First of all, welcome to the forum and best wishes for success on wherever your journey with PCA takes you. I’m not a doctor, just a two time PCa patient that was originally diagnosed incorrectly with Gleason 6, (3+3) so please don’t take my comments as medical advice. I participate on this form to inform other newly diagnosed patients about the need for the best biopsy available.

From everything I’ve read, true Gleason 6 PCa won’t develop into more aggressive cancer and can be monitored for a number of years using active surveillance. The million dollar question however is: “Can a biopsy that resulted in a Gleason 6 score be trusted to be accurate without the risk that it’s actually more serious higher grade cancer? As I understand it the gold standard for prostate biopsies today is an MRI guided fusion biopsy. Is that what you received? I’ve read that the most common prostate biopsy given, the 12 core random biopsy has historically missed up to 30% of significant adenocarcinoma resulting in under-diagnosis and under-treatment of serious disease. My insurance would not approve an MRI guided fusion biopsy and I settled for the best biopsy I could, which was a grid type perineal biopsy that attempted to sample the area at the anterior apex where a 3-Tesla MRI showed a significant PIRADS 4 lesion. We know now that the sample missed the core of the lesion and five different physicians believe that if it had been sampled appropriately, I would’ve had at least a Gleason 7 (4+3) score if not a Gleason 8 score (4 + 4) and my course of treatment should’ve been different than focal Brachytherapy that I went with. My life is forever changed as I have Stage 3 oligometastic PCa.
I had salvage RP in January, started 2 years of Orgovyx and Zytiga ADT in April and am currently in process of receiving 33 sessions of IMRT to the pelvic lymph node basin. Surviving cancer is my number one priority and helping other men avoid the same challenge ranks high with my other priorities.

You’ve got one shot to get this right the first time and I recommend that you pay attention to making certain that you can get the best biopsy possible to avoid my fate.