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Transrectal Ultrasound Guided Prostate Biopsy
Prostate Cancer | Last Active: 14 hours ago | Replies (11)Comment receiving replies
It has been over a year since you posted this - hope you are doing OK!
I just put-off scheduled ultrasound-guided needle biopsy following MRI that showed "lesion" that Urologist "didn't like the looks of". My concern: the need/lack of discussion of alternative follow-ups based on possible biopsy outcomes.
What if it finds nothing? "Lesion" is still there - does this kick-off a round of future "surveillance" biopsies?
What if it finds non-metastatic cancer? More aggressive surveillance? What kinds of treatment would be proposed?
What if it does find cancer like yours? What kind of treatment are you having?
Thanks to any/all who respond - I am going further to look for answers to the above questions before I take the jab(s).
BTW: I just had a 2.2 cm bladder stone removed and am recovering quite quickly - don't want to mess-up my recovery from that by rushing-into the biopsy...
Replies to "It has been over a year since you posted this - hope you are doing OK!..."
Hi. I had 31 sessions of radiation to the pelvic lymph basin since writing my post and just finished 1 year of ADT; ORGOVYX and abiraterone. First 6 months were a breeze. The second 6 mos was brutal. My PSA has been undetectable since starting ADT and I hope to stay in remission without ADT.
I’ll make some comments here and also PM you with my contact info in case you want to have a conversation about your situation.
My first biopsy was ultrasound guided (not MRI guided) and totally missed high risk cancer that clearly appeared on the MRI that started everything. The result was I was misdiagnosed and under treated resulting in the cancer breaching the prostate capsule, becoming locally metastatic and requiring tough surgery, radiation and 6 months of ADT misery. The bottom line to me is that you want the best biopsy to get the most accurate results to get the best treatment. Don’t settle for less! Good luck!
My 2 cents...given the range of possible findings from a biopsy, it's not reasonable to expect a full accounting of the decision tree/algorithm which will follow. E.g., # of positive "cores". Location. Gleason score of each. Associated path findings like perineural, cribiform. DECIPHER score. Second opinion on biopsy findings (get one!). PSA history, including amount, rate of increase. Size of prostate. Etc. etc.
Then there are the treatment possibilities, which are multiple even given identical findings. Along with your (and your partner's) feelings and beliefs.
Without the actual biopsy findings, it's not possible to have a fully informed discussion of what YOUR specific treatment plan should be. Otherwise you'd just be talking about population-based statistics which might not apply to your individual case.
Get the biopsy first, then talk to prostate cancer specialists in urologic surgery, radiation oncology, and medical oncology.
You'll discover there is no one right answer for any given set of findings.
I also have had 2 bladder stones removed by laser zapping. Hardest part of recovery was return of urination. Prostate biopsy was much easier...
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OK, found this link - weird Dr.-to-Dr. (I think) discussion but some significant detail I will have to study a bit more:
https://www.prostatecancerpatientvoices.com/patient-journeys/in-conversation-dr-arnold-bullock-dr-eric-kim
That took me to another website from Urologist practice in Nevada(?) it has a videotaped discussion about biopsy Dx that is a little rushed and hard to follow but it DOES touch on the issues I raised - here's the link to THAT one:
https://prostatecancerpatientvoices.com/diagnosis/understanding-your-results/videos/a-clinicians-perspective-dr-zachary-klaassen#
I have more research to do - hope this helps someone!