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Looking for information on rib biopsy for prostate cancer

Posted by pamperme @pamperme, Mar 4 9:04am

I had an RP 2.5 years ago. My PSA has started to rise and went to .15. While I was Gleason 3 4 there was EPE, two locations which margins could not be determined, cribform, 3a, and when the decipher test was recently taken it was .92. They recommended radiation and took a psma pet scan. It showed low avidity on the ribs. I was put on adt and a second pet scan was done and the advisory on the one questionable spot went down slightly so they cold not rule it out as cancer. Now they are looking to wait three months to try another psma/pet scan. It was suggested I could get a biopsy of the rib which may show cancer but if it does not than it does not rule out cancer and I would have to go back to the psma test. An mri was ruled out because it is small and the mri will have trouble picking up layers because it moves as you breathe. I need help with other people’s experience. I am on adt but like to get off of it.

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surftohealth88 | @surftohealth88 | Mar 5 8:28pm
In reply to @bens1 "@pamperme Actually, the PSE test remains accurate even after your prostate has been completely removed because..." + (show)
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@pamperme

Actually, the PSE test remains accurate even after your prostate has been completely removed because it does not rely on prostate tissue being present. It measures immune cell confirmation signatures in the blood, which reflect whether your immune system has been interacting with prostate cancer cells anywhere in the body. It’s a biomarker test that works to detect prostate cancer before treatment and after any treatment.

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@bens1

Do you know if you can order PSE by yourself, or a doctor has to place the order for that test ?

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bens1 | @bens1 | Mar 5 9:13pm

It can only be ordered by a physician, but I had my primary care provider order it for me.

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heavyphil | @heavyphil | Mar 6 7:12am
In reply to @pamperme "@wwsmith Both of my consultations agree I have a reoccurrence and recommend radiation. With the high..." + (show)
Profile picture for pamperme @pamperme

@wwsmith Both of my consultations agree I have a reoccurrence and recommend radiation. With the high decipher reading, two locations with no margins and the 2.5 cm size they both agree the prostate bed needs to be irradiated. The only question now is did it get outside the prostate bed. The ribs are a common area where they get false positives on the psma pet scan test.
The Episwitch is used to determine whether you have cancer when you have a prostate. If you have a high PSA it can give you a better idea if you have cancer and a biopsy of the prostate should be done.

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@pamperme 30% of the time it is in the pelvic lymph nodes - they MUST be included in IMRT or you are wasting your time.
Please get clarification on this as this could be your last opportunity to avoid a lifetime of ADT. Just sayin…
Phil

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pamperme | @pamperme | Mar 6 7:35am
In reply to @heavyphil "@pamperme 30% of the time it is in the pelvic lymph nodes - they MUST be..." + (show)
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@pamperme 30% of the time it is in the pelvic lymph nodes - they MUST be included in IMRT or you are wasting your time.
Please get clarification on this as this could be your last opportunity to avoid a lifetime of ADT. Just sayin…
Phil

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@heavyphil
They are doing the whole area including the lymph nodes. I intend to go with IMRT but as discussed elsewhere I was given the choice of SBRT.

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heavyphil | @heavyphil | Mar 6 1:37pm
In reply to @pamperme "@heavyphil They are doing the whole area including the lymph nodes. I intend to go with..." + (show)
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@heavyphil
They are doing the whole area including the lymph nodes. I intend to go with IMRT but as discussed elsewhere I was given the choice of SBRT.

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@pamperme Excellent - get the entire area.
Phil

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surftohealth88 | @surftohealth88 | Mar 6 2:24pm
In reply to @bens1 "It can only be ordered by a physician, but I had my primary care provider order..." + (show)
Profile picture for bens1 @bens1

It can only be ordered by a physician, but I had my primary care provider order it for me.

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@bens1

I am asking since we mentioned it to our MO and he told us that it occasionally gives false positive and that PSA level would be the best marker post RP. : / We did not want to argue with him , so I hoped that there is way to order it without a doctor.

Thanks for fast reply : )

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bens1 | @bens1 | Mar 6 4:38pm
In reply to @surftohealth88 "@bens1 I am asking since we mentioned it to our MO and he told us that..." + (show)
Profile picture for surftohealth88 @surftohealth88

@bens1

I am asking since we mentioned it to our MO and he told us that it occasionally gives false positive and that PSA level would be the best marker post RP. : / We did not want to argue with him , so I hoped that there is way to order it without a doctor.

Thanks for fast reply : )

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@surftohealth88

Early studies are showing that actually the PSA test, which only has about 50% accuracy, has more false positives, than the false positives that sometimes can occur with the PSE test.

Personally, I believe in checking as many sources as possible to find out answers as no Dr or Test seems to be 100% trustworthy.

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jeff Marchi | @jeffmarc | Mar 6 5:20pm
In reply to @bens1 "@surftohealth88 Early studies are showing that actually the PSA test, which only has about 50% accuracy,..." + (show)
Profile picture for bens1 @bens1

@surftohealth88

Early studies are showing that actually the PSA test, which only has about 50% accuracy, has more false positives, than the false positives that sometimes can occur with the PSE test.

Personally, I believe in checking as many sources as possible to find out answers as no Dr or Test seems to be 100% trustworthy.

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@bens1
The false positives are Related to conditions people have. A large prostate, BPH or some other medical issue. Then there are very low PSA’s, where some people do not produce PSA, even though they have advanced cases of prostate cancer.

The PSA is a guideline that can be used to decide whether or not analysis or treatment is necessary to pursue.

Now, if somebody has a very high PSA that’s cancer, if a PSA is over 100 It’s not going to be from medical issues.. I do know somebody that a PSA of 50 due to a very large prostate.

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