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Prostate biopsy
When I had my biopsy in 2024 they found 8% of one core with 3+3 =6 apendocarcinoms and 2% of one core that was 3+4 =7 this year my mri was unchanged but my PSA went from 6 To 11 so they did another biopsy and I only had 2% of one core that was 3+3 =6 . I have not talked to my doc yet but what are the chances that that 2% of one core could have been reevaluated as a 6 instead of a 7? The biopsy was a in guided perineal biopsy excuse my spelling p.m.
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Whatever their is, your cancer does not appear widespread if your 7 was not seen this time. It is very possible your prior reading of the 7 core was a 6. Second reviews of biopsies will often change a Gleason score on a core. I would imagine this biopsy would have covered that same area. With a clear MRI that is encouraging. Have you had a retest of your PSA. Maybe the 11 was a false reading. You can ask to have your biopsy tissue sent off for Decipher testing. Inquire with your doctor about the PSE blood test or ExoDx urine test. Those tests are usually helpful in deciding to go forward on a biopsy, but in your case can determine how aggressive cancer yours might be.
My PSA has been all over the place for years long before I had cancer I have had many useless biopsies because if it I think the highs read 48
@rice
That certainly is less usual with PSA’s that widely fluctuating. This is definitely something to stay on top of. I still think Decipher or PSE or ExoDx could be helpful.
Did they do an MRI before the biopsy? Without doing an MRI they Don’t have a target to at least evaluate. When they do an MRI you want to get a PIRADS Score on any tumors that are found. Those tumors should then be part of the biopsy and at least three cores Should come from any tumors found.
When they do a biopsy, they are only getting cores from one percent of your prostate. Pretty easy to miss something if they haven’t done an MRI first. You always want an MRI guided biopsy.
If this isn’t being done, you probably wanna move your treatment to a different place, A center of excellence.
It is true that when a tumor is found in the prostate, that may not be the only place there is cancer, that sure is the place you should start from.
@rice
A friend of ours had a huge prostate and his PSA would always be around 50. He had multiple biopsies and they never found anything. He died from a completely different type of cancer.