Hello

Pratoman-

From what I have read I am not sure how --even after your first negative biopsy-- you can "disappear from this place". If the urologist cannot find why your PSA's are high or continue to rise we always going to be looking for the cancer. In your case it looks like they finally found it and it is "slow growing" I guess that means you can either go on AS and hope it is so slow growing you will be one of guys who dies from some other issue or you can get some from of active treatment. If you go on AS it appears that part of it will be more biopsies in the future--which seems to assume that slow growing does not always stays slow growing or there is alway a fear you still did not locate the possible fast growing cancer. No wonder I see signature blocks that show minimal cancer- the kind the studies say we all have some form of if we live long enough and no cause for worry, and still have their prostate removed. Dealing with the side affects of the chosen treatment for even a slow growing cancer seems preferable then waiting for the other shoe to drop while your prostate becomes a pin cushion and possible bad things happen because of all the biopsies. Perhaps I do not have a full grasp of AS.

I am trying to figure out the best plan of action once I finally get my GP to call me back and give me a referral to a urologist. Yes-- based upon the fact I hear nothing from my GP-- my concern about detecting any prostate cancer as early as I can is not high on his call back list. I guess it is the advertised nature of this type of cancer- it is slow growing so a few more months is not an emergency like the ones he has to deal with when seeing so many patients.

So assuming I can finally get in to see a urologist in the next few weeks and he recommends a biopsy- what type would you suggest to increase the odds I will not get a false negative as you did? Aside from the saturation biopsy it appears that any biopsy that is available at a normal urology clinic is a 12-14 sample hoping to hit pay dirt. I read about the combo MRI/probe guided but it looks like you would have to fly to a huge clinic to get one of those.

This is the only disease that I have had to deal with that you almost wish you get a positive diagnosis so you can go forward and try to deal with it. A negative result is one you almost cannot be joyful about because you cannot fully believe it means you are clean--- you are just putting off finding a positive until later. When do you actually stop looking?

Marktee. I am not sure if we have spoken before, but welcome to HW and sorry that you feel the need to be here.

A.S. would normally involve just regular blood tests every six months to keep an eye on your PSA level. Further biopsies would be required only is these tests showed that your PSA had continued to rise, that is a no brainer of course.

With regard to what biopsy you should choose. This will depend on the type that your uro clinic is able to offer. If you want to be sure to detect on the first hit (and it sounds that you do) then the TRUS biopsy is not the option that you should be looking at, as it is only about 25% accurate in detecting any cancer cells the first time round, so may have to be repeated. I think that the transperineal biopsy is the way for you to go, as it is more accurate at detecting cancer the first time round, about 95%. In both types they will use the ultrasound probe, but I honestly believe it is best to have an MRI scan first. Although this may not detect any cancer, it may show areas of the prostate that should be targeted during the biopsy.

Correct me if I am wrong, but it appears that you maybe from the UK or other country that has a free health care system. If that is the case, then referrals, appointments and results will always take much longer. The insurance based private health care system in America is far better in that respect. Yes, the waiting and the unknown are the big killer. I am going through that stage myself right now.

Hopefully when you finally get to see a uro guy all will be fine, but we will still all be here waiting for you should that not be the case.

All the very best to you on your journey.

Hi Casper-

No- although it may sound like I am in a country with social medical I am not. I live in a very small town in the mountains of North Carolina. I go to a small clinic that the majority of patients are on medicare or medicaid (well sort of like social medical). My GP is so overwhelmed by patients who have next to no income I think that is why he sort of steered me to not paying for PSA tests for a few years. I think that is also why his is talking to a urologist who is about 50 miles away rather then having me pay for a consultation-- he thinks the urologist will recommend another PSA test some months from now so why send me for another large bill.


Logo-

Yes- by all of the statistics I have many years even if we find aggressive cancer. Just would like to know so I am not crying about nothing.