Information on perineum biopsies please

Biopsy by perineum (between scrotum and anus) is a direct way to access the prostate. It has an advantage of reaching areas of the prostate that are not as easily accessed by trans rectal biopsies. I have a friend who had several inconclusive biopsies TRUS style and a persistently rising psa and the perineal biopsy found the cancer. The cost should be comparable between the two methods.
As to insurance coverage you should ask your insurer and perhaps your local urologist if this is covered.
I assume here that you have no other connection to Ireland than the workplace of your daughter.

Tud gave you some excellent advice. If you are going to travel then travel to see the best, like dr Grimm in Seattle or Dr Moran in Chicago or Dr Sylvester in Fla. All have long and excellent track records and are considered the best in the field.
The perineum biopsy is done under sedation and costs are quite a bit more than a normal transrectal biopsy. As Tud suggested an MP-MRI would most likely give you more information and is less invasive.

The standard TRUS biopsy is first considered by insurance unless there is a very good reason to go to the mapping biopsy at a higher cost. Your urologist here will have to wage that fight for you. Most certainly the brachytherapy in Ireland will not be covered by insurance here.

Having had brachytherapy I also suggest that the best are in the states and will be covered by your insurance. Additionally I suggest you look at Dr Frank Critz at Radiation Centers of Georgia in Atlanta, website is www.prostrcision.com. He pioneered adjuvant seed brachytherapy and external beam radiation and is now publishing 20 year results. Also look at Dr Jeffrey Demanes, the pioneer of High Dose Rate Brachytherapy that does not leave the radiation in the body. He heads up the radiation center at the UCLA Medical Center. The website is www.cetmc.com.

In your shoes I would get the biopsy, determine what treatment is best, get it covered by insurance and then take the $25,000 or so you save and go to Ireland on vacation rather than treatment.

Have fun.

Jack

UCLA also does MP MRI

T3 means 3 Tesla. It is the magnetic field strength of the machine - the higher, the better the resolution. Most MRIs are 1.5T, so 3T is pretty good.

MP-MRI (multiparametric MRI) means that the machine scans several times, looking at a different parameter each time. Those parameters can show metabolic, fluid flow, tracer diffusion and density characteristic of a tumor and are pretty sensitive to higher grade tumors. Resolution is better with a higher Tesla machine. It may also be improved with an endorectal coil. It requires a really excellent radiologist.

- Allen

kukukajoo,
It's probably not very relevant for you. It's useful mostly when there is suspicion of undiagnosed PC, for biopsy guidance, and for men on Active Surveillance. There are other kinds of imaging better at finding mets. A normal full body technetium bone scan is a good starting point when PSA is high.

- Allen

How old are you? Considering a gs of 6 and relatively low PSA you might want to consider as until if ever things get worse

It does and I feel your pain. IMHO the technology isnt quite there yet to give you and a whole lot of us those kinds of answers w the needed precision to make a clinical decision. Another blog I read regularly is prost8blog.com. The author is a well respected Rad Onc who has well thought out opinions about prostate issues. Prostate cancer is a difficult animal to predict- hell the experts cant even gain consensus on whether to screen or not and if you do what is the cutoff and then biospy or imaging to get a diagnosis and if positive use a Gleason score that was developed in the 1960 and then modified in 2005. Then you start to discuss treatments. Best of luck!