MRI Area of Concern

[Mearnsmum1]

Updated post: Hi, my husband had just recently suffered a heart attack and is on blood thinners and aspirin etc. Complaining of abdominal pain and doctor discovered that his prostate was slightly enlarged, she couldn’t feel around the back of it and referred him to Urologist. His PSA came back 0.8 and his bloods were good. We paid for a private abdominal scan which showed a fatty liver and a slightly enlarged prostate., everything else was normal. The margins of the prostate were 3.4cm x 3.4cm x4.0 cm. Spoke to Urologist on phone who wanted to do an MRI to be on safe side as my husband’s sister died of breast cancer and his uncle has had prostate cancer. Urologist phoned today to say that MRI (not mpMRI) showed a 17mm lesion rated PIRADS 5 on left side and he wants my husband to come in for a biopsy. The measurements that MRI is that the prostate is 3.5mmx3.7x4.0mm. Can lesion have grown so quickly in 6 weeks? Cardio team do not want him to have biopsy at moment as it would involve coming off blood thinners for 10 days. I’m very worried for him. I’m worried that as lesion is larger and PSA is so low that his cancer will fall into the aggressive category. Has anyone had any similar experiences? Thanks you in advance.

[Tall_Allen]

An "area of concern" is just that. It does not mean prostate cancer. Significant prostate cancer (the kind worth treating) is highly unlikely at his PSA. Ask for a transperineal biopsy if his urologist does them because of lower risk of infection. Also, specifically ask for a nerve block to prevent pain.

[Mearnsmum1 in reply to Tall_Allen]

Thank you for your very reassuring reply. Have a good day.

[EJC61]

He's been through alot and an MRI as first step is a good idea before any talk of a biopsy. You don't mention his age but an enlarged prostate is certainly not unusual. The PSA number is fine. It's important to check it out since his uncle had PCa.

[Mearnsmum1 in reply to EJC61]

Thank you for your reply. My husband is 59. We’re just worried that the doctor used the term

“area of concern”and that was picked up in the MRI, hence the biopsy as a next step. The good thing is the fact that his PSA is 0.8. I was worried that aspirin and statins might lower this number artificially, but I think if they did, it wouldn’t be by much.

[EJC61 in reply to Mearnsmum1]

I’m 59 but was dx at 55. If it helps, my prostate has gotten bigger in 4 years so don’t panic.

[Mearnsmum1 in reply to EJC61]

Thank you.

[Cateydid in reply to EJC61]

BEST advice!!!! Don't panic.

[maley2711 in reply to Mearnsmum1]

Don't believe there is any straight line correlation between prostate size and probability of PCa. You might try Google...perhaps there is a correlation between statin use and PSA???

[Mearnsmum1 in reply to maley2711]

Thank you

[EJC61 in reply to maley2711]

I agree. Prostate size usually comes into play with BPH and possibly can raise PSA but it's totally seperate from PCa.

[EJC61 in reply to Mearnsmum1]

I take 162mg low dose aspirin every day. This has not come up with my uro. I will ask when I see him next month.

[Cateydid]

My Joe never had an enlarged prostate upon external exam. Only when they did a blood test was his elevated PS A identified. That was followed by a biopsy that confirmed cancer. I wish at that point we had engaged an oncologist specializing in prostate cancer rather than sticking with the urologist. urologist

He's in his 12th year post-diagnosis and prostatectomy. After additional radiation, chemo and lupron, he's had zytiga and Prednisone added to his treatment plan.

All is really well right now; He jogs, lifts weights and plays tennis. PS A is very low and he feels pretty darned good for a man with stage 4 metastatic prostate cancer!!!!

I share all this with you to offer hope. His oncologist told him he'll die with prostate cancer but likely not from it. I believe there are many more options to explore once the zytiga stops working, I count on this forum to help me sort it out when that time comes. There's a wealth of good information on this site to support you and your husband on this journey. I wish you peace and joy, praying you'll enjoy each day together.

[Mearnsmum1]

Thank you so much for your reply. I’m glad to hear that your husband continues to be so well and active. He’s a great example of the progress that’s been made in the treatment of cancer.

Re my husband I guess we’ll just have to go with the flow. Biopsy will be in a few weeks and another few weeks for results, I’m keeping my fingers crossed all will be well and if not, that it’s been caught early.

[aceace12]

PSA 0.8 ... very rare to have prostate cancer with that low number ..... i had MRI ...Docs said same thing areas of concerned .... but it was nothing .....

[Mearnsmum1 in reply to aceace12]

Thank you so much for your encouraging reply. Glad you’re well.

[Aodh]

Hi, I’ve been on 80Mg Atorvastatin and low dose aspirin daily since my heart attack in 2012. I was on 40Mg Simvastatin daily for a few years before the heart attack. Neither drug had an effect on my PSA level. I was diagnosed with high risk locally advanced prostate cancer in 2019, my PSA was in high double digits at that time. Following treatment, external beam radiation and continuous androgen deprivation therapy, my PSA remains undetectable. I have never stopped my heart drugs, they haven’t been a factor in my diagnosis or treatment. I hope that helps a little to ease your concerns.

Hugh

[Mearnsmum1 in reply to Aodh]

Thanks you very much.

[Yukonjack]

Im no expert , but he does need a Biopsy in light of things I believe ! Best of luck with things ....

[j-o-h-n]

My only advice right now is "don't panic" and see if you can have the urologist (a good one I hope) will do the biopsy under anesthesia because it's an unpleasant test. Actually insist upon it. Tell us your location and ask for any doctor references for your husband from the group.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/14/2021 7:24 PM DST

[Mearnsmum1 in reply to j-o-h-n]

Thank you John. We’re in the UK and we are allocated a consultant under the NHS, no choice in the matter I’m afraid. My husband has had an MRI (not mpMRI)and will undergo his rectal biopsy on 1st April with the results a few weeks later. We will just have to wait! But thank you.

[Mearnsmum1]

Update: Husband spoke to Urologist today. They have assigned his 17mm lesion PIRADS 5, but as I said PSA is low at 0.8. Not sure if this has made us feel better or worse. Worse I think