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Need some support for RARP Decision
Prostate Cancer | Last Active: Aug 1 9:42pm | Replies (19)Comment receiving replies
I believe the EpiSwitch (PSE) test can differentiate the PSA from benign sources and likely cancerous ones. Multiparametric MRI (mpMRI) are rated as PIRads 1, 2, 3 and not actionable; whereas 4, 5 are. It also shows other lesions' size, if any, their location as well as the overall prostate size. Then the biopsy can be more focused.
In the UK the standard of care (SOC) is Perineal biopsy. The more common one is TRUSS, through the rectum with ultrasound. The perineal approach requires general anesthesia. The TRUSS can cause infection at a 3-4% rate some of which can cause hospitalization. The perineal approach has zero or very few infections. It also gives a better view of the anterior lobe of the prostate. If the biopsies are preceded, as they should, with the mpMRI
the images can be fused with the per rectum live ultrasound (needed for both techniques: TRUSS & Perineum.
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We are in the UK, husbands 'only' lesion was 15mm PIRAD 5, only on the outer edge of the prostate, no other lesions shown by MRI. 3 biopsies were taken from the lesion only 1 came back positive, from the other random ones taken another 2 came back positive from lower down the prostate. Graded at 3+3 AS recommended even though all lesions should be referred if over 10mm and particularly in the location my husbands was. Thankfully he opted for surgery and pathology found lesion now 34mm aggressive Cribriform cancer, so luckily now has other treatment options and excellent oncologists too. We had to be transferred to another health authority to see a surgeon, so believe money is also a factor in the UK system as our health board now has to pay for his treatment in a neighbouring health Board.