Prostate Biopsy Complication

Posted by handera @handera, Jan 9 3:24pm

Diagnosed in October 2023 with low volume Gleason 3+4, decipher 0.22. Post biopsy PSA’s have average 6.2, compared to 7.8 prebiopsy.

My 12 month mpMRI indicated only the largest of the original three (PIRADS 3, 4 & 5) lesions was visible and it had reduced T2 and DWI/ADC signaling so everything is looking good regarding the MRI and reduced PSA.

It took me more than 2 months to recover from my 1st biopsy (21 cores) and I’m not looking forward to getting another.

Actually, even after 15 months, I still experience a low level groin soreness where tissue scar may have formed, near a nerve, after the biopsy procedure. Nothing major, more of an annoyance and a minor aggravation.

I found out this is a recognized complication of prostate biopsies; especially for those having large numbers of cores taken.

Has anyone experienced this biopsy complication?

If so, how long did it last and did you find anything to alleviate it…or did it eventually just go away?

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

clandeboye1 | @clandeboye1 | 5 days ago

In reply to @heavyphil "Not sure as it is very new" + (show)

It sounds similar to a test invented at The University of Michigan , the MPS2 urine test , which also looks at your recent PSA number .

clandeboye1 | @clandeboye1 | 5 days ago

In reply to @handera "Thanks for this information! I've been researching various liquid biopsy alternatives for AS patients and I..." + (show)

Agreed . Yet the vast majority of Urologists are reluctant to send their patients for a Biomarker Test -- They basically don't believe in them , or more likely it impacts their _ SURGERY - TAKE IT OUT TRAINING " practice .

heavyphil | @heavyphil | 5 days ago

In reply to @clandeboye1 "It sounds similar to a test invented at The University of Michigan , the MPS2 urine..." + (show)

Yes, it seems so. Was not aware of that one but it seems to test for something like 18 different markers?
So great that they are making progress in this area.
I had a 4K Score done and received a 9…..a score of 7 or below is considered low gradeGleason.
My friend had one and he got a 26!! Turns out he had a very small 4+3 tumor with a low Decipher score and had 5 sessions SBRT with NO ADT.
Me? I had an entire gland loaded with Gleason 4+3, perineural invasion; had surgery….then salvage radiation with ADT!! So why even do that test?? It’s total BS and predicts the opposite of what you really have

clandeboye1 | @clandeboye1 | 5 days ago

How did your friend make out with his Mono SBRT ? I am on AS and considering this treatment ?
My 6 Cores are (4 ) Gleason 6 and ( 2 ) Gleason 3 + 4 = 7 MRI - PI RADS 5
Thanks.

imbimbo | @imbimbo | 5 days ago

In reply to @clandeboye1 "Apparently a test invented at The University of Michigan, the MPS2 Test is similar . It..." + (show)

Is the MPS2 test available via Medicare?

clandeboye1 | @clandeboye1 | 5 days ago

No idea - I live in Canada . SOON NOT TO BECOME THE 51ST STATE .

handera | @handera | 5 days ago

In reply to @imbimbo "Is the MPS2 test available via Medicare?" + (show)

The MPS2 test was approved for Medicare coverage in September 2024.

“The coverage determination means that patients meeting the policy criteria—those at risk for prostate cancer and candidates for either an initial or repeat biopsy—will now have access to MPS2 under their Medicare plans.”
https://www.lynxdx.com/2024/11/news/my-prostate-score-medicare-coverage/

handera | @handera | 5 days ago

In reply to @handera "The MPS2 test was approved for Medicare coverage in September 2024. “The coverage determination means that..." + (show)

The MPS2 test achieves 95-99% sensitivity and negative predictive value, making it highly reliable in ruling out significant cancers.

However, its specificity for detecting clinically significant prostate cancer (Grade Group ≥2) is approximately 80% at the rule-in threshold. This means about 20% of positive results could be false positives.
https://www.nature.com/articles/s41391-022-00633-3

handera | @handera | 5 days ago

In reply to @handera "The MPS2 test achieves 95-99% sensitivity and negative predictive value, making it highly reliable in ruling..." + (show)

Here’s a nice summary of the MPS2 test.
https://prevention.cancer.gov/news-and-events/blog/improved-prostate-cancer-biomarker-test-may-help-men-avoid-unnecessary-biopsy
I note the following comment by Arul Chinnaiyan, M.D., Ph.D., S.P. Hicks Endowed Professor of Pathology and Urology and director of the Michigan Center for Translational Pathology at the University of Michigan:

“Approximately 75% of men who undergo biopsy do not have a cancer that needs to be treated. The MPS2 test provides additional information that can help avoid invasive biopsies and the discomfort and potential complications they bring.”

As I said before there’s an enormous need for something other than than the standard invasive biopsy.

Maybe this MPS2 test is the beginning of even better biopsy options that are “just over the horizon.”

heavyphil | @heavyphil | 5 days ago

In reply to @clandeboye1 "How did your friend make out with his Mono SBRT ? I am on AS and..." + (show)

He’s doing great. He hunts, skis, fishes extensively; A year out and not many issues except the erection problem. He says that initially he was good with some Cialis or Viagra but now it doesn’t seem to work.
But he’s also 74 yrs old, overweight and is- or was - on diabetes meds. So maybe not the best person for comparison….or maybe the BEST since so many men plus 70 yrs have these co-morbidities as well.
But his PSA went from 8 to .8 so far so that’s a good thing.