Going for Prostate Biopsy Tomorrow ….Looking for Opinions and Thoughts

thank you

I was in Indianapolis several years ago doing some health care consulting in the clinical laboratories at both the Veterans Admin hospital and, at another time, at Methodist Hospital. I enjoyed a couple of nice dinners at Sullivan's. I will ALWAYS go there if I am in town. One of the best steak dinners I have ever had, and in that very old-school, traditional, classy-restaurant environment.

@indyguy - trust all went well with your biopsy yesterday. Let us know how you’re doing. Hopefully you’ll have results pretty soon.

Hello,
The biopsy went pretty good and it was fast. Definitely uncomfortable but no real pain. I was surprised when it was over, the table I was on looked like a murder scene lol. I don’t know why, but I wasn’t expecting that much blood.

I have mentioned that I have a huge prostate and when the urologist came in he looked over my MRI and said “ sir you have a huge prostate “ lol. I said yes I know. He had a few more comments about the size, so I guess he was impressed with it and probably talked about me during his family dinner lol.

He talked during the biopsy and that did help. He said that with the size of my prostate and my last PSA score that my PSA Density had to be very low and the chance of any significant cancer was very low in his opinion. He said that if I was in my 70’s that he wouldn’t have even recommended the biopsy.

I was glad to hear that, but from all my reading the past few months, it seems like prostate cancer has a mind of its own. I’ll be nervously waiting for the results.

@ stldadof4 - How did your appointment go on Wednesday ?

@indyguy That's encouraging to hear. Sounds like your humongous prostate is growing in fame! Keep us posted on your results.

My appointment went well. Thanks for asking. I got passed along to a different urologist in the big group, which I knew about, and I think I like him better. He trained at Sloan Kettering and spent a lot of time talking to me and answered all of my questions very thoroughly. The first guy always seemed rushed. They are both encouraging surgery due to my age (57), but didn't feel like I had to decide right away. I let them know I wanted other opinions and to research some of the newer approaches (Tulsa Pro, etc.). He was fine with that, although he did say that insurance doesn't always cover the proton treatments since they haven't been around very long. He was also open to continued Active Surveillance (up to a year) if that's what I want to do, but explained the risks of waiting too long. It's a balance for sure.

My Decipher results should be in next week. If that affirms that I am on the "lower side of intermediate risk" (their current assumption), I am thinking of scheduling another biopsy in 6 months while I research more, but I would want transperineal next time. This guy does both, but doesn't think it makes a difference. The first guy only did transrectal, so that's what I went with. Everything I've read and heard makes me feel like transperineal is better. If the Decipher shows a higher risk level, I might be more apt to move forward with surgery sooner, but will definitely want a couple of additional opinions first.

I hope that your results turn out to be AOK. Let us know when you hear something.

@stldadof4
The transperennial biopsy can get to more parts of the prostate so it does make a difference. Maybe you can explain that to the doctor 😀😀. Arghhh!

The question is, You have one 3+4 what percentage of it was a four. A low percentage could allow you to wait six months.

Good to hear you’re getting a decipher test, That really can tell whether or not you can actually go on active surveillance for six months and get another biopsy then

@jeffmarc Everything I've read aligns with what you've said about the type of biopsy. I am glad to have this new urologist who does both. He had no problem with switching. There were 16 cores. 90% of the G7 had a tumor and 5% of that was a 4. No intraductal, cribiform, seminal vesicle invasion, EPE or ECE. (He was impressed that I knew to ask all of these things, thanks to you!) Should have decipher results next week. Really appreciate the guidance.

@indyguy - wondering if you have the results of your biopsy yet. Hopefully you were AOK, like the doc suspected!

@stldadof4
Hey,

I did get my results and luckily everything was benign.
I was so stressed out for the last 6 years regarding my prostate. I had my head in the sand and just didn’t want to deal with it.
I’m sure I will have to deal with my PSA rising for years to come. Not to mention my huge prostate lol. I might still have to have my prostate removed because of the size some day.

I am taking these results as a win today. I know some guys might seek a second opinion just to make sure everything really is benign, not me lol.
I am also aware that if I ever do a biopsy again it could come back terrible. I did schedule an appointment with my urologist for next month just to discuss my prostate size. It will be nice to just talk to him and not worry about anything being put up my butt lol.

I may just put my head in the sand for another 10 years and ignore my prostate unless I am having serious issues. It’s just too stressful for me lol.

How are you doing ? Did you get any other test results back or decide on anything yet ? So many options and opinions on what to do regarding the prostate smh. Wish it was more straightforward and easier. Not to mention having to get second opinions and traveling out of state to a COE and a lot of men paying out of pocket.

Wish it was as easy as getting your tonsils out lol.
I know whatever you decide to do will go great for you.
Please keep me updated.

@indyguy that’s awesome news!! I was hoping that’s what you’d hear. I wouldn’t worry about another opinion either based on what your dr said and your Goodyear blimp of a prostate! lol. It will be good to get checked periodically to stay on top of it without all of the worry. Very happy for you.

I’m actually doing ok. I know things could be much worse and this is early and manageable. I still don’t have my decipher results yet. If decipher shows me on the favorable side of intermediate (what my dr suspects), I think I’m going to take the next few months to explore options and then go in for a transperenial biopsy in May-June before doing anything. If things are the same, I could just continue with active surveillance, or at least I’ll be better educated about options (surgery, photon therapy, etc.). If the second biopsy is worse, I’ll take more aggressive action. Or If the current decipher results put me on the less favorable side of intermediate, I’ll take action sooner. It feels good to have a bit of a game plan.

I’m in St. Louis and Siteman Cancer Center here is apparently a COE, and they also do some of the novel things. Through my work there is a program that sets you up with Cleveland Clinic if you decide to go with surgery. Seems like they handle everything, so that’s an option too.

Thanks for the update and for checking in.