Prostate biopsy

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.

I tried decipher but the 7 cancer was to small to get a reading

With your previous biopsy core of 3+4=7, what % of that was a “4” cell structure? (That info will be in your biopsy report.)

Remember that a Gleason score, is a pathologist’s educated and experienced “opinion” of what he (or she) sees under a microscope - it’s often as much an art as it is a science. What one pathologist sees as a Gleason 7(3+4), another might see as a 6(3+3), and another might see as a 7(4+3); there’s simply no way to know who is right……

This is why it’s always good to get an independent 2nd opinion on any interpretation (MRI/biopsy/PET scan) requiring a medical opinion.

Yes, there is always the chance that it “…could have been reevaluated as a 6 instead of a 7”.

The first biopsy that was done over 4 years ago they graded as 3+4 =7 so had it sent off to John Hopkins for a second opinion and they came back as a 3+3=6 but my urologist at the med center still said it was a 7 then I had a second biopsy and they said that one was still a 7 then when they did this one it came back a 6 I am wondering if the med center has a new person that is grading the biopsies

Dr. Jonathon Epstein is one of the most prominent prostate pathologists. In this interview he discusses some of what he finds when he is asked to do second opinions.

@rice
Dr. Jonathan Epstein Who is one of the top pathologist in second opinions of biopsies has Said, during Videos I have seen, that You should check to see if the pathologist who is doing your biopsy is a specialist in prostate cancer or are they a specialist in some other issue and not really the right person to be doing your prostate cancer biopsy.

I know a few people who will ask about this and found out their pathologist was not a prostate cancer specialist. In that case, you cannot rely on them completely, You need to get a second opinion.

Dr. Epstein has done talks, recorded by ancan.org. If you go to their website, you can watch one.