My 1st Transperineal MRI Fusion Biopsy results were NEGATIVE . TThis was clearly in conflict with my MRI PI-RADS 5 result , whereby with RADS 5 your likelyhood of cancer , following a biopsy, is around 98 %
My 2nd Biopsy ( 16 core - 6 in the target area ) came back showing ALL 6 cores in the same target area as Biopsy # 1 as Gleason 3 + 3 = 6 . The remaining cores were negative .
Which one is correct ? This drove me to a 2nd and 3rd opinion of the Gleason 6 score .
The 2nd Opinion came back upgrading all 6 cores to Gleason 3 + 4 = 7
The 3rd Opinion came back : 4 Cores Gleason 6 2 Cores Gleason 3 + 4 = 7
If you have read Dr. Patrick Walsh's book : " Guide to Surviving Prostate Cancer " and other world leading Urologists , they recommend a 2nd or 3rd opiniion . Clearly your treatment options depend on the accuracy of your Gleason Score . My 2 Urologists , One at the Princess Margaret Hospital in Toronto , ranked in the top five cancer Research & Treatment Cancers in the world , plus my other Urologist , The Head of Urology at a similar leading hospital in Toronto recommended Active Survelliance .
Active surveillance recommends regular PSA tests every 3 months , and depending on the results , later to every 6 months . Plus a DRE and MRI at 12 to 18 months . Again depending on these results , a further Biopsy .
My age , almost 85, may well dictate my treatment options as I will decide , in consultation with my medical team , to discontinue AS .
At this juuncture I will likely select on of the Focal Therapies , NanoKnife which is fast gaining popularity worldwide ( less slower in the USA ) or TULSA- PRO . The other option on my list is MONOTHERAPY SBRT ( 5 Sessions )
Dr. Welsh's book has been mentioned in numerous posts on this , and other forums . It is a must buy to self educate new cancer patients and position them to be their own best " Cancer Advocates " .
I hope the foregoing answers your question . I could have well celebrated my 1st Biopsy results ( Negative ) and gone out and , being Irish , had a few pints of Guinness .
Recently I had a Bone & CT Scan which came back showing no metastasis .
My PSA at the point of my 1st MRI was 7.3 howeveer being on Dutasteride for 4 years , it is actually 14.6 . If you are on this BPH medication for a long time you have to double your LAB NUMBER PSA . or eventually multiply it by 2.5 times . Many GP and Urologists do not advise their patients of this important fact . Initially my increasing PSA was considered a direct result of my BPH . Additionally , which is common , my regular DRE tests were negative as my leison could not be detected by my GP or Urologist . Only via the MRI andd confirmed by the biopsy . Some people believe a PSA or MRI can confirm cancer - THEY CANNOT , ONLY A BIOPSY CAN .