This is just for those who received a Pi-Rads 5 score from your recent MRI. I too received this score, and after my targeted biopsy, it turns out that my gleason score was a 3 + 3. As for the biopsy, this was easy, I just followed all their instructions. I hardly felt the sedative needle that they inserted into the prostate through the rectum. As for the 16 cores they took, no pain whatsoever. I did request and got a velum pill and took it one hour before the procedure, this helped ME, deal with the anxiety. Hope this helps those going through this.
Another excellent video as it fits my present situation. 3+4, one core on the targeted biopsies being 1mm of grade 4. Do not know how many cores were taken on the targeted biopsies. Going to go for active surveillance.
My MRI indicates a PIRAD3 result with a .7x.5cm lesion in the right apical lateral peripheral zone. I have not yet discussed this with my Urologist but want to be prepared. In your opinion, would this be an instance that we could use active surveillance? I am 70 years old.
What if the cancer material (3+4) is abutting the capsule? Is it more likely to leave the prostate than if it is further away from the capsule? Is there an increased risk based on where the cancer is within the prostate?
That is a very good question since a frequent MRI descriptor of a lesion is ‘abutting the capsule”. And that often leads to questions regarding ECE (even if there is less than 5% of 4 in one or two cores). And I don’t know if PSMA scans are sensitive enough to detect ECE.
...good morning...can you help me understand these numbers...I need to decide whether to do active surveillance or to proceed with IMRT and SpaceOar gel injection with 45 treatments...here are my numbers of 6 cores submitted,... 5 cores were 3+3= 6, with 50% to 70% tissue submitted grade group 1,... I had one core 3+4=7, 70% tissue submitted 20% pattern 4 disease...any help or advice you can give me or even an alternative approach to dealing with this will be greatly appreciated...thank you in advance...
The Doc said that if you have a 10-20% amount of grade 4, the risk of it spreading in the next 10 years, may be only 10-15%, but you as an individual don't know if you'll be in the 10-15% group, or the 80-90% group. So it depends on your age, and risk tolerance. I'll be 73 in August. My value is 5% of one of the biopsies, and even I am wrestling with it. I might stick with active surveillance, or not. If I decide not to, I'm going to have the prostate removed....the hell with radiation. At the age of 72, pushing 73 I'd be very likely to have the prostate removed, due to the 20% pattern you noted. Everyone's situation is different. I don't know what you should do, because my situation is likely very different. I think the most important question I have for you is...how old are you?
I have always thought of radiation as something that causes cancer point does getting radiation treatment, such as the implants, etc., have a chance of exacerbating the cancer that’s already in your prostate? Can it cause a new cancer?
Very unimpressed by MRIs. Had two now with first a PIRADS 4 and nothing. detected in the target area and. even worse just had another with PIRADS 4 with one core of 3+3 but not in the target area and PIRADS 5 where no malignancy at all was found on biopsy, which was targeted and fusion, and involved 42 core samples [I'm surprised there's any prostate is left]. all this caused huge anxiety between the MRI results and the biopsy results. The best I can think of is that this was a less than competent radiologist.
There is a large variation between radiologists when it comes to reading prostate MRI, so that is possible, but sometimes--even with good radiologists--there are confounding elements that make it difficult or even impossible to tell whether what they are seeing is cancerous or not, which is why the PI-RADs system works like a gradient and why biopsies are still needed to look at the tissue directly under a microscope. There may be a difference of opinion, though, on whether a random biopsy is necessary if a targeted biopsy is negative; 42 cores, for example, are a lot more cores that are normally taken, even for random biopsies, which use 12-14 cores. "Saturation biopsies" which take 42 or more samples have been used with doctors and patients who want to be especially thorough; however, they have become less common since the advent of MRI. MRI of the prostate has a higher negative predictive value than the random 12-14 core random biopsy, which was the standard procedure before the advent of MRI, and MRI 'usually' allows for a targeted biopsy which requires fewer cores and thus has fewer risks than taking a large number of samples. There is a certain percentage of people (maybe 5%-15%) for whom MRI does not necessarily shed light on their situation because it misses a clinically significant cancer or because it detects something as likely cancerous that is not. If you have any questions, we have patient advocates who are trained to provide information relevant to a person's case. Feel free to contact us at pcri.org/helpline.
