Post Prostate Biopsy

Hi Davie
My husband had tinges of blood in his urine for up to 2 weeks after his biopsy. No fever or infection for him either. Morton or nsaids can cause prolonged bleeding. If anything needed for pain or discomfort he was instructed to only take Tylenol.

Blood in your urine and ejaculate can last 2 weeks or more. Like anything like this, if you're really worried, call your Urologist's office.

Please post your results when you get them. We can help translate.

My fluids were off in color for a month. It’s normal, just go with the flow, so to speak.

davie,

Here's what to look for and ask about....

Your results will be given as Gleason scores, and it will be two numbers that are added together. The first number is the dominant cell type, and the second is the secondary type. A pathologist looks under the microscope and tries to match what he/she sees with some defined appearances. The lowest score they report is a Gleason pattern 3, up to pattern five. So, you might get a score of 3+3+6--which is the lowest cancer score, up to Gleason 5+5=10, which is the worst possible.

The seriously most important things to do at that time are to (a) don't schedule surgery right then. Remember two basic things: Urologists are surgeons, and they like to do surgery. There are other options. If you have a G6, ask about Active Surveillance: basically, they don't do anything, and keep an eye on it--maybe for years. A lot of G6's never change.

Second thing to do, if you get a cancer diagnosis, is to ask for a 2nd opinion on your slides.

The nice thing is, that prostate cancer is generally slow growing, and it rarely needs immediate treatment. You have time to decide what to do about it. Like I said, there are options, and we can help you sort them out.

The important things to ask: (assuming you get a positive biopsy result) 1. How many positive cores do I have? 2. Where are they in the gland? (the gland is usually divided into 4 quadrants), 3. What are my Gleason scores? 4. Is Active Surveillance an option? 5. Can you refer me to a Radiation specialist?--this is important--Radiation therapy is an option for all cases, and even if you decide to go for surgery, getting informed about all the options is very, very important.

Thank you all for your informative input!

Here is my results from biopsy:

Left Lateral base = Benign Prostatic Tissue
Left Lateral Middle = Benign Prostatic Tissue
Left Lateral Apex = Benign Prostatic Tissue
Left Base = Benign Prostatic Tissue
Left Middle = Benign Prostatic Tissue
Left Apex = Benign Prostatic Tissue
Right Base = Benign Prostatic Tissue
Right middle = Minute Focus of Atypical Small Acinar Proliferation, Suspicion for Adenocarcinoma
Right Apex = Benign Prostatic Tissue
Right Lateral Base = Benign Prostatic Tissue
Right Lateral Middle = Benign Prostatic Tissue
Right Lateral Apex = Benign Prostatic Tissue

Doc told me that he suggested that he would like to have a second biopsy to clear out the suspicious Right Middle .

Anyone have any advises or susggests are welcome.

Thanks

Post Edited (davie1803) : 11/22/2022 2:41:20 PM (GMT-8)

According to the Doctor he said will wait for complete heal and he wants another 12, i did asked him about target only that area, but he insisted that another set of 12 to make sure, he didn't mentioned anything about order PSA test. He was talking some time end of December or early January.
Btw i have shockwave procedure to remove kidney stone on Dec 12th with the same Uro Doc

Post Edited (davie1803) : 11/21/2022 10:16:57 PM (GMT-8)

Thank you Mumbo for your informative and advises!
How do i go about to get a second biopsy opinion?
My goofy PSA might be caused by prostate inflamed from biking alot (40 miles a day, 3 days a weeks, and Doc told me blood in my urine could be cause by Kidney stone)
Is it posibility second biopsy confirm the cancer?
What is your opinion?

Thank you Mumbo,

I am going to look into the second opinion and the link you given, I am not sure my PPO insurance will pay for this but i can always login to my insurance and check.
Since all these ordeals, i haven't do much bike ride and haven't have a chance to get through another PSA test yet, the main thing i have to do right now to get rid of the stone in my kidney it has been giving me a dull pain regularly during the day.
I recently spent alot of time read through all the journey stories here in this forum and have learn alot and i have pretty much in my mind which treatment i will be choosing if diagnosed with PCa.
I am now open for any kind of suggests and advise from wonderful and knowledgeable peoples here in this forum
Thanks all

Post Edited (davie1803) : 11/22/2022 12:58:41 PM (GMT-8)

A second opinion is definitely warranted. First, you want another opinion on whatever this suspicious area is. Secondly, you want another opinion on all the other slides judged "benign". If it does turn out that there are one or two G6 lesions, yes, AS would likely be an option. I suggest you ask that all your biopsy slides be sent to Dr. Jonathan Epstein at Johns Hopkins. He is a world-renown expert in prostate pathology and is regularly sent slides for review. He said in an interview that he likes to get all slides, because he sometimes find things that other pathologists have missed in the slides originally judged to show only healthy tissue.

Whenever your next biopsy is, you want it to be either a 12-core (minimum) systematic biopsy, or, if you have an MRI and suspicious targets are identified, then it should be a targeted + systematic biopsy, where 2 or 3 cores are taken for each target lesion, and the other prostate zones are usually sampled with 1 core each.

Djin

davie1803 said...
what is the percentage rate of Minute Focus of Atypical Small Acinar Proliferation, Suspicion for Adenocarcinoma (ASAP) to be cancer do you know?

Sorry, I have no idea.

Mumbo said...
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3242985/

Web searching can find almost anything….

Thank you so much Mumbo!

halbert said...
davie,

I'm going to point out that you have much to be thankful for:

While you have an elevated PSA, any cancer you have is very, very minor. You're not in need of anything immediate on that front. Yes, getting a second opinion is a good idea, as is a follow up MRI and likely an MRI guided biopsy in the potential problem area.

Here's the thing about PSA: it's easy to get hung up on it--but it is emphatically NOT a cancer test. At least not in your state of condition. For those of us who are post-treatment, it is what we keep an eye on to see if the beast is coming back. Pre-treatment, it's like the 'check engine' light on your car. Something might be happening..but who knows what?

Someone else mentioned other things that can cause PSA to spike. Here's a few on the list:

* Riding a bike, particularly one with a narrow saddle
* ANY form of sexual release
* Having a digital rectal exam (yes, there are doctors who will do the DRE before the blood draw, then get all worried if your PSA is elevated)
* Infection. Prostatitis is usually a very low symptom situation, but it can cause your PSA to jump around a LOT.

Cancer is usually characterized by slow, steady rises of PSA over a period of years. Mine roughly doubled year over year until it got high enough to move from "we need to watch this" to "you need to go see a urologist".

So, before your next PSA, wait at least a month for your biopsy to completely heal, and be gentle to your prostate for 48 hours before the blood draw.

Thank you for the educational info you and everyone here, I've learned a lot and thankful for all the suggests and inputs.
Just wanted to be wishing everyone a happy, healthy and peaceful Thanksgiving!!!

Post Edited (davie1803) : 11/23/2022 6:44:17 PM (GMT-8)