It's been a while..

It’s been a while since posting but it seems there has been a lot going on lately. For those who haven’t seen prior posts, in May 2021 I was diagnosed with 3+3=6 Gleason score prostate cancer with no other involvement and opted for active surveillance. In August I was scheduled to have an MRI just to cross our t’s and dot all our i’s and make sure the biopsy revealed all that it could. The provider had to cancel the MRI appt last minute and pushed it out to November which was very frustrating. November came and I had the MRI and it showed a PIRADS 4 & 5 lesion, again with no other involvement all in the prostate. I decided after talking to my dr that I’d like to have radiation treatment and just take it on and hopefully get rid of it. I was able to get in to the oncologist to discuss treatment when she noticed the 4/5 lesions on the MRI were not areas shown in the original biopsy. The original dr hadn’t taken samples from all around the prostate and she wanted to see the 4/5 lesions on biopsy before any type of radiation plan was made. As frustrated as I was, I was happy she was being thorough. So here we are, almost a week ago I had a TRUS biopsy with ultrasound guidance. I have to say this was terribly uncomfortable and I wish I was given the option to be under anesthesia. I had significant bleeding with clots and pain while urinating. It got to the point I went to the ER Saturday (4 days after biopsy) and I spiked a fever and was diagnosed with sepsis. I was admitted to the hospital on Saturday and have been here since getting antibiotic treatment and treatment for the terrible pain/inflammation and discomfort from the procedure.Thankfully having a catheter seems to be helping with the pain and a CT did show everything looked good other than inflammation in the prostate/rectal area from the procedure. When I had the first biopsy done I had no bleeding, no pain really and no other issues. With this one it has been awful since she did it, it was uncomfortable then and I told her she was really jamming the probes and it was hurting. She seemed really rushed and going between multiple procedure rooms which I fear is what caused these issues. Sorry I seem to be rambling on here with information, just curious if anyone has had similar experiences with this type of biopsy procedure? Also, with having a 3+3=6 it doesn’t seem really common to have it be upgraded so quickly with ⅘ PIRADS lesions? My dr said the PIRADS are up for interpretation so she wasn’t basing thinking my biopsies will be upgrade because of those, but now I am very worried. Laying here in the hospital with all this time on my hands isn’t exactly helping my worrying about all of this, usually I’m so busy I have no time to think about it…Any input would be greatly appreciated. Thank you in advance all.

That was my understanding of PRADS as well, but after looking online (which I know isn’t always the best idea) some posts had discussed how it was sometimes an indicator of higher grade cancer being present. I have had BHP in the past so my hope is that is what’s going on and there won’t be a significant increase in my grade.

I was given 1 cipro to take prior to procedure and another to take the day after. This was the same when I had the first biopsy last May. All I can think is with this procedure she did the internal ultrasound probe then removed it and inserted the biopsy one, that’s the only difference (other than it being a different doctor performing the procedure). There was no test given for antibiotic resistance. I know it’s best they take it from the exact source, just very unfortunate how this all turned out so far. Hoping for results that are close to or the same as what they showed before. Thank you for your response.

You have been patient for two weeks, and I would make some calls around noon tomorrow to lessen the stress. Hope to hear good news when you do get them.
Michael

Thank you.

I had a similar experience with PIRADS 5 and a bilateral but only with two cores of small percentage Gleason3+3 biopsy. I had an unanimous advice to be treated and I was very much updated to a Gleason 5+3 in the path report. However, it was contained in the prostate and it has not recurred so far. I regret your biopsy side effects. Good luck.

I was considering SBRT or EBRT as single treatments, though my large prostate was a problem and the addition of HT was needed to reduce its size. Radiation is perfectly OK if you really get the teatment you need. But the problem is that, with a high PIRADS and a Gleason 3+3, you may be undertreated or overtreated, depending on the particular treatment choice and your real Gleason grade, which is never diagnosed for sure just with a biopsy. In particular, few doctors would recommend the triple combo, standard radiation treatment for high risk cases, if you have a biopsy Gleason 3+3, though the high PIRADS indicates a significant chance to have a higher real Gleason grade.