Dr. Mark Scholz: Active Surveillance protocol ???

Prostate Cancer Biopsy for Active Surveillance
by Dr. Mark Scholz

Hi All....

I've had some really good input from the members of this forum about having a repeat biopsy on AS when my MPmri is the same as last year. One 3+3 small tumor.

Just curious...I did some research on Dr. Scholz and many PC patients say he is one of the leading oncologists in the country specializing in pc diagnosis.

Virtually all the input I got from this forum agreed that a first year repeat biopsy is pretty much standard for any good AS program.

Yet Dr. Scholz says that if there is no change in the Mpmri and PSA is stable there is no need for a followup biopsy.

Just playing devils advocate here. I have read many glowing reviews of his work and diagnosis....and expensive but informative phone consultations.

Wondering if he has the data to back up his AS program and how successful he actually is at being able to monitor low grade PC cancer accurately with only utilizing imaging...until something shows up.


"Dr. Mark Scholz believes that men on active surveillance for prostate cancer can avoid having yearly biopsies if their doctors use imaging studies instead.
many are asking why can’t we do imaging studies instead of biopsies? The answer it seems to me is mostly well, we just have not done it that way. We have always done it the other way and that’s what we are comfortable with doing it the way we’ve always done it. That’s the doctor is speaking, of course, and about a million men are getting biopsied every year. So there is an existing business plan that men get regular biopsies as a part of monitoring.

However, I don’t ascribe to that anymore. "

http://www.prostatecancerlive.com/monitoring-prostate-cancer-active-surveillance/

Color me curious!

Post Edited (fuzzboxman) : 5/28/2017 8:58:28 PM (GMT-6)

Fuzzboxman,

PCa treatments, including AS continue to evolve at a rapid rate, thanks to forward thinking of doctors like Dr. Scholz. Ten years ago very few guys choose AS, today it is the norm for many lower grade PCa patients.

Also, diagnostic imaging technologies that were unavailable just a few years ago, are now mainstream. As theses trends continue to grow you will see more progressive doctors tweaking existing protocols ...... to the benefit of their patients.

I'd go with what Dr. Scholz's recommends.

I find it odd that Dr. Scholz AS program seems to used by a many men on AS who are very happy using this protocol.

Yet he has not published any data or studies of the actual success rates or how often the Mpmri alone led to a misdiagnosis.

I know the uro/medical community is very slow to change protocols...but if image only surveillance has a valid track record why wouldn't at least some more doctors be using it.

Also what about the members of this forum who have had negative Mpmri show positive results upon biopsy?

Could it be errors in reading the MPmri?

And Dr. Scholz does not even recommend the one repeat biopsy after the first year....which is mandatory in most every other AS program.

Studies show that the Mpmri can be wrong up to 20% of the time.
Yet some say its 93% accurate.

Its confusing to say the least!