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Posted 1/10/2024 1:58 PM (GMT 0)
Hi Billy,

As mentioned above, we'd be glad to offer thoughts on your path report. One thing if you choose to post it. Be sure to keep all the text for the findings, including items that end with a colon but have nothing after it. Most path labs use standard report forms, and they don't always write "negative," "not found" or "not present," but instead leave the item blank. However, that blank often means they looked for it but didn't see it, which can be good news smile

Djin
Posted 1/10/2024 2:55 PM (GMT 0)
Thank you sir, as soon as I get it I will be posting.
Posted 1/14/2024 10:39 PM (GMT 0)
Here is my MRI results guys.


5:29 PM Sun Jan 14
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INDICATION: Prostate cancer, intermediate risk, staging;unfavorable intermediate risk prostate cancer
ORDER: MR PROSTATE W AND WO IV CONTRAST
TECHNIQUE: Multisequence multiplanar MRI of the prostate was obtained without contrast. Additional images were obtained after the uneventful intravenous administration of contrast
COMPARISON:None
FINDINGS:
Prostate: 3.3 × 4.5 × 4.0 cm.
Volume:
Postbiopsy hemorrhage: Extensive blood products seen in the right posterior peripheral zone in particular. Typically the blood excludes areas of tumor.
Peripheral zone: There is low T2 signal in the left posterior peripheral zone seen on series 6, image 16 between the 4:00 and
5:00 position. This is adjacent to the capsule which is mildly irregular. The region measures close to 8 mm in diameter Additional low T2 signal and restricted diffusion is seen in the right peripheral zone slightly more inferiorly and anteriorly. This is seen for example on series 6, image 18 between the 9:00 and 10:00 position. This region measures close to 9 mm in diameter.. The capsule is definitely irregular in this region. Microscopic extracapsular disease is suspected with this appearance. Please see series 4, image 21 where there is a small area measuring close to 5 mm in diameter which appears to reflect early capsular invasion. Both of these areas appear hyperemic.
Transitional zone: Relatively small with encapsulated and partially capsule and nodules only.
No adenopathy or free fluid detected. The bladder contains no filling defects.
CONCLUSION:
PI-RADS 4 by criteria. Apparently known cancer by biopsy. 2 separate areas are identified in the left posterior and right lateral peripheral zone. On the right laterally in particular there is irregularity of the capsule and microscopic extracapsular disease is suspected but no regional adenopathy detected.
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Posted 1/15/2024 12:29 AM (GMT 0)
Billy:

Thanks for sharing the MRI report. It looks mostly positive, actually. I note the comment in the conclusion that there is a slight irregularity of microscopic extracapsular extension (EPE), but no external issues.

This is actually really good news. I interpret is as--there is some POSSIBLE escape from the gland to outside, but it is microscopic, and no external growth. That is as good as it gets. If your doctors agree, then your odds of metastatic disease go way down. Not to zero, unfortunately if you have a G9, but much lower.

I'd still strongly suggest you see a Radiation Oncologist--I'd ask if they do SBRT--sometimes called Cyberknife--where they implant gold pellets in the gland and use them to focus the radiation beams. It gives a solid kill to the cancer, does some outside the gland treatment, with minimal side effects, and is only 5 treatments, not 30 or 40.

When you get the pathology report, please share it as well.
Posted 1/15/2024 12:35 AM (GMT 0)
Thank you man! I read it as pretty good too. I understood that staying inside the gland is a good deal. Plus, it says no adenopathy which I read not spread to lymph nodes. Thanks again for your knowledge here. It really has helped.
Posted 1/15/2024 2:04 AM (GMT 0)
Hey Billy,

I think getting biopsy pathology report would have been more informative but you get what you get. The MRI report notes the difficulties encountered due to the recent biopsy which was why getting the MRI done before the biopsy is the better plan.

The MRI pretty much confirms that you have PCa as indicated by your doctor so no argument there. I note that the report says INDICATION: Prostate cancer, intermediate risk, staging; unfavorable intermediate risk prostate cancer. which they did not determine from the MRI. I suspect the radiologist has seen or been advised of the biopsy findings for his evaluation.

This would imply a Gleason 7 (4+3) classification in the pathology which means you will have to do something about it but you probably knew that already. There is a newer scan, a PSMA-PET scan, that uses a special tracer that adheres to most prostate cancer cells in the body and can locate small areas of cancer spread that cannot be seen by MRI. Depending on your final results, you should discuss getting a PSMA scan if the doctor is concerned about cancer outside of the prostate. Your MRI notes the possibility of this.

After you get all the results and meet with your doctor, you can then start thinking about the different treatment options. You will get plenty of input on that when the time comes. Just take it slow and think your way through every step and do not rush anything. Hang in there, only a few more days now.
Posted 1/15/2024 2:07 AM (GMT 0)
Thank you sir!
Posted 1/15/2024 4:57 PM (GMT 0)
Hello billygoat...not sure how I missed your thread until now, but I wanted to say hello and wish you luck. FWIW, I was diagnosed at age 51 and now I'm 63 with no sign of cancer, no significant side effects to speak of and I'm living my life. I don't see why you can't be posting the exact same thing 12 years from now. Good luck and I'm sure we can helpful as you go through your journey. This website was so very helpful to me when I was going through my treatment.
Posted 1/15/2024 4:58 PM (GMT 0)
Thanks brother!
Posted 1/18/2024 2:29 PM (GMT 0)
I have an appointment today. I have a bunch of questions written down. I’ll update on what the doctor wants to do vs what I want to do. Thank you all for the support and answering my questions! Appreciate your prayers!
Posted 1/18/2024 2:54 PM (GMT 0)
Make sure that you get a copy of the entire biopsy report and not just a summary. It should have the name and signature of the pathologist.
Posted 1/19/2024 12:06 AM (GMT 0)
I’m extremely happy after my doctor visit! My doctor was awesome and took time to explain everything! He gave me the options and didn’t try to push me in any direction. So much so that I asked him if he were in my shoes would he take the option that I did. He said “sure I would”. I asked if he was comfortable with me choosing cyber knife and he totally is. My wife asked how fast we need to do this and he said “oh no rush!” Prayers were answered gentlemen! Thank you all for the support!
Posted 1/19/2024 1:37 AM (GMT 0)
Way too easy, you better go back and ask more questions...

FYI - Cyber Knife is a trade name for SBRT (stereotactic body radiotherapy) on a specific device and can also be performed with other modern radiation equipment. You will have some options if you want to talk with a couple of radiation oncologists.

Did you ever get your final biopsy results? Would be interesting to see the details.
Posted 1/19/2024 1:40 AM (GMT 0)
I did. How do I attach it to this forum?
Posted 1/19/2024 1:58 AM (GMT 0)
You cannot attach documents, best option is to copy the text and paste into a post but edit to remove name, etc. so that anyone can read.

If you just have a printed copy, you will have to retype or convert to text in some manner to copy.
Posted 1/19/2024 1:24 PM (GMT 0)
Ok I’ll do my best
Posted 1/19/2024 10:54 PM (GMT 0)
Wife here and know that this forum helped me so much. I was basically on my own with research and trying to figure out the next steps. You are in a great place. Hang in there !
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