prostate, indeterminate category, treatment?

I'm new here. I have recently had an mpMRI scan, which showed a small area classed as, "indeterminate category" - PIRADS score for nodule is 7 points. I'd be grateful to know what treatment or tests have followed such results in other people, please.

[ASAdvocate]

Can you please provide more precise detail from the MRI report?

"Indeterminate" means a PIRADS score of 3, which does not necessarily mean cancer, and usually doesn't.

But "PIRADS score for nodule is 7 points" makes no sense to me as PIRADS only goes to 5, and a nodule is something for a biopsy to sample.

IMHO, you should not be jumping ahead and asking about treatments until you have a diagnosis of prostate cancer from a biopsy. Right now, there are some details to clarify, but no reason to guess that you have prostate cancer.

[Hidden in reply to ASAdvocate]

thanks

[Tall_Allen]

A targeted biopsy + some random cores follows. PIRADS scores are 1 to 5 -- you had a 3.

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thanks

[OldTiredSailor]

PIRADS is a standardized measure radiologists use to classify tissue and cells they see on their images. PIRADS 1 means the cells they see are all "normal" and have almost no probability of being cancerous or malignant. A 2 indicates some of the cells are not quite normal and there is a slight chance some of those cells are NOT benign. A 4 means many of the cells are different than normal and there is a high probability the cells are NOT benign. A 5 means the cells are almost certainly cancerous.

Another way to look at PIRADS is the likelihood the cells/tissue/tumor will be found to be clinically significant upon a pathology exam:

1- Almost no probability the tissue is clinically significant

2- A small probability the tissue is clinically significant

3- It is not possible to assign a probability or it is equivocal

4 - High probability the tissue is clinically significant

5 - Very probability the tissue is clinically significant

In your case with a PIRADS 3, as was mine also, the radiologist saw indicators that the cells and tissues were not normal but also was not strongly indicative of a malignant or cancerous mass.

I had other indicators of prostate cancer and chose to have a robot assisted prostatectomy five-weeks after the MRI. That surgery found TWENTY times as much cancerous tissue as indicated by the MRI and found it in both lobes as opposed to just one lobe as shown by the MRI.

A lot of research has shown that about 39% of PIRADS 3 tumors are found to be G7 when removed by surgery. Mine was G7 (3+4).

My 3T mpMRI also missed the ExtraProstatic Extension (cancer cells were found outside the prostate gland) found by the pathologist post surgery. It also understated the size of the prostate by a factor of Two.

The MRI is just one more tool in the diagnostic procedure and should be recognized as possibly providing incomplete or inaccurate information. My urological oncologist did not want to place too much significance on the MRI findings. My PSA (9.2 mid-May and 10.2 mid-June), my 4KScore (34% proability of G7or greater), my Free PSA (8.4%), and PSA Density (>.55 ng/ml) ALL told him a biopsy was necessary.

[Hidden in reply to OldTiredSailor]

thanks