MRI Before Diagnosis - Concerned

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JRinNJ
New Member


Date Joined Dec 2010
Total Posts : 6
   Posted 12/15/2010 9:28 AM (GMT -6)   

Hi all,

 

New to the group and hope not to be a permanent member of this awful club.  This is an incredible board and I applaud all of you for your feedback and compassion.

I am currently 49 and lurked here previously when I was biopsied last Jan but stopped lurking when it came back negative.  I now think I have a more serious concern.

 

One thing I don’t think I have seen mentioned on here has been an MRI before an actual diagnosis.  My timetable is below.

 

At this point it would appear that my odds of coming out negative are slim – what else could have caused the “suspicious” area on the MRI?  I am convinced that the biopsy will be positive this time - any realistic reason to believe otherwise?

 

Thanks

 

Mid-2008         PSA 2.4

Nov 2009        PSA 3.9, DRE OK, slightly enlarged

Jan 2010         Biopsy – 12 samples all negative

May 2010        PSA 4.1, DRE OK

Nov 2010        PSA 4.5, DE OK, MRi ordered

Dec 2010        MRI – revealed “suspicious” spot

12/22/10          Scheduled biopsy – 1-2 samples from suspicious area

Post Edited (JRinNJ) : 12/15/2010 9:43:13 AM (GMT-7)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3747
   Posted 12/15/2010 10:11 AM (GMT -6)   
My main concern would be your steadily climbing PSA number...SOMETHING is going on...It took them 3 tries to find my cancer with my PSA accelerating north of 10...While the MRI might have spotted something, in cases like yours, a Color Doppler Ultrasound guided biopsy can also zero in on suspicious areas of the prostate. You may have to travel to find a treatment center that uses this technique. Your planned 1 or 2 core biopsy is minimally invasive and might be worthwhile....

When PC is in it's earliest stages, the standard 12 core biopsy frequently does not detect it...But very early detection is the key to long-term survival especially if it turns out the cancer is Gleason 8 or higher.... Other tests can help to confirm the presents of cancer, free PSA percentage, a PAP test, and, as a last resort, a saturation biopsy...It all depends on just how aggressively you and your doctors want to get and what your insurance company is willing to pay for....
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

JRinNJ
New Member


Date Joined Dec 2010
Total Posts : 6
   Posted 12/15/2010 10:41 AM (GMT -6)   
Thanks for the feedback.  While I certainly hope the result is negative, if there is something there better to be found while it's early.  The Dr did say that if it is something, it is very early and localized.  I guess he can tell this from the MRI?
Mid-2008 PSA 2.4
Nov 2009 PSA 3.9, DRE fine, slightly enlarged
Jan 2010 Biopsy – 12 samples all negative
May 2010 PSA 4.1, DRE again OK
Nov 2010 PSA 4.5, DRE OK - MRI ordered
Dec 2010 MRI – revealed “suspicious” spot
12/22/10 Scheduled biopsy – 1-2 samples from suspicious area

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 12/15/2010 12:20 PM (GMT -6)   
JR, I had a spot on my lower spine that was pick-up on both a bone scan and MRI. Both my radiologist and uro thought it was cancer. I was scheduled for a biopsy as you are, but a second MRI indicated that the spot was just a tangle of blood vessels. At a PSA of 4.5 mets to bone is very unlikely, but not impossible. BB
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/15/2010 1:43 PM (GMT -6)   
It might set your mind at rest a bit if you searched the board for "calcification" It has nothing to do with cancer but shows up in the prostrate on both MRIs and DREs.

Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 12/15/2010 2:03 PM (GMT -6)   
Good point Geezer, but unfortunately, My scan showed up calcification, and the biopsy did the rest !
Lets hope for not the same result for you, Good Luck JR..............................Kev
Age 52yrs [Gold Coast Qld, Australia]
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4 Gleason Score 3+4=7 Stage T1c
RP 24/12/08 Dr Philip Stricker [Sydney]
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c Three small foci total volume <10%
Margin status- Focal Involvement
Nil - EPE
ED- okay with Meds.
PSA at 2 yrs, no change remains 0.03
"Everyday in Every-way I Get Better'

JRinNJ
New Member


Date Joined Dec 2010
Total Posts : 6
   Posted 12/15/2010 3:00 PM (GMT -6)   
Thanks for the replies.  Glad at least something else was identified that could be deemed "suspicious" from an MRI :-)
 
My DREs have always been fine, although perhaps calcification could be in an area the DRE doesn't reach.  I'm hoping that's it, but have to figure it's a longshot.  I guess you could say I'm hoping for the best but planning for the worst.
Mid-2008 PSA 2.4
Nov 2009 PSA 3.9, DRE fine, slightly enlarged
Jan 2010 Biopsy – 12 samples all negative
May 2010 PSA 4.1, DRE again OK
Nov 2010 PSA 4.5, DRE OK - MRI ordered
Dec 2010 MRI – revealed “suspicious” spot
12/22/10 Scheduled biopsy – 1-2 samples from suspicious area

mycroft
Regular Member


Date Joined Oct 2010
Total Posts : 54
   Posted 12/15/2010 3:26 PM (GMT -6)   
Fairwind said...
Other tests can help to confirm the presents (sic: presence) of cancer, free PSA percentage, a PAP test, and, as a last resort, a saturation biopsy...It all depends on just how aggressively you and your doctors want to get and what your insurance company is willing to pay for....


