HealingWell
Search Close Search
☰

First biopsy positive, second was negative

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 11/1/2017 2:49 AM (GMT 0)
My first biopsy done in May of this year indicated PC Gleason 3+4. 12 cores
My doctor recommended a second biopsy, but MD collects only 11 cores, 5 in each side and one in the center.
No cancer was detected.
It seems that the second biopsy had missed the cancerous cells. But, I do not know if this could be something that I haven't thought about.
Someone has gone through the same situation? What as the outcome?
thanks
Posted 11/1/2017 3:53 AM (GMT 0)
odd that a second biopsy was ordered. Why?

Normally you would get a second biopsy. The first found PC. Biopsies can be a bit random so not finding on the second, doesn't mean that the first PC cells detected magically went away.

You're the first one I've heard like this. Very odd.

Andrew
Posted 11/1/2017 4:14 AM (GMT 0)
This can happen..Needle biopsies only sample a very small percentage of your prostate gland..It sounds like MD uses a slightly different pattern than your first 12 core biopsy did..That MD pattern apparently missed the spot where the first biopsy found the cancer. Your original lab report will detail exactly where the positive core came from. That would be the place to look again...The good news is the cancer is still very small and localized, easy to treat and cure...
Posted 11/1/2017 1:00 PM (GMT 0)
This not unusual if only a small amount of cancer (<10 percent of a core) was found found in the previous biopsy. It has happened to me.

Often, a second biopsy is ordered if the patient is considering active surveillance, or the psa is higher than what the biopsy results found.

So, was PCa found in only one core? What percentage of that core was involved? Was a genomics test run against that core? What is your psa history? How old are you?

The more data that you post, the more focused our replies can be.
Posted 11/1/2017 3:58 PM (GMT 0)
I am 56 years-old.
I was ordered a second biopsy because I only have two cores identified with cancer in the first one.
One core was 3+4 and the other 3+3.
Doctors believed that with the low PSA (2016=2.5, Apr2017 = 3.3, May2017 = 4.34, July2017 = 3.8, Oct2017 = 3.1) and small amount of cancer, active surveillance would be appropriate, despite Gleason 7 was identified in the first biopsy.
MD Anderson used the 11-core biopsy based on statistics of actual biopsies made after radical prostectomy.
Posted 11/1/2017 4:25 PM (GMT 0)
CURE,

Did your Dr. tell you that at your young age of 56 that the PSA numbers you indicate are low?

When my husabnd was DX at age 53 his PSA was 4-5 and was told he should be almost undetectable.
Good luck in choosing your treatment options.

BOOGEE
Posted 11/1/2017 5:16 PM (GMT 0)
Hello Cure:

Yes, it's entirely possible that the second biopsy missed any cancer. But, AS does seem like a reasonable choice give the results of both biopsies. Nevertheless, if I were you I would get both sets of biopsy slides re-read by an expert pathologist like Dr. Epstein at Hohns Hopkins. Going forward it seems reasonable to be sure about those readings and Dr. Epstein is the best. Reading those slides is an art and you want to have an artist do it.

Jim
Posted 11/1/2017 5:26 PM (GMT 0)
Biopsies are like sticking a needle into a blueberry muffin. Sometimes you get blueberry and sometimes you get muffin.

I agree with Jim's comment above about getting a second read on the biopsy slides, specifically from Johns Hopkins. If you are inclined to Active Surveillance, this would be the first part of getting the data you need.

Good luck to you!
Posted 11/4/2017 11:26 PM (GMT 0)
Thank you Jim and Michael.

My first biopsy slides were checked by two pathologists. One from Methodist and the other one from MDAnderson. I did not have a second option in my second biopsy slides. I have to go in person to Johns Hopkin. As we there is no option for opinion from distance for patients in some States, and one of them being Texas.

I am really in a gray zone of little cancer but of intermediate risk.
Posted 11/5/2017 10:28 AM (GMT 0)
I had similar numbers and would suggest a Decipher or other genomics test to see the metastasis probability. With 3+4 you are on the riskier side of AS. My decipher pushed me over the edge to get treatment. Good luck. One concern I would have is thinking the second biopsy cancels the first, it does not the 3+4 is still there. Denis
Posted 11/5/2017 11:14 AM (GMT 0)
Curesearch, it's not all that unusual to have this happen. The reason is that PC is multi-focal, which means that there is no one single tumor, but several tumors spread out throughout the gland. Biopsy is hit or miss...and it's not all that unusual to have a total miss.

That being said, with the 3+4 you're in the "you're going to have to treat this eventually" group. Maybe not in the next month or two...but in all likelyhood treatment is in your future.

For now, if you're at MDA, that's as good as it gets. Gather information about all the options (surgical, radiation) and make a thoughtful considered decision.
✚ New Topic ✚ Reply