Anyone have an Ultrasound-Guided Transperineal Prostate Biopsy?

Posted by dandl48 Dave @dandl48, May 15, 2020

Will be in Rochester the week of Memorial Day to have my Esophagus scoped, have Barrett's Esophagus and to also have the above mentioned biopsy. I have a lesion on the prostate and a PSA of 12.75 with a free PSA of 6. My last biopsy was a transrectal Ultrasound Guided one that came back with no cancer. Three months ago I sent my last biopsy done here in Oregon to Mayo for review and they were very surprised that it seems that the needle didn't get the lesion. Since I was scheduled to return in May for the scoping I decided to have Mayo do my next Biopsy. Never did have a Transperineal one and was wondering if anyone here has had one? If yes, was it done with you out or just with a local? How were you after the procedure? Thanks in advance,
Dave

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@dd2312

I also had the procedure at Mayo and the discomfort was minimal. I would recommend it without reservation. No sedation was needed, it as it was performed as an outpatient in the clinic with a local anesthetic. It provided accurate diagnostic information for deciding on the treatment options. And, proton therapy is an option at Mayo when appropriate.

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I too had the Proton therapy, SBRT, 5 treatments over the course of 10 days and it couldn't be easier. Coming up to my second year anniversary in a few weeks.

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@colleenyoung

@kingsnake, I think this might be the recent article and video you are referring to:
- Mayo Clinic Minute: Prostate biopsy technique reduces infection risk https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-new-prostate-biopsy-technique-reduces-infection-risk/

You'll notice that I moved your questions to this existing discussion that @dandl48 started:
- Anyone have an Ultrasound-Guided Transperineal Prostate Biopsy?: https://connect.mayoclinic.org/discussion/anyone-have-an-ultrasound-guided-transperineal-prostate-biopsy/

I did this so you can read the previous posts and hopefully get your questions about the procedure and insurance coverage by fellow members like @dandl48 @bodeygolfer @roger15 @mrbill @john57.

Kingsnake, will you be having the biopsy at Mayo?

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Moderator: thanks for the warm welcome and funneling my question to the right forum.

I am in Colorado, and I am undecided as to whether travel to Mayo for an initial biopsy is warranted. I am trying to gauge from comments on this board as to whether Mayo could provide real advantages at this stage over a local Urology clinic. If they both do the traditional 12-core grid biopsy, then travel to Jacksonville or Phoenix might not be the best use of funds - which might go farther to be used for a second opinion on reading the biopsy results?? But I could be persuaded.

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@kingsnake

Moderator: thanks for the warm welcome and funneling my question to the right forum.

I am in Colorado, and I am undecided as to whether travel to Mayo for an initial biopsy is warranted. I am trying to gauge from comments on this board as to whether Mayo could provide real advantages at this stage over a local Urology clinic. If they both do the traditional 12-core grid biopsy, then travel to Jacksonville or Phoenix might not be the best use of funds - which might go farther to be used for a second opinion on reading the biopsy results?? But I could be persuaded.

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@kingsnake I had 3 trans rectal biopsy's prior to going to Mayo for the MRI Assisted biopsy. The first 3 came back with no cancer found, taking only 8 samples on one and 12 on the remaining 2. This is all with my PSA continuing to increase. Once I decided to give Mayo a shot, they suggested the MRI assisted biopsy that I agreed to. They took 18 samples and did find the cancer. If your insurance would pay for it, why would you not go to Mayo since it's ranked in the top 3 hospitals in the country for cancer treatment. In your post you didn't list Mayo Rochester, is there a reason for that? Best of luck.
Dave

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@kingsnake

Moderator: thanks for the warm welcome and funneling my question to the right forum.

I am in Colorado, and I am undecided as to whether travel to Mayo for an initial biopsy is warranted. I am trying to gauge from comments on this board as to whether Mayo could provide real advantages at this stage over a local Urology clinic. If they both do the traditional 12-core grid biopsy, then travel to Jacksonville or Phoenix might not be the best use of funds - which might go farther to be used for a second opinion on reading the biopsy results?? But I could be persuaded.

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My odyssey started here in Omaha, where I had both my MRI and 16-core Transrectal Fusion Biopsy. After my results (Gleason 4+3=7, Intermediate/Localized) on 7/11/2022, I really thought I'd go with surgery, but I thought I should evaluate radiation, too. My doctor's clinic no longer had a radiology oncologist, so I'd have to visit a third institution for that evaluation. That's when I listened to the "inner voice" and contacted Mayo Rochester. They worked miracles with my nephew and his cancer, so I thought I'd be foolish not to go (only 6 hrs for me). Kingsnake, I don't know what you have to work with in CO, but the sheer organization and professionalism at Mayo brings peace of mind. I saw a surgeon on a Monday and, thanks to a cancellation, a radiology oncologist on Wednesday. That was serendipitous, so I wouldn't hold it as standard, but it showed that Mayo does try to work with you and your situation. I won't go into detail about my road to making a choice (I don't want Colleen to have to move my comment elsewhere), so I'll say only that I start The Process for radiation on Oct 13.

Good Luck, Kingsnake. There be a wealth of information in these many comments. Take your time and don't get overwhelmed.

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@davinik

My odyssey started here in Omaha, where I had both my MRI and 16-core Transrectal Fusion Biopsy. After my results (Gleason 4+3=7, Intermediate/Localized) on 7/11/2022, I really thought I'd go with surgery, but I thought I should evaluate radiation, too. My doctor's clinic no longer had a radiology oncologist, so I'd have to visit a third institution for that evaluation. That's when I listened to the "inner voice" and contacted Mayo Rochester. They worked miracles with my nephew and his cancer, so I thought I'd be foolish not to go (only 6 hrs for me). Kingsnake, I don't know what you have to work with in CO, but the sheer organization and professionalism at Mayo brings peace of mind. I saw a surgeon on a Monday and, thanks to a cancellation, a radiology oncologist on Wednesday. That was serendipitous, so I wouldn't hold it as standard, but it showed that Mayo does try to work with you and your situation. I won't go into detail about my road to making a choice (I don't want Colleen to have to move my comment elsewhere), so I'll say only that I start The Process for radiation on Oct 13.

