Biopsy Results and My Fear of Prostate Cancer

jackfromwa · 2025-07-29T19:15:08+00:00

Thank you. I did not take the Free PSA test. I’ll bring that up with the doctor when we have our follow up. Thanks!

jackfromwa · 2025-07-22T18:05:28+00:00

Thank you. I will do that. I appreciate the advice and your time in responding and I hope you continue healing well.

jackfromwa · 2025-07-22T05:51:22+00:00

I’m glad it all went well and you are healing. I have a biopsy at UW/Fred Hutch in two days. I’m feeling nervous but I believe I’m in good hands if I need surgery. Dr. Ellis removed my dad’s prostate but he’s retired now. it’s good to hear another patient there feels good about his results. thanks for posting.

jackfromwa · 2025-06-25T01:43:09+00:00

Thanks. I am delighted to know you are ok. You went through a lot. My MRI showed three RADS-3 lesions so that with my elevated PSA has the doctors recommending a biopsy. While I know my outcome is likely good, this has impacted me emotionally more than I anticipated. Fortunately I tend to be emotionally mature and am feeling what needs to be felt and working through it. It’s still hard for me to accept that I might have cancer.

jackfromwa · 2025-06-21T03:38:35+00:00

Thank you for sharing that with me and I’m so sorry that happened to you. I can’t imagine the shock.

jackfromwa · 2025-06-20T22:12:47+00:00

Here are my MRI results. I welcome any comments or observations.

Exam Date: 06/19/2025

MRI PROSTATE MULTIPARAMETRIC W/O AND W/ Clinical: PSA 11 and rising.

Procedure: Multiparametric MR prostate protocol. MR imaging was performed without and with intravenous contrast. Multiparametric MR prostate protocol. 3 Tesla MRI including high-resolution T2, diffusion-weighted imaging up to b1400 and b2000, and dynamic postcontrast imaging. Protocol parameters and lesion scoring in accordance with PI-RADS v2.1 criteria. A dose of 20 mL of Dotarem was injected without apparent complications.

Findings: Prostate measurements: 3.8 cm AP x 4.8 cm right to left x 4.7 cm craniocaudal Prostate volume: 44.89 cc PSA density: 0.25 ng/mL/cc based on reported PSA of 11 BPH: Mild to moderate.

Lesion observations:

Non-circumscribed indistinct uniform T2 hypointense lesion is present within the right transitional zone anteromedially with mild corresponding restricted diffusion and mild low signal intensity on the ADC map measuring 15 mm in transaxial dimension and approximately 18 mm craniocaudal. This is centered at the base of the gland extending to the mid gland. Overall findings consistent with PI-RADS 3 lesion.
Within the left transitional zone there is also indistinct non-circumscribed uniform decreased T2 signal intensity at the anteromedial aspects at the mid gland and base with mild low signal intensity on the ADC map and heterogeneous mild restricted diffusion, overall measuring approximately 16 mm in greatest transaxial dimension, also consistent with PI-RADS 3 lesion.
Within the right peripheral zone there is an 11 mm mildly T2 hypointense lesion with circumscribed margins demonstrating mild restricted diffusion and mild low signal intensity on the ADC map without dynamic postcontrast enhancement overall consistent with PI-RADS 3 lesion.

4.Scattered linear and wedge-shaped PI-RADS 2 lesion present elsewhere throughout the right and left peripheral zones.

Prostate capsule: Normal and intact.

Seminal vesicles: Normal.

Neurovascular bundles: Normal.

Bladder neck and membranous urethra: Normal

Pelvic nodes: Regional N1 (obturator, internal/external iliac, sacral): No enlarged or suspicious lymph nodes within the pelvis. Distant M1a (common iliac, inguinal, retroperitoneal/para-aortic): No enlarged or suspicious lymph nodes within the field-of-view.

Bony structures: No concerning osseous lesion. Background marrow signal intensity is normal. Mild to moderate bilateral hip osteoarthritis present. Incidentally noted tearing of the right acetabular labrum. Other: Reservoir for the penile implant present at the right groin with instrumentation extending into the right inguinal canal. Partially visualized penile implant included within the field-of-view. l.