Pirads dont mean much until biopsied.. I'm surprised 1 and 2 Pirads are not biopsies given how off biopsies can be on higer pirads.. BHP can mimic high pirads.
What?? Watch more of these videos. The view of Dr Scholz is that this may almost be treated as not cancer at all as I understand it. The usual treatment now is to put patients in this position on Active Surveillance, which is what happened with me. So unless there are factors you don't mention, I'm very surprised he should recommend hormone therapy. It has awful side effects. My advice is contact the peri helpline. I hope this helps.
If you wanna curve ball, 6 of my cores are benign 3 are 3+3 and nothing over 10%, 2 are 3+ 4 nothing over 10% and the last one 3+4 80% and 30% is gleason 4..which disqualifies me for AS ..I think..because my DNA profile said no aggressive cancer and no cribaform morphology present..
![“อาร์ต พศุตม์” เกือบเอี่ยวทุกคดีดัง เอ๊ะไว้ก่อน ไม่มีอะไรได้มาง่ายๆ | แฉ 16 ต.ค. 67 [2/3] | GMM25](http://i.ytimg.com/vi/0Gx-0-kUBv8/mqdefault.jpg)
This is just for those who received a Pi-Rads 5 score from your recent MRI. I too received this score, and after my targeted biopsy, it turns out that my gleason score was a 3 + 3. As for the biopsy, this was easy, I just followed all their instructions. I hardly felt the sedative needle that they inserted into the prostate through the rectum. As for the 16 cores they took, no pain whatsoever. I did request and got a velum pill and took it one hour before the procedure, this helped ME, deal with the anxiety. Hope this helps those going through this.
Tell plz the result of biopsy was what. ? Also what's the treatment if someone has a positive biopsy?
Excellent information.I’m on active surveillance, awaiting genetic results.
Brilliant video, everything i needed to know being on active surveillance!👍🙏
Had a 2 Pi rad and that's RAD!!!! So stoked!
Another excellent video as it fits my present situation. 3+4, one core on the targeted biopsies being 1mm of grade 4. Do not know how many cores were taken on the targeted biopsies. Going to go for active surveillance.
My MRI indicates a PIRAD3 result with a .7x.5cm lesion in the right apical lateral peripheral zone. I have not yet discussed this with my Urologist but want to be prepared. In your opinion, would this be an instance that we could use active surveillance? I am 70 years old.
I have a Gleason 3+3 with low volume in 4 of the 12 cores. However, the Decipher came back with high risk. Why wouldn't the Gleason have been higher?
What if the cancer material (3+4) is abutting the capsule? Is it more likely to leave the prostate than if it is further away from the capsule? Is there an increased risk based on where the cancer is within the prostate?
That is a very good question since a frequent MRI descriptor of a lesion is ‘abutting the capsule”. And that often leads to questions regarding ECE (even if there is less than 5% of 4 in one or two cores).
And I don’t know if PSMA scans are sensitive enough to detect ECE.
...good morning...can you help me understand these numbers...I need to decide whether to do active surveillance or to proceed with IMRT and SpaceOar gel injection with 45 treatments...here are my numbers of 6 cores submitted,... 5 cores were 3+3= 6, with 50% to 70% tissue submitted grade group 1,... I had one core 3+4=7, 70% tissue submitted 20% pattern 4 disease...any help or advice you can give me or even an alternative approach to dealing with this will be greatly appreciated...thank you in advance...
The Doc said that if you have a 10-20% amount of grade 4, the risk of it spreading in the next 10 years, may be only 10-15%, but you as an individual don't know if you'll be in the 10-15% group, or the 80-90% group.
