Can An MRI Scan Detect Prostate Problems?

Posted on Thu, 16 Feb 2017

Question: My urologist said that I have atypia(?) and recommended a MRI to see if it was cancerous, but I am very claustrophobic and there is no open MRI for prostate. So he proposed doing a focused biopsy. He had done two, the latest two years ago, for PIN, but it was OK. Is that necessary? Required? No alternatives?
And, secondarily, is there any relatively safe way to shrink the prostate so that I would not need to awake so often? He had mentioned possible medication, but I didn't understand its benefits and side effects.

I may have mis-spelled the name of the condition, but that's what it sounded like. He said something like "a-sap" and then called it "a-typia"? And said that people with it had a 40% chance of its being malignant. He wanted to do a sort of focused MRI to see, but I am very claustrophobic and there were no options for my being able to be sedated for the MRI, so he wanted to proceed with the biopsy.

Answered by Dr. Dr. P. T. Patil (39 minutes later)

Brief Answer:
Your Urologist may be suspecting you to have Cancer of Prostate

Detailed Answer:
Hello
Thanks for query .Based on what you have described the meanings of the words that your Urologist are Atypical and Asap means as soon as possible .

Based on his clinical and digital rectal examination carried out by him I guess that he is suspecting you to have Cancer of the prostate and that is the reason he has advised for MRI.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Do you have obstructive voiding symptoms like frequency for urination ,urgency ,nocturia etc suggestive of Enlarged Prostate which is very common at this age .
2) What is your PSA ?

The only definitive test to diagnose or rule out Cancer of the prostate is to do MRI guided prostate biopsy.

You can discuss with your Urologist regarding what are the clinical findings and what he is suspecting .

There is no harm in going for MRI .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (3 hours later)

The results of the PSA from yesterday won't be ready for 5 days. The PSA from last October was 2.7. The problems that I have had with urination have been mainly in the evenings. (I do go often during the day when I have had much liquid, but the evacuation is complete.) During the evenings, I tend to have to urinate 2 or 3 times, and find it helpful if I walk around a little before urinating. Is this at all helpful?
My two types of questions are: 1) is there a simple, non-invasive way of easing nighttime urination frequency? My urologist suggested two possible medications -- I can't remember their names -- that might shrink the prostate. What are they? Do they work? Are there any important side effects?
2) more pressing. Is there any other test for Atypia than biopsy? Will the PSA result be at all relevant here? Does it make sense to wait and watch? He never referred to this abnormality before, even though he did two biopsies 2 and 3 years ago to check on PIN, so how can he have discovered this? He suggested a focused MRI, but I am very claustrophobic. Are there any open MRIs for prostate? Or ones that would complete sedate me? They said there were not any, but suggested Valium. I doubt that would work for me. Is a biopsy the only other reasonable alternative now?

Will I get responses to these two detailed inquiries?

Let me ask again for responses to my previous two questions. I am at a loss as to what to do.

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
Dutasteride & Tomsulosin are drugs that can help to relieve your symptoms

Detailed Answer:
Hello
Thanks for follow up .

Looking at your previous value of PSA being 2.7 which is absolutely normal I do not find any reason to do MRI guided Biopsy of Prostate .Your symptoms of frequency and Nocturiaa can be relieved by two drugs like Dutasteride and Tomsulosin once daily .

Wait for your PSA results to come ,it will decide whether there is the need for MRI guided biopsy or not .If PSA is more than 5 the only test to rule out cancer of the prostate is MRI guided Prostate Biopsy .

Normally we do not take decision to do MRI guided biopsy only after one reading of PSA is higher .We advise Biopsy if PSA values show rising trend when done consecutively for three times at regular interval of one month..There is no harm in waiting and watching the trend of PSA .

Till then you can take Dutasteride and Tomsulosin once daily .It will help you to reduce nocturnal frequency .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (4 hours later)

Thank you for you reply.

Answered by Dr. Dr. P. T. Patil (29 minutes later)

Brief Answer:
O.K.Bye

Detailed Answer:
Hello
Thanks for follow up.

Start taking medications suggested and take a call about MRI after getting the PSA report
Thanks and Regards.
Dr.Patil.,

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar