1. < Prostate Cancer

What can I expect after my biopsy?

Posted by ericp502 @ericp502, Mar 28 9:39pm

51 year old and was diagnosed two weeks ago via MRI with a Gleason 7+ cancer.

MRI results below. Nothing was found in the lymph nodes or seminal sack. I have BPH on the Right side and that has been effecting me for several years.

LEFT PERIPHERAL ZONE: Ovoid focus at the lower 3rd peripheral zone measures up to 5 x 3 x 7 mm in largest AP, transverse and craniocaudal dimensions. This demonstrates diffusion restriction and low ADC signal. This does not enhance asymmetrically from the adjacent central gland. No other similar-appearing focus identified.

Prostate volume: The prostate measures 4.0 x 5.4 x 4.4 cm in largest AP, transverse and craniocaudal dimensions. This corresponds to a volume of 49.76 cc. Calculated maximum expected PSA of 5.97 ng/mL
IMPRESSION:
Suspicious diffusion restricting nodule in the left-sided peripheral zone at the apex. PI-RADS 4

I’ve been through multiple Urologists trying to get help with my enlarged prostate. The urologist I’ve had for 20+ years due to kidney stones wouldn’t give me a PSA because I was too young. He said to wait until I was 50 even though my father has prostate issues and he was my father’s urologist. My dad has had a PSA of 15 with multiple biopsy’s but no cancer found.

The second urologist did run my PSA and it was a 5. He did set me up for PSA screenings every six months but the only treatment he would do was prostate massages anytime I came into the office. That didn’t help and truthfully made my problem worse.

Went to my third urologist last July. My PSA was still a 5. February of this year my PSA jumped to 7.25 and they did the MRI where they found the issue.

My biopsy is next Thursday and I was accepted into the Brown Cancer Center in Louisville, KY. I meet with that team later in April. My only concern is looking through all the doctors profiles on the team none have prostate issues as their main focus.

I’m right now assuming with my age and no signs of spread that removal will be the recommendation. With my enlarged prostate issues causing me so much pain and affecting my daily life I’m thinking that might be the right direction.

Has anyone had experience with the Brown Cancer Center in Louisville, KY? Any other recommended paths?

I did submit for the “Color” genetics testing that was recommended on another post.

I’ve lived a good life and I’m not complaining. This is just part of life but I don’t want to leave my wife alone. That is my biggest concern.

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

Moderator
Colleen Young, Connect Director | @colleenyoung | Mar 31 8:33pm
In reply to @clandeboye1 "@ericp502 My 1st piece of advice to you is to EDUCATE YOURSELF , on all aspects..." + (show)
@clandeboye1

@ericp502 My 1st piece of advice to you is to EDUCATE YOURSELF , on all aspects of Prostate Cancer , as you are obviously unaware , as we all were at your stage of the journey , of the test procedures and reading their results . i.e How do you get a Gleason Score , and it's NOT from a MRI . Immediately purchase Dr Patrict Walsh's book " Guide to Surviving Prostate Cancer " . It will walk you through all the warning signs , tests , what the results men and your various treatment options , typically, but not 100 % , based on your Gleason Score . Additionally follow Dr . Mark klotz U -Tube Series -- His series will answer most off your concerns .
My 2nd " CRITICAL " piece of advice , and this is covered in Dr. Walsh's book .
Upon receiving your Biopsy Pathology Results -- Get a 2nd and even a 3rd Opinion of your Biopsy slides .
Google : John Hopkins or Cleveland Clinic , plus others regarding 2nd Opinion of Prostatte Biopsy results .
WHY : In my case . MY 1st Biopsy was negative with an MRI RADS 5 Score . Obviously a conflicting result .
My 2nd Transperineal MRI Fusion Biopsy ( same as the 1st ) came back 6 Cores out of 16 Gleason 3 +3 = 6
A 2nd Opinion of these results ALL 6 Cores were upgraded to Gleeason 3 + 4 = 7 - Favourable Intermediate PC
a 3rd and Final opinion was : 4 Cores Gleason 3 + 3 = 6 and 2 Cores Gleason 3 + 4 = 7 .
What did I learn : A Prostate Biopsy is one of the most difficult to diagnose . A breast Biopsy for example is not .
You must find a PATHOLOGIST performing a high volume i.e. On a regular basis , of prostate cancer Biopsy intrepretations . It is not uncommon for pathologists to disagree even witth todays assistance of AI .
John Hopkins as example receive thousands of requests worldwide , for 2nd opinions .
Good luck .
p.s. Do not rush and make a knee jerk treatment decision you may regret the rest of your life . Money spent on Dr. Walsh's book may well change your life -- Money well spent .
p.p.s. With respect to BPH there are many options to treat this condition , WITHOUT removing your prostate Resum being one . I was on Flowmax for several years and have been switched to Dutasteride for the past 5 years . My prostate is 80 cc.

