Lesion 3 and Lesion 4 MRI

Its starting to get real now... Dr. stated a lesion 3 and a lesion 4 were found on the MRI and have ordered up a 2nd biopsy to see if either of them are PC. I have no idea what these lesions are or the significance of the scale used to classify them as 3 and 4. Doesn't PC start in one part of the prostate? If it was cancer why would there be two lesions so early? I'm just trying to get over the initial shock at this point, PC is becoming a very real possibility now. Live life to the full one day at a time because there are no guarantees.

It's quite common that by the time a man is diagnosed with PCa, there are already multiple lesions, and it's common that they have different Gleason scores (which is basically their severity).

(1) Whether or not you lesions are cancerous is the first question that will be answered: only a biopsy can tell.

If it is cancer, the next questions that will be answered are (2) whether or not the cancer is confined to the prostate, or has started to grow out of the thin prostate capsule into neighboring structures; and (3) whether (a) you are a good candidate for Active Surveillance (monitoring your cancer with no treatment until it progresses or until you decide it's time to treat) or (b) your should decide on a treatment modality in the near future.

If your biopsy doesn't detect cancer, your MRI will serve as a baseline for comparison in case your PSA should continue to rise. A biopsy can miss existing cancer, in which case your PSA will probably continue to rise and the cancer will require repeat MRIs/biopsies to be detected.

The name of the game that we all learn to play is One step at a time! We are here for you and can help answer your questions. If it is cancer, we can suggest what steps to take and how to learn learn more.

All the best,

Djin

I had PIRADS 5 and 4 lesions from MRI so Urologist said biopsy is next. The rest is in my signature.

Djin pretty much laid it out. One step at a time. However, your mind will want jump ahead to all the possible treatments and outcomes, your future, your family, and so on. It is quite the journey and when you get to the end, you will wonder why you freaked out and have a new appreciation for life and its unavoidable conclusion. I look back to 2018 and wonder why I was so confused and terrified at first. A cancer diagnosis tends to do that to most people but it will pass once you are actually doing something to solve the problem if and when that is determined.

Into, we get your shock and feelings of uncertainty. But please don't jump to any conclusions. You will get some pretty good info from your biopsy results and we can help you interpret this and advise you re next steps. Just so you know, the biopsy will not tell you whether or not the cancer is outside of the prostate. It will provide info re any cancer inside the capsule. IF you test positive for cancer then it's likely you will want to get a PSMA scan that will help determine if there is cancer elsewhere....but we're getting ahead of ourselves.

One thing I do want to emphasize however is that even if you have cancer it is most likely very treatable and you probably have a long life to live, dying of something else somewhere down the road. So go ahead and worry but with a perspective of hope.

Another thing you might consider is to start a signature that you can establish in your profile settings. Include things like age, PSA trend, scan and biopsy results as you get them. That way folks won't keep asking you basic questions and can focus on the main issues.

Good luck. When is your biopsy? And you said it was a 2nd one...what did the first one reveal?

Jim

IntoTheUnknown said...
It is good to see so many others going through this that have not only the experience to help new members but also valuable advice on what to expect in the months ahead. I'm not sure how long it takes for the initial shock to go away but Ive decided to take it easy and mostly just wanted to be alone to process all this. Even hobbies are taking a back seat to this while I wait to find out if they verify cancer and most importantly the stage. I fear that many years of high and jumping PSA numbers may have allowed this thing to grow and its only a matter of time before it might metastisize to lymph nodes etc. I can only hope that if biopsy confirms the lesions that they remain confined in the prostate. I have no fear of death and have lived an amazing life and even had my hurricane work featured on the Weather Channel. Now my entire world has been turned upside down and any future projects I want to go out and shoot might not even be possible depending on treatment options and how much of a drain they have on my energy and quality of life. I do fear a loss of control and losing my independance. I have no intention of telling my son and will try to hide everything for as long as possible. Best not to worry or burden anyone.

Don't go there, your mind is saying death sentence and the reality is that most men have ordinary prostate cancer that can be treated a number of ways and life marches on.

My wife was involved right away being a cancer veteran herself, follow by my father who was a PCa survivor and then my two sons after I had a positive diagnosis and some idea of a solution. The biggest problem I had with my brother/sister and two sons was to eliminate the idea of having the "good" cancer and no, you don't just take meds for it.

about a month or so after surgery, road trips & vacations still occurred and life got back to normal once the physical restrictions were lifted. After radiation at 9am, I would head to Home Depot, food store and/or fitness center to do my daily business and get on with my day. Sure, I was tired and and took more naps when needed but still kept going forward and getting things done.

Prostate cancer diagnosis and treatment is not a walk in the park but it is not even close to a death sentence and just another one of life's setbacks. Heck, I was getting knee injections a couple of weeks after prostate surgery which is just another part of getting older that I don't enjoy either. There is a newscaster here (MSP - Randy Shaver) who had lymphoma treatment early on and later PCa treatment that he shared on TV while he continued to do TV Sports and News. He rarely missed a broadcast during 6 weeks of radiation and is retiring this year.

Look at all the survivors of PCa and not the men that die from it after discovering too late. You are doing all the right things and no reason to be pessimistic.

Mumbo, what Jim said.
Michael

Info, you are getting way ahead of yourself. This, as others have said, is the farthest thing from a death sentence, or even a life if chronic illness, as you can get, in cancer world. The majority of us have been where you are and so many of us are only here to help others, because for us, cancer is in the rear view mirror and not really part of our lives anymore.

Could you have cancer? yeah, could it be the aggressive grade? yeah, but the majority are not. Will the road be bumpy if you do? yeah, but probably for a relatively short time, and you will then go on to live a long and robust rest of your life.

I say this as someone who arrived here in 2014, with my hair on fire. I was hysterical, I even cried when I went for my bone scan after the biopsy (which in hindsight wasn't even necessary with my pathology. I went through surgery, then 3 years later radiation and hormone therapy. That ended over 5 years ago. And I am enjoying every day of life.

So try to take a deep breath. We know it's hard. We are all gonna die. But for the majority of us, who have been diagnosed with prostate cancer, it won't be from that.

One step at a time. Get the biopsy done, get the results then take it from there. We are here and we will help you as much as you want.
Hang in there.