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Pi-rad 5, found fat

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Prostate Cancer
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Posted 2/22/2017 8:27 PM (GMT 0)
(ADA advised me to put this on a new topic. Thanks.)

This is my husband 's story: Turned 70 this year
PSA 17.1 (June 2016), Prostate 140cc
MRI (July 2016)
One Pi-rad 5 found, 16mmx 3mm
Fusion biopsy: 5 samples, no cancer cell found, just some fat(?), no gland
PSA 18.8 (Dec, 2016)
Second opinion from another urologist: PSA3 result: 39% low risk and 14 % high risk prediction if taking 12 core biopsy.
His urologist leave for our decision depending on our tolerations.
Scheduled second MRI and fusion biopsy in two week.
DRE: negative all the time; PSA 11 in 2009, 12 core biopsy, all negative; PSA ups and down these years

Any thought? Thanks!
Posted 2/22/2017 8:42 PM (GMT 0)
My bad, it's ASAdvocate, not ADA.
Posted 2/22/2017 10:27 PM (GMT 0)
Id say for a 70 year old he is pretty fortunate to not have found any cancer...now to insure a continued long and happy life...beware over treatment and have him work on the fat/fit issue...My good...
Posted 2/22/2017 10:38 PM (GMT 0)
Great!

Keep in mind that the harder you keep looking for something minuscule, the more likely you will be to eventually find something...and the more likely that minuscule something will be essentially nothing.
Posted 2/22/2017 10:41 PM (GMT 0)
PI-RADS 5 means that cancer is highly likely to be present, correlation between PI-RADS 5 and cancer is high but not 100%. Maybe 10% of all with PI-RADS 5 do not have any cancer.
Posted 2/22/2017 10:54 PM (GMT 0)
I wouldn't return to the urologist who wrote 'no gland'!

Regarding the PI-RADS scoring system, I gather from others on this forum that this is a 'work in progress'. See Gemlin's post, among others
Posted 2/22/2017 11:56 PM (GMT 0)
Thanks you for all your response.
Sr Sailor: the first urologist did the fusion biopsy. Result: no cancer cell found. He said he was not happy with the result because it didn't include any glands. That's why we found another urologist for second opinion. He told us the report found some fat and some non-cancer thing. Either the previous got the wrong spot of the pi-rad 5 or there is no cancer.

I will post when the next biopsy result comes out. For the time being. I just keep my fingers crossed. Thanks.
Posted 2/23/2017 12:12 AM (GMT 0)
TA said he has never heard fat in prostate and I found nothing on internets. My question is: where else can you find fat? is it possible that the first rologist missed it by a mile?
Posted 2/23/2017 12:57 AM (GMT 0)
It could just be an anatomic anomaly. Fat is often on the outside of organs (visceral fat) but not often on the inside, although it does happen (e.g., fatty liver). We are all anatomically unique. If it was a fusion biopsy, he didn't miss it, it was just a false positive. It's easy to see why a glob of fat, lacking in glandular tissue, might be read as PIRADS 5. It doesn't sound like a big deal to me.
Posted 2/23/2017 1:17 AM (GMT 0)
Thank you for your kind words. It made me feel much better. My husband turned 70 this month. Good thing is that he is very optimistic. I bet he even doesn't think about it until he sees the worrisome on my face. People don't know might think I am the one who diagnosed. He is in good health with only high blood pressure under control. We often walk over a mile in warm weather.

Best wishes to all of you! It's truly a warm and informative forum. Will keep you posted.
Posted 2/23/2017 1:57 AM (GMT 0)
fear trumps knowledge every time...the converse is true also...why would anyone ever choose fear...please don't say wiring... Not directed at you elsa...your husband has set a good example for you in the regards of fear...follow that lead and continue to have a warm relationship whatever the weather..
The first part of my post is rhetorical...aimed at whoever it hits....
Posted 3/14/2017 8:18 PM (GMT 0)
Result:
MRI 3/2: two Lesions; both PI-RAD 3.
Fusion biopsy 3/9
Urologist called: Good news, no cancer cell found. Just keep the yearly routine PSA test!!!
I want to thank all those who have encouraged us, given me hope and calmed me down. Special thanks to Tall Allen who responded to my PM right away with his kind words and great knowledge.
I will come back to visit all my old friends here and wish you the very best!
Posted 3/14/2017 8:28 PM (GMT 0)
Congratulations on the clean bill of prostate health. Your experience helps others understand the limitations of imaging. While you seem very nice, I hope you never have cause to stop back here again. smile
Posted 3/15/2017 12:32 AM (GMT 0)
Happy ending after all the confusion...
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