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

@stldadof4
I think waiting until you get your Decipher would be what I would do to discuss treatment options. This is what I did so just passing on my experience.

Your biopsies of 3+3=6 you stated are your most concern. These numbers are of the least concern. Pathologist don't even list any numbers below 3+3=6. Your 3+4=7 are something a lot of posters would have loved to have.

Please discuss your options after Decipher. It will give you the risk level of your PC and not the subjective Gleason Score. Regarding PET scan. I had the PSMA done as was recommended by UHFPT R/O. I had it and was negative.

I chose proton radiation after getting two different opinions from two different COEs.

You are young. I was 76 when diagnoses with PC. Thus you have a very long life expectancy. Discuss with your medical doctors the pros and cons of every treatment plan and decide what is best for you and your life. If in doubt at all seek a second opinion. Again I did this and just passing on what I did to help me make the right decision for me.

@stldadof4 in

Thanks for letting us know. Like you said, not terrible, but you were hoping for better. I am a newbie on here like you, but it sure seems like if a man has a prostate biopsy something will show up. I think it’s more rare that a prostate biopsy comes back completely negative. Seems like it’s always something and a lifelong thing that they say you have to check often. To be honest, it really pisses me off lol. Sorry that you didn’t get the news you wanted. I go next week for the biopsy and then wait for the dreaded phone call. I’m betting I won’t get the results I want either…I just want them to say everything looks great, see you next year lol.

After I had my MRI and the urologist office called I purposely did not answer the call lol. I waited and listened to the voice message and then called them back. I dread the phone call as much as the biopsy.

Like a few have said on here maybe you won’t need surgery right away if ever. I know I would put it off unless my results were really terrible. If you do have the surgery I’m sure you will do great. These guys and women on this site are awesome and their experiences are really helpful. Keep us updated and I will do the same.

@stldadof4
Well, just heard from the Dr. on my biopsy results and 3 of the cores were positive for cancer (adenocarcenoma). One was Gleason 3+4=7, and two were 3+3=6. I believe the G7 was targeting the spot they saw in the MRI (pirads 4) and the two G6's were random, but I am not 100% sure on that. (The two random G6's actually have me more a little more concerned than the targeted lesion because they are literally a shot in the dark.) He is recommending RALP (prostatectomy) because of the G7 and since I am relatively young (57) and otherwise healthy. He confirmed what others have said here, that you can always do radiation later, if it comes back, but not necessarily the other way around. He also said this is very treatable, which is consistent with what I've learned here. I told him that I would want another opinion before proceeding with surgery, but they are going to set me up with their surgeon to talk about the option. They are going to do the decipher test, and I will look through the guidance here on getting second opinions. I'm thinking I should probably also request a PET Scan. There's my update. Obviously could be a lot worse, but I was hoping for better. @indyguy -- I hope you get better news following your biopsy. Please continue to keep us posted.

@stldadof4 As others have said, you still need a little more information before choosing a treatment. I chose Tulsa Pro at Mayo for my single lesion 4+3 in July of 2024. No sign of cancer at this point. I have a friend who recently had pretty much the same biopsies you did, with two spots of 6 and one 7. He also has decided on Tulsa after meeting with multiple doctors and an oncologist. We were both 65 when treated. One thing Tulsa does not have is long term data on success, but early results show similar recurrence rates as surgery and radiation at 3 years.

Medicare paid for it. I have heard some insurance companies are now paying for it as official Medicare codes came out in 2025 which has helped drive inclusion.

@stldadof4 in

Thanks for letting us know. Like you said, not terrible, but you were hoping for better. I am a newbie on here like you, but it sure seems like if a man has a prostate biopsy something will show up. I think it’s more rare that a prostate biopsy comes back completely negative. Seems like it’s always something and a lifelong thing that they say you have to check often. To be honest, it really pisses me off lol. Sorry that you didn’t get the news you wanted. I go next week for the biopsy and then wait for the dreaded phone call. I’m betting I won’t get the results I want either…I just want them to say everything looks great, see you next year lol.

After I had my MRI and the urologist office called I purposely did not answer the call lol. I waited and listened to the voice message and then called them back. I dread the phone call as much as the biopsy.

Like a few have said on here maybe you won’t need surgery right away if ever. I know I would put it off unless my results were really terrible. If you do have the surgery I’m sure you will do great. These guys and women on this site are awesome and their experiences are really helpful. Keep us updated and I will do the same.

@indyguy we are definitely in similar places and I’m dealing with similar feelings — pissed off about the possible lifelong nature of this, but also realizing it’s relatively common as we men age, and obviously could be much worse.

You’re right about biopsies typically finding something. I guess it’s because they wouldn’t do them if there wasn’t already a fairly strong suspicion. In that respect, I felt mentally prepared for the call and know that you will too. I honestly would have been surprised if they said there was nothing. I probably wouldn’t have trusted it! Lol.

I have an appointment on Wednesday and I know they will push surgery, but I’m not ready to move forward without a better understanding of my situation and options. All of the info here is so helpful for asking the right questions, advocating for yourself, and understanding the alternatives. I remembered that there is a cancer helpline through my employer. I believe they guide people through this sort of research. I’m definitely going to look into that too. I also ordered the Walsh book several have recommended here.

It helps that PC is generally slow growing. Time is usually on our side to do our homework and make a thoughtful decision.

I hope all goes smoothly for you on the 11th, and the phone call after. There’s some relief in at least having some answers now and not wondering. The mental side of the biopsy was worse than the physical for me, but I’m glad that my pee finally looks normal again! lol

@indyguy My Gleason score was 7. They said my cancer was aggressive.
I waited. When they finally took my prostate out, it had already spread outside the prostate.
You probably don't want to do that.

@lacraig1
Yes I know there is a fine line between waiting and watching and just getting it done. How long did you wait to have surgery ?