrasound at the same time and asked if I could crank my head around and look at the screen. The reason being that my prostate was so clear and normal he said he'd be doing the biopsy, but he wasn't worried and I shouldn't be either. By the way, my PSA was 1.5. Up from 1.44 a couple of years before that. So, I didn't worry, but a few weeks later I had a message on my phone that four of the 12 cores had cancer.

Bottom line is that a rising PSA and a suspicious ultrasound may be nothing, just as my nothing was something and until the pathologist looks at the cores, it's impossible to even hazard an intelligent guess on your dad's situation.

One thing I can also say for sure is that IF the cores come back positive don't panic. You've stumbled upon a great group of support people here and they'll help you and your dad make intelligent right choices --- they did for me.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"  

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 9/18/2009 9:29 PM (GMT -6)   
Hello and welcome to HW, Solon.

It was a couple of suspicious shadows on a CT during my 2nd prostate biopsy, that made my uro/surgeon have me come back a third one six weeks later. He targeted just 7 needles into the suspicious area, and all 7 came back positive for cancer. I am glad that he was experienced enough to have me come back, I didn't want to at the time, I wanted to wait a whole year for the next biopsy. If I had listened to myself, I still would have had cancer a year later, but it would have been much worse situation.

Hoping for the best for your father. I agree with JohnT, without a biopsy at this point, still a lot to speculate and worry about.

Please keep us posted.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4818
   Posted 9/19/2009 2:34 AM (GMT -6)   
My journey began with the finding of “nodules” aka lumps on my prostate. I was told of the possibility that Calcium build up could be the cause. Unfortunately, the biopsy proved other wise.
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2457
   Posted 9/19/2009 7:38 AM (GMT -6)   
My annual physical exam showed an elevated PSA (3.9) but the DRE was normal. My GP sent me to a Urologist who repeated the PSA test a month later. My PSA had dropped to 3.5 but my free PSA was 11%. At that point I was told that because of my low free PSA I had a 30% chance of having prostate cancer and a biopsy confirmed that. I hope that your father doesn't have PCa but only a biopsy will confirm that. Good luck.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

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