Good Luck, Kingsnake. There be a wealth of information in these many comments. Take your time and don't get overwhelmed.

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Davinik, details welcome. 🙂

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@kingsnake

The topic was recently reviewed on the Mayo website. Article suggested more accurate diagnosis using targeted biopsy samples guided from key areas of the prostate with the aid of a either a Real-time MRI, or a “Fusion” process which overlies a map of the prostate to guide sampling. A side benefit was no risk of infection from colon perforation caused by biopsy needle.

My questions are:
1) Has anyone used this procedure?
2) Is it a valid choice for one’s initial biopsy?
3) Does insurance cover this procedure?

Thank you.

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My husband had an MRI fusion transperineal biopsy at Mayo in Rochester in March of 2021.
It was a great experience, minimal discomfort, as the procedure was done under light anesthetic.
We were on commercial insurance at the time, and it paid 100%.
Later, when trying to get in a study at Johns Hopkins, his slides were reviewed by Jonathan Epstein, who is considered the top pathologist for reviewing prostate cancer slides.
He was in complete agreement with the Mayo pathologists.
You can have 100% confidence in Mayo Rochester. I cannot speak to the other sites.

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@kingsnake

Moderator: thanks for the warm welcome and funneling my question to the right forum.

I am in Colorado, and I am undecided as to whether travel to Mayo for an initial biopsy is warranted. I am trying to gauge from comments on this board as to whether Mayo could provide real advantages at this stage over a local Urology clinic. If they both do the traditional 12-core grid biopsy, then travel to Jacksonville or Phoenix might not be the best use of funds - which might go farther to be used for a second opinion on reading the biopsy results?? But I could be persuaded.

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Hello, I can relate to your concerns. I live in Wyoming and had a traditional 12-core grid biopsy. The results were sent to a lab in Loveland, Colorado. Six samples showed Gleason scores of 6 and 7. (Two were 7. ) My doctor recommended surgery for me. I’d wanted a second opinion. I contacted the Mayo Clinic in Phoenix. They requested my results from the lab. I then had a Zoom appointment and discussed my options. After talking with two different Mayo doctors, my treatments idea switched from radiation to surgery. It took a while to get my surgery done because of COVID-19 concerns at the Mayo Clinic. I had an MRI at the Mayo Clinic the day before my surgery. My surgery went well; I went home to recuperate the same day.
Good luck with your decision. I know every situation is different. Jerry

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@dandl48

@kingsnake I had 3 trans rectal biopsy's prior to going to Mayo for the MRI Assisted biopsy. The first 3 came back with no cancer found, taking only 8 samples on one and 12 on the remaining 2. This is all with my PSA continuing to increase. Once I decided to give Mayo a shot, they suggested the MRI assisted biopsy that I agreed to. They took 18 samples and did find the cancer. If your insurance would pay for it, why would you not go to Mayo since it's ranked in the top 3 hospitals in the country for cancer treatment. In your post you didn't list Mayo Rochester, is there a reason for that? Best of luck.
Dave

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Dave,
To your question, my first post was made before any real research…just based on my familiarity with people who had told me about the Mayo Clinic’s in Phoenix and Jacksonville. With some more reading I do now see the top rating for Rochester.

A recent media poll ranked the prostate care programs at Rochester and Phoenix as “Top”……and for some reason Jacksonville was a bit lower at @Highly Rated.

This is probably just a statistical wobble from patient surveys…..but is there anyone here who can compare or prostate contrast care quality or options at the 3 clinics?

I sense that their standard of care really probably transfers across all 3, but I just thought I would ask.

Thanks

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@jerryegge

Hello, I can relate to your concerns. I live in Wyoming and had a traditional 12-core grid biopsy. The results were sent to a lab in Loveland, Colorado. Six samples showed Gleason scores of 6 and 7. (Two were 7. ) My doctor recommended surgery for me. I’d wanted a second opinion. I contacted the Mayo Clinic in Phoenix. They requested my results from the lab. I then had a Zoom appointment and discussed my options. After talking with two different Mayo doctors, my treatments idea switched from radiation to surgery. It took a while to get my surgery done because of COVID-19 concerns at the Mayo Clinic. I had an MRI at the Mayo Clinic the day before my surgery. My surgery went well; I went home to recuperate the same day.
Good luck with your decision. I know every situation is different. Jerry

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Jerry,
Thank you for sharing your experience. I’m still at the over-whelmed stage and hearing about the experiences of others who have walked this path is so helpful.
Be well.

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@leebeth

My husband had an MRI fusion transperineal biopsy at Mayo in Rochester in March of 2021.
It was a great experience, minimal discomfort, as the procedure was done under light anesthetic.
We were on commercial insurance at the time, and it paid 100%.
Later, when trying to get in a study at Johns Hopkins, his slides were reviewed by Jonathan Epstein, who is considered the top pathologist for reviewing prostate cancer slides.
He was in complete agreement with the Mayo pathologists.
You can have 100% confidence in Mayo Rochester. I cannot speak to the other sites.

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Leebeth,
Thank you for sharing the experience your husband and you had with Mayo. All of the bits of information I am acquiring are helping me build confidence and make the necessary decisions ahead.
Be well.

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