AS Protocol - Recent MRI

[Hope4Happiness]

Hi Folks,

I was diagnosed with G6 PCa in August 2017 after a biopsy at MSKCC (2 of 14 cores -- 1% and 3%). I just had my scheduled MRI this week -- here are the results:

-- 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!

[Tall_Allen]

You can take Proscar or Avodart for the BPH

[Hope4Happiness in reply to Tall_Allen]

Hello Allen -- I was hoping I could get some insight from you.

Because of this observation on the recent MRI:

"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."

MSKCC is recommending a MRI-guided biopsy before the end of 2019.

I'm a bit depressed about that because not only would this be my seventh biopsy, but I just had my confirmation biopsy in April 2018. My original G6 diagnosis came from a biopsy in August 2017.

I understand that with a "more focal" lesion appearing since my last MRI in June 2017, that the biopsy is warranted, but... I'm concerned just how much "biopsying" my prostate can or should take? Seven biopsies in 10 years seems a bit much to me, and I'm just wondering if there is any long-term damage from all these biopsies?

Thanks very much in advance for any comments.

[Tall_Allen in reply to Hope4Happiness]

I'm not a big fan of multiple biopsies either. And PIRADS 3 is a mild suspicion. There is a test called CONFIRM MDX of the old biopsy tissue that checks for genomic alterations characteristic of PC, even when there is no Gleason score. You can ask for that - I don't know the cost. If you get a biopsy, you can ask them to restrict it to 4 cores from the suspicious area.

[Hope4Happiness in reply to Tall_Allen]

Thanks so much for your response -- your insights are exceptionally helpful!