Dr. Andrew Chellakumar Fenn
Radiation Oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I just recently had magnetic resonance imaging (MRI). I wanted to get your opinion on it. I am a 52-year-old with a genetic father who died of prostate cancer. My prostate specific antigen (PSA) scores have ranged from as high as 3 to as low as 2 in the past couple of years. My most recent PSA test was about a month ago and showed a reading of 2. I have been experiencing pain in the scrotum area, which my doctor suspects are due to central pain syndrome (CPS) without infection. I have found relief through pelvic exercises and quercetin. I had an MRI today and won't see the doctor until later in the week. About a year ago, I also had a free PSA reading of 29. Could you please provide your opinion on my MRI and your findings?
Hi,
Welcome to icliniq.com. I understand your concern. I will get back to you. I am unable to open the files you attached. I have asked for technical support. In the meanwhile, if you could resend the files or re-attach them, as well as contact support, it would be a great help. Sorry for the inconvenience.
Patient's Query
Hi doctor,
Thanky you for the reply.
Hi,
Welcome back to icliniq.com. I had a chance to go through the images. As I am a cancer physician, I do not usually review prostate MRI (magnetic resonance imaging) images unless it is biopsy-proven prostate cancer. If there is a report of the MRI from the radiologist, that you could share, that would be helpful. The high PSA (prostate-specific antigen) that was recorded a year ago may be due to one of two reasons - 1. The test was done immediately after a rectal exam. 2. You had a prostatic infection, which has since resolved and your prostate specific antigen (PSA) is back to normal. As such your scrotal pain could be due to a number of causes and your urologist is probably best placed to help you with that. As of now, your symptoms do not look suspicious or suggestive of anything sinister. On the MRI, there does not seem to be anything out of the ordinary. The prostate is a little large but is probably appropriate for your age. There seem to be areas of different hypo intensity inside the prostate, probably healed infection (but I am not an expert on that; the radiologist is best placed to answer that). Please reply if you have any more queries or more information to share.
Patient's Query
Hi doctor,
Thank you for the reply. I do not have the report I was trying to get the image interpreted. I did not know the difference in fields. If you have a radiologist colleague to help interpret it would ease my tension. I am nervous because my father died of prostate cancer.
Hi,
Welcome back to icliniq.com. I am sorry I will not be able to help with that. But considering that your prostate specific antigen (PSA) is normal, I would not be too worried. As I said earlier, the jump in PSA and almost immediate return to baseline values, suggests a benign process rather than cancerous one. So I would not worry about it too much.
Patient's Query
Hi doctor,
I have a copy of the report. Can you help me interpret findings?
Hi,
Welcome back to icliniq.com. I am sorry I will not be able to help with that. But considering that your PSA is normal, I would not be too worried. As I said earlier, the jump in prostate specific antigen (PSA) and almost immediate return to baseline values, suggests a benign process rather than cancerous one. So I would not worry about it too much. The magnetic resonance imaging (MRI) seems to confirm the initial suspicion that your disease process is benign and nothing to worry about. If your PSA levels do not rise beyond 4, I do not see any reason in recommending any further course of action.
Patient's Query
Hi doctor,
Thank you for the reply. Do you think I should get yearly prostate specific antigen (PSA) and digital rectum exams?
Hi,
Welcome back to icliniq.com. Yes, it would be wise to get it done, especially considering that you have a strong family history of prostate cancer.
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Radiation Oncology
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