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Good PSA/MRI active surveillance results still require fusion biopsy?
Prostate Cancer | Last Active: Nov 26 2:56pm | Replies (31)Comment receiving replies
You are in a confusing situation. Active surveillance is used when the Gleason score is a six because that’s not really considered cancer (a doctor meeting recently trying to change the nomenclature).. The problem is at any time the tissue can become cancerous. The only way to find out is to do additional biopsies.
A high PSA alone can happen without cancer being active. I know someone who’s PSA went up to 50, he had more than one biopsy and it was never cancerous.
Some people can be on active surveillance for many years and they never get to the point where they needed to be treated for cancer. I have recently heard from someone who had their biopsy shows that they have a Gleason eight even though they had only been on active surveillance. Things can happen quickly and you want to be on top of it.
At least the fusion biopsy allows them to look in spots that are suspected of being a problem. You really don’t want to wait until your tissue becomes highly cancerous,, better to get occasional biopsies. My brother was on active surveillance for six years, then his biopsy showed he was 4+3 a Gleason 7. Time for treatment.
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jeffmarc, thanks for your reply-
Yes: "confused" is where I'm at trying to understand all this.
This progressing could require far more invasive procedures than a biopsy, but recent PSA's of 3.7 then 1.9 along with my stable/unchanged MRI after 14mos lead me to question whether wanting another biopsy regardless of the good results is an extremely conservative decision by my urologist, possibly driven by desiring protection against malpractice litigation(?) I need a better understanding of the risk rolling with current results and avoiding the biopsy -and also don't understand why other less invasive testing (free PSA, MiPS, etc) not considered first, to collaborate the good results.
Not cool with having another biopsy just to check that box when everything else indicates no advancement -unless for some reason that's justifiable regardless of my good test results.