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DrRussMd, Board certified internist
Category: Urology
Satisfied Customers: 64980
Experience:  In internal medicine we deal with prostate, bladder and kidney diseases, including cancers.
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I was diagnosed with 10% of one of 3 cores in the right

Customer Question

I was diagnosed with 10% of one of 3 cores in the right medial section-gleason 6 in April 2010. The urologist/oncologist suggested a "wait and see" approach. I have had PSA tests twice a year since then and they have gone up and down, lately as high as 20.5 and then down to 16 etc. I have always had high PSA since I first started when I was 50. Now I am 60. I also have had two biopsies and one MRI. When the PSA went up to as high as 20.5 I was very scared that the small cancer originally found had gotten worse. But the last biopsy in October 2014 was completely negative as well (just after the PSA of over 20) as the one before in March 2012.The MRI in July 2010 according to my urologist showed nothing. I just had another MRi this April and urologist was not optimistic and scared me. First an MRI can not definitely show cancer,only a lesion etc which may be cancer. According to this latest MRI in April it stated that the "tumour they found was a 4 which they define as probable cancer. He also thought it was a gleason 7, not 6. But my greatest fear is that this "tumour was found in the left lateral upper 1/3 posterior peripheral not like the original one they found in 2010 which was in the right lateral mid peripheral zone. So they saw no tumour in the other original zone( right lateral) but this time they found a 'tumour"stated as 4 (this hospital 's MRIs are explained differently than the other.) in the left lateral etc zone.What does all this mean? Did the cancer spread and why did the MRI not show the original carcinoma in the original biopsy in 2010 in the opposite (right zone). He says another biopsy should be done, obviously, but I am confused to say the least and extremely worried.
As with many men I have an enlarged prostate and distended urinary bladder. That is why urinating can be difficult at times.. But after in the report it stated: IMPRESSION: "suspicious nodule" in the left base peripheral zone' meaning perhaps not cancer and how did they reach a number of 4 with an MRI?So many questions and I feel I should make out my will. Maybe you can answer all these questions before I become suicidal. I suffer from anxiety and depression.
Submitted: 1 year ago.
Category: Urology
Expert:  DrRussMd replied 1 year ago.


At most it means the cancer has simply become larger.

Not sure what you mean by 4.

Need to see how that is worded in the report.

It does not say it is outside the prostate.

In this case, still curable.

Repeat biopsy at this point in mandatory.

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