How many biopsies?

@bkizer
Can I ask how you had your biopsies? Where they done transrectal or transperineally?

If transrectal done where you given the medical advice that having it done that way carries a 1-2% increased risk of infection? Sounds low but if you read those who did get infected, they will say would have made a different decision.

This is not me as a medical professional but from my Mayo urologist.

You will see a lot of posts regarding these procedures and different opinions on discomfort ect. For me my personal choice was I wanted it done transperineally. I did not want the additional risk of infection, nor the anxiety over rectally done and discomfort.

I did have to challenge my urologist wanting to do it transrectal because of my health issues but was able to have my other doctors refute that excuse. I think the transrectal is easier. I do know if my urologist had done transrectal would have been done in an office setting where the transperineally requires anesthesia and in a surgery type setting.

TY!

Friendly reminder about the Community Guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/

See guideline number 1.
"1. Be careful about giving out medical advice
Sharing your own experience is fine, but don't tell other members what they should do."

More information about prostate biopsy from Mayo Clinic https://www.mayoclinic.org/tests-procedures/prostate-biopsy/about/pac-20384734

Yes, you’ll find that while on active surveillance having biopsies every few years is common. Recently, some have started just having MRIs every few years and then only IF there’s been a change, only then having a repeat biopsy. I’m not sure how much that’s caught on.
With a Gleason 6(3+3), I was on active surveillance from 2012-2021; during that time I had 4 transrectal biopsies. All were uneventful and I never got an infection.
With my PSA continuing to rise (to 7.976), that final biopsy showed a Gleason of 7(3+4). It was then that I had treatment (proton radiation).

My facts - Had transperineal (T) biopsy Dec 24 and my urologist recommended follow up PSA in June 25 and (T) biopsy in Dec 25......so for now just active surveillance based on last PSA June 24 4.55 and prior PSA Feb 24 7.37. Note my biopsy results were Gleason score: 3+3=6.

How did you feel about your procedure (Proton Beam)?
May I ask where your cancer was ablated? Peripheral zone? Fully functional, recommend? Did you research TulsaPro?
Thanks,
Kyle

The proton beam radiation treatments were relatively uneventful: 28 fractions; 2.5 grays/fraction; with SpaceOAR Vue just in case.
The science behind proton’s Bragg-Peak characteristics was convincing. With a great radiation team in place, I only needed to lay still on the treatment table, and enjoy the zen (and count ceiling tiles) while they did the heavy lifting.
My proton treatments were done at the University of Cincinnati proton center.
If insurance will pay for it, I’d recommend it
TulsaPro was FDA approved for the ablation of prostate tissue in late 2019. The first post-FDA-approval use of TulsaPro ablation of prostate tissue was in early-2020; TulsaPro was relatively new at the time; proton treatment had a good track record. So, TulsaPro was never seriously considered.

Thanks for the reply Brian.
You feeling 100%, functional?

I wish my husband had more biopsies. He had only 2 in span of 6 years and now we are in trouble. His first biopsy in 2019 showed 3+3 on just 2 plugs of 12 , and week ago they finally did second biopsy which showed one plug with 4+3 gleason with ductal involvement which puts him now in high risk group :(. Basically doctor dropped the ball and we missed opportunity to have local treatment and 100% cure. I am beside myself crying days and nights and blaming myself for not coming to forums like this before. We are now changing doctor, of course, but can only hope for the best. BTW, PSA was going up and down starting 2015 with 5.8 , than at one point going down to 3.5, than 4.2, 5.08 last year and now jumping to 7.5. He also had only 3 MRI with last being done 6 years after second one. I did a ton of reading in the past 7 days and now understand that he had very passive surveillance with watching mostly PSA behavior instead of active surveillance with MRIs and Biopsies every 1-3 years regardless of PSA. Now I am dying of sadness and worry. In every single mayor hospital/organization average protocol advises MRI and/or biopsy every 1 to 3 years , or even both depending of findings.

FYI; I had 12 biopsies to start- Feb. 2022. All Gleason scores 7,8,9. Thus 28 radiation treatment followed. Even had pelvic lymph nodes affected. Started ADT treatments= For 25 months. PSA Last month- < .01 . Been that way for 2 years. So I may be stopping ADT soon come Aprils s PSA results.