MRI this week -- AS protocol - Active Surveillan...

Active Surveillance - Prostate Cancer

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MRI this week -- AS protocol

Hope4Happiness profile image
17 Replies

Well, it's that time. I'm off to MSKCC in NYC this week for my scheduled MRI as part of my AS protocol. My previous MRI was June 2017 and last biopsy (a "confirmation" biopsy) was April 2018. I'm a Gleason 6 -- 2 of 14 cores, both less than 5%.

Thanks for all the insight and great support I receive here at this community! Wish me luck! I'm hoping I can continue on AS!

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Hope4Happiness
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17 Replies
AS2010 profile image
AS2010

May the force be with you.

TB2G profile image
TB2G

Your diagnosis and mine are nearly identical. I had 2 of 16 cores 3+3 G6 <5% each. Had that confirmed by Dr. Epstein. How long have you been on AS? Did you have an oncodx Test done. My initial diagnosis s on 5 July this year at mayo. Spoke to two doctors there who both recommend AS. I am considering RP anyway since I have acute prostatitis for 3 years now that is very bad when it flares up.

G.

Az

Umpire20 profile image
Umpire20 in reply to TB2G

Prostatitis can be a Beast but I'm sure erectile dysfunction and Incontinence could be worse

Good luck. Let us know how it goes.

Darryl profile image
DarrylPartner

Please say hello during the Prostate Cancer conference prostatecancerconference.org

Hope4Happiness profile image
Hope4Happiness

I received the results of my MRI:

-- In two years, my prostate size increased from 43cc to 57cc (!). I'm 54 years old -- is this in itself going to be a problem?

-- PROSTATE ADDITIONAL FINDINGS: BPH indenting and elevating the bladder neck. Previously noted ill-defined T2 signal abnormalities in the peripheral zone bilaterally decreased, probably representing prostatitis or postbiopsy change.

-- PROSTATE LESION:

* PIRADS v2 Score: 3

* Size: 1.1 x 0.9 cm

* Location: Right, anterior, apex, peripheral and transition zone

* Extracapsular extension: None.

* Seminal vesicle invasion: None.

* Adjacent organ invasion: None.

-- IMPRESSION:

1. Since June 9, 2017, more focal appearing right anterior apex lesion,

possibly stromal BPH nodule or tumor. If biopsy planned, targeting of this

lesion is recommended. PI-RADS v2 score: 3.

Any thoughts here are welcomed and appreciated. Thanks!

Umpire20 profile image
Umpire20 in reply to Hope4Happiness

Men should know their Prostate size. Larger prostates produce more PSA. In March 2019 mine was 108cc. As of August 2019 it was 44cc. Average size is 15cc-30cc but as you age it continues to grow even if you're not diagnosed with Benign Prostatic Hyperplasia (BPH)

I'm no expert on reading MRI's. My medical urologist, surgeon urologist and RO said that they get concerned with P-Rads 4 and 5 assuming all other factors are ok. I specifcally asked my regular urologist, I call him my medical uro, about Pi-Rads and targeting biopsies and he said that unless there are 4's and 5's, it wouldn't help to target. He was basically talking about my data. Reading my latest MRI, my situation seemed to improve from the last 18 months, so this is probably why he said that. When to you see your uro? Let us know what he says.

Hindemith1 profile image
Hindemith1

Based on personal experience I would recommend having the MRI read by another radiologist, preferably someone with a strong track record in prostate readings. In my case it was a dramatic difference.

Hope4Happiness profile image
Hope4Happiness in reply to Hindemith1

Thanks very much for your reply. The reason why I chose to be tested and monitored at MSKCC's Sidney Kimmel Center for Prostate and Urologic Cancer was because of their focus and specialization in this area. Would not a center such as this have specialists with "strong track records in prostate readings" reviewing MRI results?

That said, I did have all my biopsy slides read by Dr. Epstein down at Johns Hopkins as a second opinion.

Hindemith1 profile image
Hindemith1

Yes, absolutely. Guess I'd skipped over the MSK part of the opening, or forgot it quickly as my memory is the leaky sieve. Can't get better than that place! And the looksee by Epstein is pure gold (I did the same).

Umpire20 profile image
Umpire20 in reply to Hindemith1

Plus Sloan Kettering no longer uses Gadolinium contrast Agent in their MRI

aceace12 profile image
aceace12

im in same protocol , What type MRI are you having ?

Hope4Happiness profile image
Hope4Happiness in reply to aceace12

I wish I could give more specifics, but I had the standard prostate MRI given at MSKCC.

Umpire20 profile image
Umpire20

I've been on Active Surveillance for Gleason 6 since diagnosis Nov06. Good luck! - Jim

TB2G profile image
TB2G in reply to Umpire20

Jim, how much has your psa score gone up in that time frame?

aceace12 profile image
aceace12

good luck .. very similair to me.. had MRI in Nov targeted biopsy in Dec .. Seen doctor last friday .. good results .... im staying on AS till next MRI in 2025...PSA avery 3 months ..

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