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Where are all the people on Active Surveillance (AS)?
Prostate Cancer | Last Active: 9 hours ago | Replies (23)Comment receiving replies
Did anybody on AS here do an MRI and how did those results impact the biopsy decision?
Replies to "Did anybody on AS here do an MRI and how did those results impact the biopsy..."
@ezupcic Yes, my PSA had risen to 7.8, which triggered my GP to schedule a visit with an urologist. My urologist indicated that the next step would to obtain a mpMRI....IMHO a mpMRI is an absolute MUST before submitting to any type of prostate biopsy.
In my case, the mpMRI found three lesions, one PIRADS 3, one PIRADS 4, one PIRADS 5. This triggered a targeted TRUS biopsy. I had a 21 core biopsy, which included the standard 12-core systematic portion.
It turned out the PIRADS 3 lesion was benign and the PIRAD 4 and PIRADS 5 lesions were 3+3, involving 5% of the specimen. The strange thing (at least in my mind) was that the systematic portion of the biopsy found 5 additional low volume cores (3 with 3+3 and 2 with 3+4)...not sure if these additional cores also sampled the mpMRI identified lesions or whether they were from lesions that the mpMRI missed or were just too small to see..
The deciding factor regarding treatment was the Decipher GRID report (attached), which recommended AS, based on their clinical-genomic model...my urologist agreed...I started my "aggressive AS protocol" immediately.
A 12 month mpMRI follow-up indicated that the original PIRADS 3 and PIRADS 4 lesions were no longer visible and the PIRADS 5 lesion had shrunk and it's T2/DWI signals were dropped from "moderate" to "mild" and my post-biopsy PSA levels have averaged ~25% lower than my prebiopsy level. I continue to apply my "aggressive AS" protocol.
All the best!
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@ezupcic
Yes. I was AS for 16 months and my psa went up a bit on my annual physical. I advised my urologist office and they were somewhat dismissive in a small rise. I asked for a psa early (by 6 months) and that indicated a rise. I then asked for my MRI early (by about 6 months) and that indicated pi-rads 4. I asked for an appointment with my urologist who immediately scheduled a perineal biopsy and the results showed progression and cribriform. I am gleason 7 now and starting SBRT (5 sessions with ADT for 6 months) Be your own advocate. Waiting for anything is a waste of time.