Biopsy Infection

"Doctor seems not concerned" would take me to a second opinion quickly. Sorry you have endured this.

The problem you have is why we try to get people to have a transperineal biopsy, to avoid the possibility of an infection. I had three different transrectal Biopsies and never had an infection, but we’ve had people in here who’ve had terrible issues with infections after transrectal biopsies.

Everyone that I have heard of that has gotten an infection has been able to recover fully. I know that at least one person had to stay in the hospital for a while because of it.

Did your biopsy find anything?

Yes 6 are cancer. Aggressive form. All on right side. Surgery May 8th for removal. Very frustrating. Doctor office called today no growth your fine. Don’t feel fine. Pet scan 4/18 read report seems to be not spread. Never heard from doctor office.

You want to know what the Gleason score is. Aggressive form can be many things that score can explain them.

Ask the doctor, or look at the biopsy results it should be listed. Was anything else found in the biopsy?

Is the same doctor doing your surgery - one that did biopsy ? If yes, I suppose he is just regular urology guy ? In that case I would strongly advise to go for second opinion to oncology urologist and to the center that specializes in prostate cancer.
Also, your infection has to resolve before surgery :(.
Please try to find somebody for second opinion ASAP , both regarding biopsy findings and regarding infection treatment. I agree with Jeff, you need to know your gleason score and how many cores were done etc.
You mention Pet scan - did you mean PSMA PET scan ?

It just doesn’t seem like you have enough information to make a decision about what to do. If you are just seeing a urologist, you must realize they are surgeons. Therefore, the answer to prostate cancer for them is surgery. You may have many more options than surgery and I think you need to see another doctor to Get a second opinion. Have You had the opportunity to talk to a radiation oncologist about treatment?

You need to be proactive you can’t let your doctor just direct what you are to do. You can get information about options here and then be more informed to make a decision Based on what more than one physician has to say. See a Genito urinary oncologist or even better go to a center of excellence like Mayo. This will give you many more options.

How old you are is a factor in what is best to do.

You really need to know that Gleason score on those cores that are cancerous. You really want to see the whole biopsy report. If you posted it here, we could take a look at it and see if there’s something in there that is especially worrying.

Do you have other cancers in the family? Have you had hereditary, genetic testing? You can get it done free at this below site as long as you live in the United States. Don’t check the box you went your doctor involved or it will delay them sending the kit until your doctor talks to them.

Prostatecancerpromise.org

Started off with very nasty results from a biopsy. Make it worthy worth it, be proactive.

If your doctor is not concerned about having an e. Coli infection, how concerned is he going to be about any other aspect of your treatment??!
As surfer and jeff both suggested, get another opinion. Don’t let the word “aggressive” make you think you have to have surgery immediately. You have time to know exactly what grade of cancer you have before jumping the gun. Not saying that surgery is not the best option, but you need a LOT more info to make an intelligent decision,
If you still don’t feel well, you could still have an infection and the very last thing you want is to have major surgery ( yes, it is major!) with bacteria floating around your bloodstream. Sepsis can be fatal.
I am sure your head is spinning from all this, but please, take a deep breath. Even IF your cancer is aggressive by universal measures (not just your surgeon’s opinion), you have plenty of time to treat it properly in a timely fashion. Best,
Phil

Good input from others on the "medicine side".

My Qs: Are you comfortable with your treating MD and your medical care to date, including communication?

If there are any questions in your mind, remember the old grade school adage "stop, look and listen".

"Stop" - or pause the path that you are following.

"Look" - broaden your scope of vision to include the possibility of other providers or 2d opinions.

"Listen" - to your head and your gut. Are you truly comfortable with the direction that you are heading?

This is your opportunity to elect primary treatment for Prostate Cancer. Be comfortable with your choice of Surgeon or Radiologist, facility and treatment before moving forward.

Best wishes.

The moral of the story: ONLY YOU are the best advocate for your health. Period. Full stop.

I sought 9 opinions from urology, radiation oncology and medical oncology before I did anything. I also research my doctors extensively, I always have, and verified that my doc was the best around to treat me based on his Da Vinci rating as well as his physician rating for treating prostate cancer specifically.

Don't rely just what you read here, on articles or even what your doctor tells you - always deep dive into every aspect and understand what absolutely everything means - Gleason's, Deciphers, Cribiforms, etc. That's the only way you are informed and can be an advocate for yourself.

Did you say that they took 24 biopsy cores transrectally? That seems to be an insane number to me. That may explain your infection risk and would be another red flag regarding your current urologist.

Ask for a copy of your biopsy report and copy it into ChatGPT or some other AI tool for interpretation or simply google the terms. As mentioned before, High risk could mean many different things, so get smart about your cancer and get an appointment dor a second opinion at a high volume center. Fly thete if necessary or drive 10 hours if there is none close to where you live. It is definitely worth it.