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Fusion biopsy

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Posted 4/26/2017 7:31 PM (GMT 0)
My husband had a fusion biopsy and just found out the results. He will be seeing urologist but want to be as informed as possible and this site is awesome.
PSA 9
Synoptic summary.
Histologic Grade: Primary Gleason Pattern: Grade 3
Secondary Gleason Pattern: Grade 4 = Total Gleason score 7
Number of cores positive: 1
Total number of cores - 6
(He has had a previous two biopsies and they couldn't find anything therefore fusion biopsy)
Total linear millimeters of carcinoma: 5 mm
Total linear millimeters of needle core tissue: 15 mm
Periprostatic fat invasion: not identified
Seminal vesicle invastion: not identified
Lymph-vascular invasion: not identified
Perineural innvaserion: not identified

Additional pathologic findings: none identified

The urologist will probably suggest prostatectomy but have any of you had any other treatments with good results such as radiation. (He is 67, rising PSA since 2013).

Thank you so much.
Posted 4/26/2017 7:38 PM (GMT 0)
Get a referral to a good RO. While surgery will work, RT such as brachy seeds, or SBRT will work too.

With that report, most of the mainline treatments will work fine.

I went with IMRT and after 5 years, it looks like they got it all.

Andrew
Posted 4/26/2017 7:50 PM (GMT 0)
Be sure to get those biopsy results confirmed by Epstein's lab at Johns Hopkins.

He has plenty of time to see specialists and make a decision. Where are you? We may be able to point you towards the kinds of specialists Andrew mentioned.
Posted 4/26/2017 8:16 PM (GMT 0)
Wilhar - with that pathology (one core of G3+4=7), most if not any of the primary therapies will have the same disease control abilities. The choice, at least for me, was driven not by disease control but by side effects profile. For me, I reasoned that if any of this list of treatments will work, I should choose the one that will leave me with side effects that I can tolerate.

Heck, some Active Surveillance programs would even accept you. At least that's what my uro opined. I chose CyberKnife SBRT, but only because that is what was "right" to me.

You have time to learn, discern, and choose the treatment whose side effects will burden you the least. Once you begin to choose a direction, come on back and we can help.
Posted 4/26/2017 9:20 PM (GMT 0)
Hello thank you for all of your support. I don't know if it makes any difference, just to add - specimen is approximately 60% Gleason 3 disease and 40% Gleason 4 disease present overall. No perineural or lyphovascular invasion. The specimens were mid anterior and basal anterior. Thanks again.
Posted 4/27/2017 1:12 AM (GMT 0)
With your husband's scores he has an excellent likelihood of being totally cured, regardless of what form of treatment is chosen. FWIW a negative biopsy allowed my cancer to grow for two years and it became "locally advanced" before my GP persuaded me to see a different Urologist and get the fusion biopsy... Your husband is quite fortunate.
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