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Posted 8/31/2014 3:47 AM (GMT 0)
Thanks so much for all of you who provided me with very valuable suggestions. I met my urologist and asked him for a second opinion for my biopsy report. Another pathologist from another center thinks that I have ASAP on one core. I have three questions and would like to get some help and advice from you.

1.ASAP (Atypical Small Acinar Proliferation). I read from online articles all stating that if someone has ASAP finding in his first biopsy, he will have 50% chance of being found cancer in the second biopsy. My question is if ASAP is so pre-cancerous, why the other 50% could not be found to have cancer in their second biopsy?

2. PSA density. My last PSA is 4.3 and my prostate volume is 12.4, thus my PSA density is very high, which is .35. Does anyone know the value of PSA density? Does it mean that the higher, the worse like total PSA? I read somewhere saying that greater .15 is bad. But I also read some else saying that below .40 is okay, between .40 to 1.0 is bad, and above 1.0 is terribly bad. Anyone else has read something like that? Does PSA density predict aggressiveness of prostate cancer?

3. My urologist left me a messaging saying that I need to do a second biopsy. I have not called him yet since I want to make up my mind first on what to do. Does anyone know how long should I wait for the second biopsy? I read some articles saying 3 or 6 months, but some articles saying 4-6 weeks. I am concerned because I just had biopsy 5 weeks ago, and I don't think my wound on my prostate is totally healed. Do I need to wait a little longer time to do a second biopsy?

Thanks all
Posted 8/31/2014 11:45 AM (GMT 0)
I don’t know much about the frequency of doing another biopsy; but I'd definitely speak to another URO and get a second opinion. I did ask a second URO when I was diagnosed and he confirmed the findings.

All the best.

.
Posted 8/31/2014 11:50 AM (GMT 0)
You have an extremely small prostate since so called normal can be twice that size at its upper limit of normal. That may be skewing your PDA density with respect to any rule of thumb on %'s.

It never hurts to have a second urologists' Opinions.

This is first I have ever heard of ASAP, so no comment on that.

LupronJim
Posted 8/31/2014 2:35 PM (GMT 0)
I will only answer the third question and it is only my opinion. Unless you have some other significant change such as rapidly elevating PSA levels, I would not have a second biopsy for at least a year and more likely 2 years.

Biopsies are not risk-free procedures. They always cause some stress on the body, the mind and the prostate. You've just had one that has come up negative - If it were me I would be celebrating not asking to have another one.

I would suggest checking out the following:

http://ornishspectrum.com/video/cancer/
Posted 9/1/2014 2:12 PM (GMT 0)
Asian Man,
Sometimes the worst answer is "I don't know." Given you low prostae volume and nearly normal PSA, I would get a second opinion before I submitted to another biopsy. My first and only biopsy wasn't that much fun for me. I would say you have time on your side.
George
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