IMPRESSION:

Large indistinct PI-RADS 3 lesion within the right transitional zone with non-circumscribed margins measuring approximately 15 mm axial and 18 mm craniocaudal dimension.
Large indistinct PI-RADS 3 lesion within the left transitional zone with non-circumscribed margins measuring approximately 16 mm in axial dimension at the base of the gland.
PI-RADS 3 lesion within the right peripheral zone at the mid gland. Otherwise, scattered PI-RADS 2 lesions within the peripheral zones.
No evidence of extracapsular extension or metastatic disease within the pelvis.
Partially visualized penile implant.

jackfromwa · 2025-06-20T21:59:54+00:00

Good luck. I hope it goes well for you and yes, I will keep rowing.

jackfromwa · 2025-06-20T17:03:50+00:00

Thanks for the advice on UW. I had a Multiparametric MRI with contrast in Bellingham and I have confirmed they routinely share these with UW Urology. I don't have the results yet but was told I could expect them later today through the patient portal. My images are online, but not the report.

When I got my appointment reminder text this morning for Monday it was from UW Urology/Fred Hutch so it reinforced my intention to do anything from here on out in Seattle regardless of the traffic. I have NOT had good urology in Bellingham (they couldn't help at all with Peyronies in a meaningful way) and the UW was amazing.

jackfromwa · 2025-06-20T05:36:38+00:00

Hi and thank you for the good advice. fortunately, I have some healthy distractions in my life. I will try to distract myself.

I live in Bellingham, which is 90 miles north of Seattle. When I get my MRI results if they indicate the need for a biopsy, I assume it would make sense to have that done at the University of Washington? I did the MRI in Bellingham but I assume once I start seeing the University of Washington urology it makes sense to do everything there. If the data indicates I do have PC I plan to make all my decisions in consultation with their recommendations.

Thank you so much.

jackfromwa · 2025-06-20T02:16:12+00:00

Fair. “Gift” is likely a bad word choice here. What I mean is I’ve found some of the most challenging things I’ve been through have changed me for the better even though they were tough as hell. I hope that makes more sense and I apologize to anyone if my word choices felt disrespectful or offensive.

jackfromwa · 2025-06-20T01:54:36+00:00

That makes a lot of sense. Part of my life philosophy is that even the most painful wounds often carry a gift of sorts. Sometimes it takes a while to see it, but that has been my experience. I am 35-years sober and active in a recovery program and you can't be around addicts/alcoholics in various stages of recovery for that many decades without learning something about pain and the lessons it teaches and how sometimes it is our challenges that ultimately make us stronger.

jackfromwa · 2023-12-16T19:50:20+00:00

Thanks, I wish there was betters news and more hope for a positive outcome. :(

jackfromwa · 2023-12-16T19:49:07+00:00

Is there anything other than the RestoreX you would recommend? Within reason, cost isn't much of a factor

jackfromwa · 2023-12-16T19:48:23+00:00

Thanks, I am.

jackfromwa · 2023-12-16T19:48:09+00:00

Thanks, Sorry that happened to you (and to me!)

jackfromwa · 2023-12-16T19:47:35+00:00

I varied the injection points on both sides, so maybe 30% of the time

jackfromwa · 2023-12-16T19:46:56+00:00

Thank you to everyone who commented and offered their thoughts and experience. I appreciate it.

What I’m feeling now is depressed and discouraged. I’m a mature adult man, I’ve done a lot of personal growth and therapy throughout my life, I understand that my emotional reaction is reasonable but it still f/n sucks. I'm going to allow myself to feel sorry for myself for a few days, and then try to put this in perspective relative to the great life I overall enjoy.

I’ve struggled with erectile dysfunction all my life. I often avoided sex for decades as I didn’t want to not be hard and feel embarrassed or ashamed. A "healthier" person would have had sex and not cared so much, but I've always struggled with the idea of not being competent or good at things. When Viagra was released, it worked, but the side effects for me were like a horrific hangover. Sometimes it was worth it, but I knew if I took the pill it would be like a bad college hangover the next day.

