Second tumour on mpMRI

[Aussieguy1]

Just received my MpMRI results over the phone from my urologist.

I stated in previous posts I have been monitored on Active Surveillance for Gleason 6 prostate cancer since March 2019. Most recent PSA 6.7.

In March of 2021 no changes in MpMRI. PIRADS 4. Tumour located in left apex contained within prostate. Had grown by a minuscule 0.3mm, to 4.3mm.

Now Decembers 2021 MpMRI indicates this same tumour to be 8mm and another has grown in the left mid zone of my prostate which is also 8 mm and also rated PIRADS 4. This particular tumour has never shown up on any 3 previous MpMRI. Could a tumour really grow to 8mm since March 2021 to December 2021 that has not being detected before and be considered slow growing? Plus could my original tumour in the left apex that has been consistently 4mm grow another 4mm in that time? If slow growing Gleason 6 this seems rapid to me?

I am awaiting another biopsy but due to Covid long delays in our healthcare system here. I’m trying not to be concerned but as I say seems like quick growth, I realise that without the biopsy I have no idea of the score or grade but could this indicate a higher grade tumour with this new presenting tumour, and the sudden growth of the existing one graded at Gleason 6?

Any answers for me going forward, or just sit tight and await second biopsy which should have occurred at 12 months post diagnosis but has been held up also due to Covid and our public health care system here in Australia.

Thanks for any insight. I understand a little about what’s going on but not enough.

Sorry long post.

Aussieguy1 - Ian.

[Tall_Allen]

Tumor size from mpMRI is very problematic. My guess, is that a different radiologist might read it differently. As you correctly say, GS6 is slow-growing, and if the purported increase in size is not coincident with the same kind of increase in PSA, it is of dubious significance. You will only know for sure from a biopsy. If Decipher is available there, that might make you more comfortable with waiting.

[Aussieguy1 in reply to Tall_Allen]

Thanks Tall_Allen for your response. Yes the report was done in a new radiology centre and read by a different radiologist then previously, due to the move to a different state.

I will sit tight and await the biopsy, all paperwork has been submitted, just awaiting the call.

I agree about obtaining genetic testing, I will research this and discuss it with my urologist. There is a family history of prostate cancer, both father and older brother. Also a history of breast cancer.

Thanks again, you are a person of immense empathy and help so many people on this sight.

[Leeaussie5]

I feel for you. You don’t say where you are. Right now, outside of WA, dealing with the health system must be really hard. And there is so much that isn’t covered by Medicare. I don’t have a lot to add, other than best wishes.

[Aussieguy1 in reply to Leeaussie5]

Thanks Leeaussie5 for your best wishes.

Yes Medicare has its great points, but your always out of pocket for prostate MRI. Unfortunately my GP doesn’t bulk bill and of course your upfront for the urologist. I believe the Pet Scans are pretty costly as well.

I was stupid and dropped my private health cover due to cost and are reliant on the public system and as you know it’s under immense pressure dealing with COVID, I feel for all the healthcare workers and also for the people awaiting elective surgery and procedures. But to be honest the public health care system was in trouble before COVID. COVID has just heightened the pressure. I have friends with prostate cancer who have accessed their superannuation and paid up front for biopsies and surgery, but it is many thousands of dollars.

I live in a very small rural town in South Australia. My specialist is 2.5 hours away in Adelaide, Telehealth has been great. My GP is only 25 minutes down the road.

Thanks for reaching out and your kind words. I will sit tight and await the call up for the biopsy which will be performed in Adelaide. Hopefully the wait won’t be to much longer. But the urologist tells me it could be 6 to 12 months. First biopsy I was a Category 1, no such luck this time Category 2, so I won’t be holding my breath.

You take care. Best wishes to you as well.