tale of 2 biopsies

brian3222 said...

Surgeons are still telling me that i need to take it out

Seriously? I think if I was in your situation I would be looking for another doctor. What's he going to say if he cuts your prostate out and still finds no cancer? Oops? BTW, that has been reported on this site several times over that past few years. Not a pretty picture.

I would recommend that you find a doctor who is experienced in AS protocol and will do appropriate follow up exams/tests as needed so that you can either continue with AS indefinitely or get treatment when it is necessary.

Jim

My Biopsy from Aug of 2014 gleason 6 , the cores that had cancer read:

Adenocarcinoma 3+3=6 One of one core: 10% Core 9

Adenocarcinoma 3+3=6 One of one core less than 10% Core 10

That was it.
Yea I know surgeons like to remove things, it's like going to a Ford dealer and asking if One should buy a Ford.

So I am having a targeted MRI/biopsy done of the suspicious area in a coupld of weeks. The doc finnaly called me back.

What does MPMRI mean?
thanks

brian3222 said...
Adenocarcinoma 3+3=6 One of one core: 10% Core 9
Adenocarcinoma 3+3=6 One of one core less than 10% Core 10....

That's one of the lower scores I recall seeing here. Many posters here would consider that a great Active Surveillance score.

brian3222 said...

What does MPMRI mean?

All MRI's are not created equal.

Multiparametric MRI, 3 Tesla is the one that has highest resolution, and is basically 3D. It requires either a rectal coil, and/or an apron, with diffusion weighted imaging and is usually enhanced for the last ten or so minutes. The gadolinium enhancement basically should show increased blood where cancer is present.

Mp MRI is what will be used to determine a target for a targeted biopsy.

While biopsy is the standard for determining the presence of cancer - 3T, Mp MRI, with enhancement has a 89% negative predictive value.

Reading and grading pathology of prostate specimens is subjective, as is reading and interpreting mpMRI scans. Thus, to me it was imperative that Dr. Epstein look at my 6 cores of PCa and Dr. Busch in Chattanooga review my mpMRI. As a result my 3 cores of 3+4's were changed to 6's, and since my first scan, done at U. of Miami and reviewed by Joe Busch I now endure the inconvenience of travelling to Tennessee for my last two because I drank the Joe Busch koolaid. He might be the best at reading mp MRI scans of the prostate and he will sit you down in front of the monitor and spend an hour with you as if he had nothing else on his agenda that day. And when you leave his lab you will have had a long drink of the koolaid too, I guarantee it.

I'm in my 15th month of AS and it is mainly because of these two men, and from what I've learned since my D-day will not hesitate to jump up on the soapbox and urge men like you to do three vitally important things after the their diagnosis: get a second opinion, get it/them from the best you can find, and take charge of your fate by researching this disease. That includes forums like this which are packed with stories and advice from those who have "walked the walk". It is an education you'll forever be grateful for.

Sounds like you've started and are on the right path despite some head scratching parts of your reports. Good luck on your journey.

I certainly don't know how you could come to that assumption after reading my post. Nothing could be further from the truth. So I'm going to assume that was sarcasm.

Wonderful news Brian. So glad you found this site and decided to go on AS. Best wishes for continued health.
Beth n Gary