The only test that is diagnostic of PCa is a biopsy.

The other tests mentioned are useful, but will not tell you whether you have PCa.
Dx 2004 at 67 yoa: Extensive Gleason 9 + Gleason 8.

Uro wanted to do cryotherapy, which I would have declined had I known anything. It failed, except I was rendered totally impotent; the only thing that worked as advertised.

IMRT + Lupron.

Studied PCa extensively.

Fired rad onc, who refused to read Dr. Strum's evaluation of my case.

Hired med onc. Have been on IADT since 2006.

Soby
New Member


Date Joined Sep 2010
Total Posts : 9
   Posted 12/16/2010 12:52 PM (GMT -6)   
 
Where are you being treated, where they do an MRI and 1-2 core biopsy?
 
Sounds pretty advanced, to me. 

JRinNJ
New Member


Date Joined Dec 2010
Total Posts : 6
   Posted 12/16/2010 2:37 PM (GMT -6)   
Soby said...
Where are you being treated, where they do an MRI and 1-2 core biopsy?
 
Sounds pretty advanced, to me. 
 
 
 
Not sure I can mention specifics, but he's in Bergen county, NJ.  Pretty big operation with several facitlities and surgical centers for these kinds of things (biopsies, vasectomies, etc). 
 
The MRI was after my PSA continued to rise (I had a 12 core biopsy in Jan which was negative).  I guess he wanted to see if the MRI showed anything before subjecting me to another full biopsy.  Since it showed a suspicious spot, he is biopsying from that area.

Mid-2008 PSA 2.4
Nov 2009 PSA 3.9, DRE fine, slightly enlarged
Jan 2010 Biopsy – 12 samples all negative
May 2010 PSA 4.1, DRE again OK
Nov 2010 PSA 4.5, DRE OK - MRI ordered
Dec 2010 MRI – revealed “suspicious” spot
12/22/10 Scheduled biopsy – 1-2 samples from suspicious area

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 12/16/2010 3:47 PM (GMT -6)   
Having an MRI or a color doppler ultrasound should be a standard practice for anyone before undergoing a 2nd or third biopsy. Your doctor seems to have things well in hand.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/16/2010 3:53 PM (GMT -6)   
Alot money made off scans, especially on low stats people, Dr. Strum has written straight forward about the wasted money. I doubt you have a positive scan from PCa, but maybe possible in special cases.  Many people get the ct and bone scans with low stats, and it cannot tell with certainty that you are even clear or not....this is the real truth. Great money maker in any event.
 
Mycroft- Kudos for firing a doc whom wouldn't listen to real advice  (loved hearing it)-Strum rules
 
Fairlywinded (-: - gave you some ideas on other tests, markers that might be useful. Hey I took alittle fun at his name sake which he is good natured enough to handle it, did so below on mine too. (lol)
idea
Zoo-fish (me-zufus)- I say question everything and all the time, the experts generally are far from it and make mistakes and some even lousy judgement at times, of course PCa is not anywhere near perfect science status. Ask your doc how many variant types of PCa have been found now (24-fyi) or to discuss the (3)pathology  DNA ploidy types to you....then see what he knows. Would love to be there if he doesn't know about such. rolleyes
 
Don't worry right now the odds are better that you do not have a hot spot with those stats and things are probably not as horrible as you may think. 
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Post Edited (zufus) : 12/16/2010 3:01:21 PM (GMT-7)


JRinNJ
New Member


Date Joined Dec 2010
Total Posts : 6
   Posted 12/16/2010 4:13 PM (GMT -6)   
Zufus - thanks for the attempt to reassure me but still quite worried. While I really hope the odds favor that spot on the MRI not being cancerous, I can't help but think the opposite.

I will take it one step at a time, get the biopsy and go from there. In the meantime, I hope to relax as much as I can this weekend with family, maybe increase my scotch intake a bit (!) and prepare for what's ahead.
Mid-2008 PSA 2.4
Nov 2009 PSA 3.9, DRE fine, slightly enlarged
Jan 2010 Biopsy – 12 samples all negative
May 2010 PSA 4.1, DRE again OK
Nov 2010 PSA 4.5, DRE OK - MRI ordered
Dec 2010 MRI – revealed “suspicious” spot
12/22/10 Scheduled biopsy – 1-2 samples from suspicious area
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