Prostate cancer stage: Does it change after biopsy?

Staging prostate cancer is based on a series of tests, including the blood PSA level and prostate biopsy results, as well as imaging tests if they are done. A prostate biopsy is usually done before staging is complete.

Learn more here:
- Tests to Diagnose and Stage Prostate Cancer https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/how-diagnosed.html

@calderonda, have you had the biopsy? Has staging been completed? How are you?

Depends on what's there and what the biopsy hits (or misses).
My MRI was suspicious for PCa w/ an identified lesion.
Biopsy was more definitive with multiple cores cancerous; G 7s, 8s and 9.
Best wishes for a good biopsy result.

Hi Colleen,
Thank you for taking the time to reply. My biopsy was completed last week 4/22 and I am awaiting the results. If I understand correctly, the biopsy will complete the second half of the staging with the grading of the cancer (pathological workup)? I'm a little anxious, scared, and overall a mixed bag of emotions. I've had some physical symptoms over the past 3 years with severe fatigue so the MRI results were a sense of closure in a sense. Thanks again and I'll keep you posted.

Thank you @michaelcharles for the info! This was my fourth biopsy in 4 years. However, this was my first transperineal fusion saturation biopsy so I'm hoping they caught it. In comparison to my last MRI in 2022, my recent MRI revealed two new lesions along with possible EPE and lymph node involvement. I was batting 1.000 with the previous 3 negative biopsies but I don't know how much longer I can maintain that streak. Thanks again and struggle well!

@calderonda any update? How are you doing?

I was biopsied at 4+4. After removal, pathology downgraded it to 3+4

How many 4+4 cores did you have at biopsy and were lower grade cores present?

6 out of 12 cores were 4+4 and all were on the right side. The left side was clear.

The pathology report doesn't specific location only that the score was downgraded to 4+3 (I was mistaken when I claimed 3+4)

I had two MRI over the course of 6 years. Both were clear. I decided to have a second biopsy after the second MRI(the first biopsy showed no cancer). It came back with two cores of 14 showing cancer, one 3+4. I decided to have an RP. (I also had an enlarged prostate). Surgery went well and I had no incontinence issues. However, my pathology report showed my cancer was 4+5. Margins were clear and no lymph node concerns. I have had 5 blood tests so far and all have shown PSA at < 0.01. Hope and pray for more of the same in the future. I write to show you that all my tests came back with different results. Do whatever you have to do so you have accurate results and can make the best decision for you. Good luck🤞

Good Day Colleen,
Since the prior three biopsies were TRUS, they went the transperineal route this time around. MRI targeted with 22-cores and thankfully all were benign. The biopsy report indicated all cores were prostatic tissue. The N1 finding now leads me down another road with a abdomen/pelvis CT scheduled in a couple of weeks. The initial lymph node involvement had made sense since I have other lymph nodes in my neck and underarms acting up. With the prostate biopsy negative, I anticipate a referral to a new specialist to find the culprit of the lymph node issues. Thank you everyone for your feedback and wishing you the best! Struggle well and keep your head's up!