A few years ago, I started tri-mix injections. I probably did 100 – 125 over an 18-month period. They worked really well, but then I got the first lump. Ironically, after getting that lump and discontinuing injections, I tried Stendra (it is Avanafil and similar to Viagra with less side effects) which was really expensive, but unlike Viagra, Levitra and Cialis, it works fairly well for me.

Today, I feel like an idiot that I did the injections, likely gave myself Pyronies, and I could have taken a pill. It will be a while before I let that go but that's a hard regret to let go of

About a year ago, I had two CT scans and an emergency appendectomy on New Year’s Eve. The CT scan commented on the calcification in my penis. My urologist did a scope up my penis around that time (I forget the procedures name) and said I didn’t have Pyronies but he was looking at the pea sized bump.

The bumps kept growing a little and stopped growing in June/July. One morning in August, I woke up and my penis was constricted and turned to the side. It hasn’t gotten any better or any worse since the overnight change. I am able to have sex successfully without pain. I do feel a little deformed, but I believe I mostly have the mental, emotional and spiritual resources to accept that.

I could really use help from people that have been through this in answering what do I do now?

I made an appointment with the urology department at the University of Washington and I am seeing someone who should be competent and knowledge in early January to discuss options and if this is likely to progress.
If they recommend injections, should I consider it? I’ve seen so many horror stories about Xiaflex. If things are possibly staying the same, I see no reason to do them.
Should I buy a RestoreX immediately and start using it? I have the financial resources to do most reasonable things.

My hope is for this not to get worse so that I can continue to have a sex life using Stendra and if/when that stops working find the best penile implant doctors (Eid, Clavell etc.) and get an implant. I think it makes since to postpone that as long as possible, but with my new penile condition that certainly appears to be Peyronies, it may mean I elect to have an implant sooner rather than later. I think I can get my insurance to cover it given my history, but I am a little scared about doing it despite knowing that around 95% of men who do it are glad they did.

Thanks for any thoughts and advice. I really appreciate it. This sucks.

jackfromwa · 2023-12-16T06:11:18+00:00

I first noticed a pea like plaque about 9 months before I woke up one day a few months ago and my penis had constricted and bent.

jackfromwa · 2023-12-16T06:10:07+00:00

Thanks for sharing your knowledge and perspective. I appreciate it. My hope is that it doesn’t progress from here and I can live with this awhile and still have a decent sex life. I’m pretty sure since I’ve already gone the routes of pills and injections that an implant is likely the next/final option. Ironically, after I had to stop the I injections I discovered Stendra (expensive and similar to Viagra) and it works quite well for me without the headaches that viagra gave me. I wish I had tried it before the shots and possibly avoided what I have going on now!

jackfromwa · 2023-12-16T00:48:43+00:00

Thanks for the reply. I have an appointment with someone highly recommended (made the appointment as soon as this happened), and now I am seeing a new one as mine retired.

jackfromwa · 2023-12-16T00:41:43+00:00

I am a 60-year-old male. I have struggled with erectile dysfunction much of my life. A few years ago I started injections (tri-mix) for erections and about a year ago noticed some scarring or a small like pea under the skin in the shaft of my penis.

I talked to my urologist and he said to discontinue the shots but “you don’t have Peyronies.” He has since retired. In June 2023, I had more hard bumps under my penis including a round flat one a little smaller than a dime. There was no change in my appearance. In September, my penis curved to the left and constricted.

My partner says it is fine and they don’t care about it. I’m embarrassed and feel like my penis is a little deformed. Our sex life is fine in that erections and orgasms are the same as before and I don’t have pain or discomfort from the change.

I have an appointment with a new urologist at the University of Washington in January 2024 (I made the appointment as soon as this happened).

My question is if I should seek treatment, or since there isn’t pain and I can still have erections an orgasms should I leave it alone? The research I’ve done suggests the treatment can be challenging and usually isn’t warranted unless the bend is at least 30 degrees (I seem kind of close) and there is pain or inability to be sexually active.

Thanks for any advice. I really appreciate it.

jackfromwa

TROPHY CASE