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Good PSA/MRI active surveillance results still require fusion biopsy?
Prostate Cancer | Last Active: Oct 25 2:40pm | Replies (30)Comment receiving replies
oct172024,
Agreed that there is "no suitable alternative" to the biopsy, however, the investigators of this 3 year study concluded that men with negative mpMRI scans can safely omit the one-year confirmatory biopsy, BUT should still get a standard three-year biopsy.
Your urologist simply disagrees on the timing...that's his prerogative and I'm glad to hear you hold him in high regard and intend to follow his recommendation.
The good news is that there is an extremely high likelihood (at least 82% - 86% - but probably higher because of your very low PSA level) that you'll get additional confirmation from a 2nd biopsy, at this time, that nothing has changed.
BTW: What do you attribute your very low PSA level, as compared to those taken prior to your 1st biopsy? I think the PCa patient probably has a better sense of the reason(s) for their lower PSA level, in their particular case, after a PCa diagnosis.
Replies to "oct172024, Agreed that there is "no suitable alternative" to the biopsy, however, the investigators of this..."
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Good Q.
Maybe the PSA that spiked to 9 and started this journey was false/lab error.
Or maybe was inflammation-related, since that's what "lesions" on MRI's could actually be?
Also, read that dehydration can affect PSA.
If 2nd biopsy confirms no PCa, then I question the 9 PSA.
After last year's biopsy, my urologist said PSA no longer needed b/c PCa diagnosed.
Very glad that I ignored that by requesting PSA with recent blood panels, and getting the 3.7 and 1.9 results. Those results support my MRI being stable/unchanged after 14mos.
Was thinking today about a friend who's a GP that told me they don't get PSA tested. Years ago their father had a prostatectomy that messed up their life, and the GP apparently decided that something else will eventually alert them to PCa if serious enough to require treatment.
A personal decision that I found very interesting -what I was thinking today: assuming 2nd biopsy confirms "no PCa", I could have avoided all this if I also didn't have PSA tests!
Regardless, glad that I test PSA despite all the mental gymnastics/tests over the past 18mos.