Anyone against multiple biopsy’s for low grade prostate cancer?

It is my understanding that the risk of spreading the cancer outside the prostate with multiple biopsies is NOT a zero risk. I did not get a direct answer to that question.

In the original poster's case, unless there is a clear spike in the PSA, the risk of doing another biopsy far outweighs the reward. His brother's claim about incontinence and impotence seems a bit of a stretch imo.

That is the problem with PSA testing however ...so many unnecessary biopsies. Just my opinion and I know everyone won't agree but raising the cut-off to a number between 6 and 10 makes a lot of sense to me.

Is there any evidence that 4 is the most appropriate number to use? I would love to read that report. Why aren't we privy to that original document when those numbers were ordained?

I would avoid additional biopsies unless there is a new spike in PSA.

Remember -- the biopsy needle pulls out a bit of tissue for examination. Can it release some malignant cells into the bloodstream as it's withdrawn ?? Don't mess with unnecessary disturbances to a tumor.

My long story, short. I had a biopsy after increasing PSA results last Fall (one 3-3 found). Before committing to active surveillance, I had a scan which showed a “shadow” which led to another computer-guided biopsy finding five spots including one 3-4 and another 4-3 for a game changer in my mind. After a full body scan and bone scan came back negative, I had a RALP two days ago. I wanted the chance to get the cancer out of my body. Had I stopped with the first biopsy, well, who knows.

As said here often, we all have to find and follow our own paths that are influenced by our age, numbers, spread, potential spread, etc. What works for me might not for you and vice-versa. Gather as much info/data as you can, talk to as many people with experiences as you can find, make a decision and, as my friend on here, Michael, encouraged me leading up to my RALP, don’t second guess yourself.

I wish you the best of luck with whatever path you choose.

My urologist told me that there is no evidence indicating a biopsy can spread the cancer.

I had my biopsies done transperinial at Mayo Jacksonville. I think about 20 were taken. My urologist wanted to do it via rectal because I have heart failure but I did not what it done that way per my worry about infections. Had to have my heart failure doctor state having anesthesia was not a problem and could tolerate it.

From all the research and consultations the findings from a biopsies are the gold standard of accurately finding out if you have cancer or not. It is important to have an experienced urologist do it. Asked how many done, how done, etc. In past they used to randomly do biopsies throughout prostrate and take a chance of finding the cancer. But biopsies have changed and mine used a MRI/Fusion to do them.

My oncologist/radiologist however treated my entire prostrate. His reasoning did not want to take a chance that biopsies missed an area that had cancer. Had 30 rounds of proton pencil beam radiation treatments at UFPTI.

I would highly recommend a Decipher test done. They use the biopsies already taken you do not have to have another biopsy done. It is a genetic test that can more accurately give a risk of metastasizing. Mine changed from intermediate to low risk. The facility that does Decipher will work with you on paying for it if you insurance will not cover. They will charge you based on your income. In my case Medicare covered the Decipher test as well as my secondary insurance.

I wish I hadn't done active surveillance. The doctor dropped the cancer bomb and I should've gotten 2nd opinion right away. I probably would have gotten radiation right away, I delayed ,my 2nd doctor says I could still be a candidate, but it this time very concerned and had robotic surgery.

Biopsy doesn't spread cancer, great question. How about multiple Biopsy now exposing cells to oxygen, does oxygen make cells grow ?

@batsam10
Your Gleason score is low. But your PSA level you gave is not low. It is above the higher limit of 4.0. 4.0 is the highest number for being considered normal. Now many things can cause a PSA to rise and it not be cancer.

Just to give you my experience I too was having my PSA go up steadily. My PSA was 3.75 considered normal but my PCP did not like the continued rise in numbers ove the years and referred me to my urolgoist who also did not like the continued rise and ordered MRI with contrast. That test revealed suspicious areas, biopsies revealed Gleason Score 3+4=7 and diagnosed with prostate cancer.

I mentioned this because just having a PSA under normal or just above normal does not mean do not have cancer. Ever single medical provider I see (Mayo and UFHPTI) all stress it is the continued rise of PSA that can be indicators for further diagnosis. Some individuals will have higher than normal PSAs and not have cancer and of course just like me can have it with PSA under normal.

Did they offer you a Decipher test? That test does not require another biopsy, they use the same biopsies. The Decipher will confirm or change the risk level you were given from the biopsies. I had it done and went from intermediate to low risk. I am not sure that is viable now since yours was done back in 2022.

I am not a medical professionals so my comments are just my experience and what I have been told by my doctors. You mentioned PCP advising another biopsy. Are you seeing a urologist? If not would surely recommend seeing one and getting a urologist opinion.

Also consider second opinion. If you can try to go to a major medical provider. Even check with them and see if you can do a second opinion by sharing your medical records. It will help you deal with what you should do. What you do should be what is best for you. Decide that from your research, your present doctors and as I suggested a second opinion.

I will not try to advise about biopsies and the possiblity of causing cancer to spread. That would be something to discuss with your urologist and also explore by doing research at major medical providers.