Wow... Got the biopsy results today

Leah77 said...
I am starting to wonder if my husbands biopsy missed the target. I asked the dr and he said that happens about 15-20% of the time . They did 3 cores of the target, only one was positive.

The way to avoid this problem is to have the biopsy performed in the MRI machine by the same expert radiologist who analyzed the MRI images and identified suspicious areas. This allows the expert to actually verify the placement of the needles in the suspicious areas in live MRI images.

Fusion biopsy is a misguided strategy that allows the urologist office to remain the center of attention (and revenue). This is not the solution to the challenge of maximizing biopsy accuracy.

Mumbo said...
BOB - Are you sure this is possible with an MRI assuming metal tools are used?

So called "in-bore MRI" biopsy is not speculation. You have to seek it out, and perhaps pay extra. Having a high PSA at age 70, I was covered by MEDICARE and my MEDIGAP PLAN F, and paid nothing.

Mumbo said...
Coverage/cost of newer procedures is another issue. The MRI guided biopsies were hard to get covered not too long back from what I have heard and RALP had a similar problem at one time. Good to hear that Medicare appears to cover it.

My earlier comments were addressed only to the question of what it takes to achieve an accurate biopsy. Money talks in all things medical. Most people don't get the best available diagnosis and treatment.

Unfortunately, the widespread adoption of fusion biopsy has become an obstacle to people being informed of a better method. If people choose not to spend for the better method, that is one thing. If they are not given the information that it is a choice, that is another thing.

MEDICARE covers what is "medically indicated". In this case, the combination of my particulars, and somebody's opinion. The first opinion comes from a front-line doctor. If that front-line doctor is a urologist invested in fusion biopsy, what will his opinion be?

Please go slow. There have been men on this forum, and I don't think I'm being overly dramatic, who have been near suicidal because they had a dx very much like your husbands, were rushed into RP surgery, and had very serious, life altering side effects. In the case of G6 PCa, the cure can actually be worse than the disease. I was in your husband's shoes 5 years ago and I am so glad I opted for AS. Please see my stats below. They tell a very interesting story.

Every situation is different. I'm just saying you should slow way down, do a lot of research, and make the decision that is right for you.