With doctors, as with every other area of human endeavor, it is a very small percentage of the working population that is involved in advancing the boundaries of knowledge. Most working people spend...
PBH: What you want above all is for the biopsy to sample the highest grade of tumor that is present. That is what an expert in-bore biopsy achieves that typical biopsies may not. The fact that you...
Nothing said so far about input from a radiation oncologist. Don't know how it works in Canada, but I would not have surgery without hearing from the best available RO....
The trustworthyness of the MRI is only as good as the equipment, the image quality, and the expertise of the practitioner who analyzes the images. The differences in tissue appearance, based on...
Contact information (from November 2017) DRC RADIOLOGY CHATTANOOGA OUTPATIENT FACILITY Jeannie Holder 423-622-4700 option 6...
Not sure if you kept reading on the other thread. Even if you did, the nonsensical posts by logoslidat et. al. may have made you stop before you saw what I posted there. --- It is routinely advised...
You have demonstrated a determination to investigate thoroughly. Therefore, the following is offered. It is routinely advised here to receive a second opinion on biopsy results from the widely...
My earlier comments were addressed only to the question of what it takes to achieve an accurate biopsy. Money talks in all things medical. Most people don't get the best available diagnosis and...
So called "in-bore MRI" biopsy is not speculation. You have to seek it out, and perhaps pay extra. Having a high PSA at age 70, I was covered by MEDICARE and my MEDIGAP PLAN F, and paid nothing....
The way to avoid this problem is to have the biopsy performed in the MRI machine by the same expert radiologist who analyzed the MRI images and identified suspicious areas. This allows the expert to...
https://www.verywellhealth.com/is-gleason-6-prostate-cancer-really-cancer-4118536 ...
beaverduck: A partial repeat of my comment to another poster's thread: The 12+ core transrectal ultrasound biopsy was adopted as the standard approach during a time when there was no effective...
Every scan of every type, including the latest and greatest, has a size below which it cannot detect. If treatment shrinks the abnormality, it can "disappear" from subsequent imaging. Whether or not...
bbqdude: 2017 August: PSA 2.7 2018 August: PSA 4.17 2018 October: PSA 4.7 2018 October 26: biopsy Gleason 3+3 You need an explanation for this progression, and you don't have it. The latest PSA...
Not everyone can afford to travel to, and pay for, the best practitioners. For those who can, every biopsy should be MRI-guided in-bore, performed by the truly expert person who identified the...
Until a method is approved by the FDA, it is almost certain that no insurance plan would pay for it. To my knowledge, the GA68 PSMA PET scan is not yet approved in the United States. It is commonly...
There are other sources of elevated PSA besides prostate cancer. In addition, there are multiple types of equipment used for PSA sample analysis. It is known that there can be 20% variation between...
For proponents of the advanced MRI before biopsy (I am one), this is one of the positive features. The 3T multi-parametric MRI, analyzed by an expert practitioner, reveals subtle differences in cell...
JNF: Your friend does not need a urologist. He needs a truly expert diagnostic radiologist to perform and analyze a 3TESLA multi-parametric MRI. If he is near you in Georgia, I recommend that he...
It seems to be not well understood by some that a biopsy pathology report flowing from a typical transrectal ultrasound biopsy cannot possibly be an accurate definitive statement of the disease...
randyd: Surgery is only a cure for prostate cancer when the exact location of all cancer is identified, and the surgeon can remove the cancer without leaving any behind. Unfortunately for all of us,...
The bubble is not working for me as you describe. I logged off, logged back on later. An old thread had been updated, and moved to the top of the list. The bubble was gray. Right now, one cannot...
Admin: Under the old forum format, the "modified envelope" icon on the left identified threads previously read by the logged on user which had no subsequent replies added (no interest, skip). The...
richh: The 12+ core transrectal ultrasound biopsy was adopted as the standard approach during a time when there was no effective imaging method for the detection of probable prostate cancer targets...
MRI machines do not spit out pieces of paper that say "PI-RADS 5" and "BPH". These are conclusions of the doctor analyzing the MRI images, and are only as good as the expertise of the analyzing...
The fact that Ohio State University has many people making worthy efforts in the area of cancer research does not change the fact that the molecule being discussed, for which they applied for a...
Expanding/paraphrasing on what PDA said: Ohio State applied for a patent on a molecule which is not any form of Vitamin E. They started with gamma tocopherol (my Vitamin E3), and engineered...
Never having looked into this topic before, this thread motivated me to survey the large body of reading material available online. I learned the following. Vitamin E is not one thing. There are (at...
barbling4: There has been no mention of any symptoms of, or investigation for, BPH or prostatitis. You should be satisfied that neither is the cause of your elevated PSA. A more detailed history of...
barbling4: You are correct that the typical prostate biopsy procedure is not "entirely safe". I declined to undergo biopsy without prior expert imaging and analysis (3T multiparametric MRI). If your...
mentor5959: If circumstances permit, expert imaging before biopsy is the way to go. The challenge is to find practitioners who can provide truly expert imaging. Many cannot. Faced with that...
Balladeer: You are not going to find anything approaching the definition of "proof" that indicates one sequencing of brachytherapy is better than the other. Participants in this forum, including Tall...
Much of this is not new to some readers. It is verbose for the benefit of relative newcomers. With highly elevated PSA, and BPH ruled out (original post), MRI is the logical next step. But if you...
Balladeer: When I first began my research, it took a lot of careful reading to get a handle on the terminology. I did not find it to be particularly logical/helpful in some cases. Since I know that...
Balladeer: The choices: 1. The radiation triple play. 2. Systemic treatment only (some combination of hormone therapy, chemotherapy, and immunotherapy) avoiding the negative aspects of radiation...
Balladeer: Final comments The viewpoints diverge because at the current level of knowledge, so much is unknown. I am not promoting or discouraging any path. I just recognized that you are more...
Some may be wondering why high risk patients with clear abdominal CT and bone scans would be looking for additional scans. It is because the "standard of care" scans are such poor detectors of...
Balladeer: In circumstances similar to yours, I was seeking the best available scan for detection of metastases. This resolved to the ones whose descriptions include DCFPYL and GA68. These are...
The following is written as much for other interested readers as it is for the originator of this thread. Medical providers sometimes arrange things for their convenience and revenue, to the...
This forum is potentially a very good source of information and counsel from people who have already navigated the mine field of prostate cancer diagnosis and treatment. The accuracy and usefulness...
Some locations in the prostate are more difficult to biopsy than others. When the most common biopsy method (transrectal) does not allow good access to the suspicious area, an alternative method...
I went to a practice that did diagnostics only, no treatment. They were set up to provide a face-to-face meeting the same afternoon as the MRI was done. This is completely atypical. The radiologist...
The unfortunate truth is that all existing technologies fall far short of detecting all instances of cancer spreading beyond the prostate. If the MRI analysis indicates biopsy, and biopsy detects...
There is a tendency for people to think of prostate MRI as a single well-defined concept. It is not. First, there are differences in equipment. The "power" of MRI equipment is stated in TESLA units....
I elected 3T mp-MRI before biopsy. Check out Dr. Joseph Busch, Chattanooga Outpatient Center, in Tennessee....
In my opinion, your aversion to going straight to the poke-and-hope-you-happen-to-see-something TRUS biopsy represents good analysis of the situation. I elected to go with the 3T MP-MRI first,...
Newly diagnosed (details below) and investigating initial therapies. Have read very widely and deeply (beyond the rookie stage). Comfortable with detailed and complex subject matter. I observe that...