So it depends on your age, and risk tolerance. I'll be 73 in August. My value is 5% of one of the biopsies, and even I am wrestling with it. I might stick with active surveillance, or not. If I decide not to, I'm going to have the prostate removed....the hell with radiation. At the age of 72, pushing 73 I'd be very likely to have the prostate removed, due to the 20% pattern you noted.
Everyone's situation is different. I don't know what you should do, because my situation is likely very different. I think the most important question I have for you is...how old are you?
I have always thought of radiation as something that causes cancer point does getting radiation treatment, such as the implants, etc., have a chance of exacerbating the cancer that’s already in your prostate? Can it cause a new cancer?
Very unimpressed by MRIs. Had two now with first a PIRADS 4 and nothing. detected in the target area and. even worse just had another with PIRADS 4 with one core of 3+3 but not in the target area and PIRADS 5 where no malignancy at all was found on biopsy, which was targeted and fusion, and involved 42 core samples [I'm surprised there's any prostate is left]. all this caused huge anxiety between the MRI results and the biopsy results. The best I can think of is that this was a less than competent radiologist.
There is a large variation between radiologists when it comes to reading prostate MRI, so that is possible, but sometimes--even with good radiologists--there are confounding elements that make it difficult or even impossible to tell whether what they are seeing is cancerous or not, which is why the PI-RADs system works like a gradient and why biopsies are still needed to look at the tissue directly under a microscope. There may be a difference of opinion, though, on whether a random biopsy is necessary if a targeted biopsy is negative; 42 cores, for example, are a lot more cores that are normally taken, even for random biopsies, which use 12-14 cores. "Saturation biopsies" which take 42 or more samples have been used with doctors and patients who want to be especially thorough; however, they have become less common since the advent of MRI.
MRI of the prostate has a higher negative predictive value than the random 12-14 core random biopsy, which was the standard procedure before the advent of MRI, and MRI 'usually' allows for a targeted biopsy which requires fewer cores and thus has fewer risks than taking a large number of samples. There is a certain percentage of people (maybe 5%-15%) for whom MRI does not necessarily shed light on their situation because it misses a clinically significant cancer or because it detects something as likely cancerous that is not.
If you have any questions, we have patient advocates who are trained to provide information relevant to a person's case. Feel free to contact us at pcri.org/helpline.
Pirads dont mean much until biopsied.. I'm surprised 1 and 2 Pirads are not biopsies given how off biopsies can be on higer pirads.. BHP can mimic high pirads.
I have 3=3 stage 1 my doctor wants to put me on casodex is that an accepted treatment for 6 cancer
What?? Watch more of these videos. The view of Dr Scholz is that this may almost be treated as not cancer at all as I understand it. The usual treatment now is to put patients in this position on Active Surveillance, which is what happened with me. So unless there are factors you don't mention, I'm very surprised he should recommend hormone therapy. It has awful side effects. My advice is contact the peri helpline. I hope this helps.
I had RP to remove the gland with lynph node disection.. i prefer to deal with erectile disfunction for a few years that have cancer in my body.
If you wanna curve ball, 6 of my cores are benign 3 are 3+3 and nothing over 10%, 2 are 3+ 4 nothing over 10% and the last one 3+4 80% and 30% is gleason 4..which disqualifies me for AS ..I think..because my DNA profile said no aggressive cancer and no cribaform morphology present..
@@justdoesntaddup8620 Wow so so sorry to hear that, 21 is quite excessive , happy you made it through your ordeal, and thank you for your concern
@@justdoesntaddup8620 yes my 2nd opinion came from the world class Johnathan Epstein
@@justdoesntaddup8620 yes my 2nd opinion came from the world class Johnathan Epstein
@@RH-xd3nx I had 42 core samples taken, only 3 positive low risk
I agree 21 is alot in one test I thought 14 was bad he says 2 extra is tolerable