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MRI Before Diagnosis - Concerned

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Posted 12/15/2010 3:28 PM (GMT 0)
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)
Posted 12/15/2010 4:11 PM (GMT 0)
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....
Posted 12/15/2010 4:41 PM (GMT 0)
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?
Posted 12/15/2010 6:20 PM (GMT 0)
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
Posted 12/15/2010 7:43 PM (GMT 0)
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.
Posted 12/15/2010 8:03 PM (GMT 0)
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
Posted 12/15/2010 9:00 PM (GMT 0)
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.

Posted 12/15/2010 9:26 PM (GMT 0)

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.
Posted 12/16/2010 6:52 PM (GMT 0)
 

Where are you being treated, where they do an MRI and 1-2 core biopsy?

Sounds pretty advanced, to me. 

Posted 12/16/2010 8:37 PM (GMT 0)

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.

Posted 12/16/2010 9:47 PM (GMT 0)
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
Posted 12/16/2010 9:53 PM (GMT 0)
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. 

Posted 12/16/2010 10:13 PM (GMT 0)
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.
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