MRI scan

[rojule]

Hi, I have had prostate cancer for four years now i'm 67 and in that time PSA has been around 4 to 5, I have had three biopsy's but never had an MRI scan, is this something that I should ask for?

On my last visit to the urologist I was told that he would have to beg a favour to get me on the scanner, as I have another appointment tomorrow should I insist.

[Roger2Dodger]

I certainly would. What does your Urologist mean "beg a favor" to get a scan. Doesn't make sense to me. I was diagnosed with PCa almost a year ago. I have had 2 MRI, and CT SCAN . And 2 biopsies. where do you live? A MRI in my opinion you should have had after your biopsy.

[rojule in reply to Roger2Dodger]

Hi, thanks for the quick reply, when diagnosed I lived in north Norfolk under Queen Elizabeth Hospital, now under Norwich and Norfolk Hospital.

I will let you know what happens after tomorrow'

Regards Roger.

[jimreilly]

I would ask him to please beg the favour

[telboy15]

Seems very strange to me. I will say though that a PSA of 4 or 5 is not that high, about the max 'normal' for your age. You have had a biopsy which should have shown your Gleason score. That is the important score rather than the PSA. In my case. my PSA in August 2015 was 5 (at my age of 74). A rectum exam (which you should have had also) showed a small lump on my prostate. Biopsy gave overall Gleason score of 8 (quite high), BUT MRI, CT and Bone scans were all clear. I was offered a full prostatectomy by Da Vinci keyhole robotic surgery, which I opted for, rather than radiotherapy. I had that in Nov 2015. PSA has been in recordable since (0.1).

Put simply, ask for an MRI scan although I am surprised that you appear not to have had one before, as this is normally done prior to a biopsy. Do check it out though.

Terry

[rojule]

Update on my visit to Urologist, my PSA is at 4.2 at the moment and Gleason is low grade 6, MRI not considered necessary unless figures start to rise.

So carry on with three monthly PSI and six monthly check ups.

Thanks all for advice.

[telboy15]

Seems that all is well then. Gleason of 6 and PSA of just 4.2 sounds pretty good to me.

Terry

[cfrees1]

The MRI is mostly used to determine if the cancer has escaped the prostate capsule and try to locate mets. My entirely ignorant speculation would be that your doctor is confident that the cancer is still within the capsule so an MRI is not necessary. You can ask him this directly though, to try to understand his thought process. I never understand why our doctors are not more open about "how" they make their decisions, what factors are they considering? what determines when they would suggest a step or not? As you can tell, I drive my urologist crazy with questions.

[MelbourneDavid in reply to cfrees1]

cfrees1, the MRI is also valuable for identifying the size and location of cancer within the prostate and finding any significant lesions that a Trans-rectal biopsy has missed. Neither is able to find 100% of all cancerous lesions but for unexplained rise of PSA an MRI is very valuable.

[MelbourneDavid]

With your PSA stable and fairly low, there is no reason to think there is any undetected cancer, so your urologists position is reasonable.