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11.16 PSA, two negative biopsies, queued up for a third
Prostate Cancer | Last Active: May 25 7:36am | Replies (26)Comment receiving replies
Quick follow-up on this. Third prostate biopsy conducted. 2/19. Results came back 2/23 as follows:
1. PROSTATE, LEFT LATERAL BASE, CORE BIOPSY:
- BENIGN PROSTATE TISSUE
2. PROSTATE, LEFT MEDIAL BASE, CORE BIOPSY:
- BENIGN PROSTATE TISSUE.
3. PROSTATE, LEFT LATERAL MID, CORE BIOPSY:
- BENIGN PROSTATE TISSUE.
4. PROSTATE, LEFT MEDIAL MID, CORE BIOPSY:-
- BENIGN PROSTATE TISSUE.
5. PROSTATE, LEFT LATERAL APEX, CORE BIOPSY
- BENIGN PROSTATE TISSUE.
6. PROSTATE, LEFT MEDIAL APEX, CORE BIOPSY:
- BENIGN PROSTATE TISSUE.
7. PROSTATE, RIGHT LATERAL BASE, CORE BIOPSY:
- PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3 +
4 = 7 (GRADE GROUP 2), INVOLVING APPROXIMATELY
50% OF THE FRAGMENTED TISSUE. APPROXIMATELY
10% GLEASON PATTERN 4. PERINEURAL INVASION IS IDENTIFIED.
8. PROSTATE, RIGHT MEDIAL BASE, CORE BIOPSY:
- BENIGN PROSTATE TISSUE AND SEMINAL VESICLE.
9. PROSTATE, RIGHT LATERAL MID, CORE BIOPSY:
- PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3 +
4 = 7 (GRADE GROUP 2), INVOLVING APPROXIMATELY
30% OF THE FRAGMENTED TISSUE. APPROXIMATELY
20% GLEASON PATTERN 4.
10. PROSTATE, RIGHT MEDIAL MID, CORE BIOPSY:
- BENIGN PROSTATE TISSUE AND SEMINAL VESICLE.
11. PROSTATE, RIGHT LATERAL APEX, CORE BIOPSY:
- BENIGN PROSTATE TISSUE.
12. PROSTATE, RIGHT MEDIAL APEX, CORE BIOPSY:
- BENIGN PROSTATE TISSUE.
Three biopsies - one per year and new doctor was able to provide some relief.
Next steps.
Recommend Orgovyx for 30 days while I get a PET-Scan (March 13) then discuss a treatment plan. Doctor says all options are on the table but highly recommends HIFU given age and health.
I do plan to get a second and perhaps third opinion post pet scan, nevertheless has anyone done HIFU? Thoughts ?
Replies to "Quick follow-up on this. Third prostate biopsy conducted. 2/19. Results came back 2/23 as follows: 1...."
@ma740988 As others have suggested, don't take Orgovyx before you do a PSMA PET scan. You need that scan to work as best as possible and Orgovyx will suppress your testosterone and resulting PSA that the tracer fluid in the scan relies on. The fact that your doctor recommends Orgovyx before having that scan is a red flag. Start seeking more opinions right now. See my bio for more info.
@ma740988 It seems odd to me that he would put you on Orgovyx right off the bat…
Yes, you need treatment, but without the PSMA you don’t know at this point if there’s any spread.
He could be overly cautious at this point, but as others have pointed out, you DON’T want to lower your PSA before the PET scan…weird
Phil
So out of 12 biopsy samples on your third biopsy, you had 2 that were 3+4, and of the two, one had 10% Gleason 4 and the other 20% Gleason 4. Favorable intermediate (7). You've had 3 biopsies total, probably 36 biopsy samples, and only 2 are 3+4. You are a candidate for active surveillance and/or remediation. One step above 3+3 which many doctors don't consider cancer at all. If you were a 7 unfavorable, or worse, the decision would be easier. The fact that there is some cancer present warrants a Pet Scan, which is more information in making a decision based on data.
Get a second opinion about hormone therapy based on your biopsy results before starting. It seems excessive for a intermediate favorable and has some very undesirable side effects. Get the Pet Scan to see if there is any cancer outside your prostrate. Before making any decision on radiation or surgery, get a second opinion on the two biopsy samples from a reputable pathologist. You have a higher PSA, but PSA doesn't confirm cancer, only biopsy can do that. Your results are favorable intermediate, you have time to make smart decisions. Good luck.
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@ma740988
Your case is great illustration of why yearly biopsy is important with suspected cancer. Now you caught it in time *high five, and you have MANY options for treatment and very successful one at that ! : )))
I agree with Jeff, ADT before scan might effect PSMA scan , so double check with your doctor what his thoughts are about that.
I would also suggest from personal experience (which was not good at the beginning), that you always seek a second opinion and now that you need a treatment go to the best possible cancer center in your area that offers all those different options and works with cancer patients exclusively.
Wishing you all the best : ))) and complete eradication of PC in very near future ! I know that hearing those words that C is there are frightening - try to keep in mind that you discovered it very early and that you have a great chance of getting rid of it for good .