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Repeat Biopsy?

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Posted 2/2/2012 12:31 AM (GMT 0)

Hello All,

Although this is my 1st post, I don't feel like a newby since I have been monitoring this forum for almost a year.  The information found here has been very helpfull.  I have chosen AS and have a 1 year check up with my uro on 2/15.  My guess is that we will continue AS and he will suggest another biopsy.  I am thinking about delaying until evidence of rising PSA.  My goal is AS until a "magic pill" is discovered :)  Any thoughts or suggestions for additional tests is welcome. Thanks

Posted 2/2/2012 12:54 AM (GMT 0)
Welcome to the club and at the same time I'm sorry you are here.
You certainly caught you PC at an early stage. My thoughts are the 1 core that is hot I believe is at the left lower portion of the prostate right next to the neurovascular nerve bundle. I wouldn't want the PC growing into the nerves. Good luck and keep us posted.
Posted 2/2/2012 1:05 AM (GMT 0)
I agree with your guess that the doc is going to want another biopsy. It looks like you're the textbook candidate for AS. Best of luck with any tests, and I hope things hold steady for you for many years.

I don't think we've got too many AS guys hanging around here. Let us know how you make out with your tests.

Jonathan
Posted 2/2/2012 3:34 AM (GMT 0)
I had hoped for AS but my biopsy results made chose treatment now.

So you're trying to figure out if you go with the doc's biopsy recommendation or not. Tough call there - we all know about the fun that comes with that procedure but it also can give good info. Not sure what other tests would give you good info at your stage.

I'd wait and see what the doctor's argument for a biopsy is and how strongly he feels about it. He might just offer because he thinks it will make you feel better to know.

Let us know how it works out.
Posted 2/2/2012 3:54 AM (GMT 0)
Platinum,
The biggest risk of AS is biopsy sampling error. You should get another biopsy within a year to insure no error. Psa for a patient on AS should be every 3 or 4 months and doubling time and psa density monitored. Treatment would be considered if psa doubling time reduces to less than 3 years or psa density exceeds 1.5 or a biopsy shows an increase in Gleason grade or a significant increase in the amount of positive cores or the % of cancer in the cores.
I would highly recommend a color doppler ultrasound in order to establish a baseline so any growth can be easily identified. You should read "Invasion of the Prostate Snatchers" by Dr Mark Scholz as it has a very good AS monitoring protocol.
Posted 2/2/2012 5:39 AM (GMT 0)
I agree with John. I’m all for Active Surveillance when it’s appropriate, and it certainly seams appropriate for you; but you need to be “active” about it, with frequent PSA checks and regular biopsies. From the first biopsy, you know there is cancer present and it appears to be only a small amount. But that’s only based on the samples taken. Visualize it like this: a 10 foot by 10 foot room with 10 foot ceilings. Now put 12 pencils into the room … the room is your prostate and the pencils represent the biopsy cores. So there’s a lot of un-sampled territory. And PCa can be in several different areas of the prostate. I’ve read that on average there are 7 separate cancers found in the prostates of prostatectomy patients.

Hope you get good results and can continue your AS. Good luck and keep us posted.
Posted 2/2/2012 8:28 PM (GMT 0)
Platinum,

I've been on AS for about 2 years.  I changed Doctors recently to a group that actively promotes AS as well as focal therapy (along with the traditional therapies).  They do recommend repeat biopsy as part of the AS regiment along with MRI.  If the biopsy does not change after the first few then they go to just the MRI.

So, in your case, a repeat MRI is probably a good idea, even according to medical folks who are strong believers in AS.  I just had one, not much fun, but I trust what these doctors say.  I'm also thinking of trying a focal therapy and the Dr. wanted up to date info to make that decision on also.

Dave 

Posted 2/2/2012 9:16 PM (GMT 0)
Great news!  Hope we hear many years of the same boring report.  The only thing I might add is to suggest that you have your biopsy sample read by one of the experts like Epstein or Bostwick to make sure you know exactly what you have.

Tudpock (Jim)

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