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@clandeboye1, @ericp502, and everyone on the forum, I appreciate the passion with which members dive into research to make important decisions, and that you share your research and decisions in the forum.

I am, however, posting a friendly reminder about the Community Guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/

In particular, see guideline #2.
2. Remain respectful at all times.
- Exercise tolerance and respect toward other participants whose views may differ from your own. Disagreements are fine, but mutual respect is a must.

I believe that you agree on more than you disagree. On this forum, we only have text to communicate without the benefit of enhancing our messages with tone of voice or body language. Let's do so with respect.

REPLY
ericp502 | @ericp502 | Apr 3 8:50am

Biopsy complete. The procedure was easy but woke up in recovery with significant pain in my groin. Heading home now.

REPLY
1 reply
jc76 | @jc76 | Apr 3 10:11am
In reply to @ericp502 "Biopsy complete. The procedure was easy but woke up in recovery with significant pain in my..." + (show)
@ericp502

Biopsy complete. The procedure was easy but woke up in recovery with significant pain in my groin. Heading home now.

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@ericp502
Well that is over. Now the wait for diagnosis.

I had I think 18 (not sure exact number) biopsies take tranperinal. I had no pain afterward. I am not sure as don't remember if you had transrectal or transperinal. If you woke up in recover you probably had transpernial.

We are all different thus some of us have not pain or discomfort and some do.
Good luck on your diagnosis. Getting a Decipher score will really help determine options for treatments and/or no need for them.

REPLY
ericp502 | @ericp502 | Apr 3 4:04pm

They did 25 cores. Some were targeted to the spot on the MRI and some where other parts of the prostate as well. Not sure why they wouldn’t just target them all at the spot since the decision of treatment would be for the worst portion of the prostate which would be the spot identified by the MRI.

Everything went well but woke up with really bad testicle pain and pain in my lower abdomen. My BPH causes me a lot of pain anyway but this was way worse.

REPLY
1 reply
jc76 | @jc76 | Apr 3 5:02pm
In reply to @ericp502 "They did 25 cores. Some were targeted to the spot on the MRI and some where..." + (show)
@ericp502

They did 25 cores. Some were targeted to the spot on the MRI and some where other parts of the prostate as well. Not sure why they wouldn’t just target them all at the spot since the decision of treatment would be for the worst portion of the prostate which would be the spot identified by the MRI.

Everything went well but woke up with really bad testicle pain and pain in my lower abdomen. My BPH causes me a lot of pain anyway but this was way worse.

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@ericp502
I thought same as you about biopsies. However prostate cancer is and can be there at cellular level and not seen on a MRI as a lesion. It is why so many biopsies are done and not just what look suspicious on MRI.

If treated with radiation my R/Os at UFHPTI and Mayo really gave me informative information about treatments and cellular level prostate cancer. My R/Os radiate and treat the entire prostate not just the areas where biopsies were done nor what the MRI showed,
Why?
If you don't treat the entire prostate you could easily miss an area in prostate that has prostate cancer cells. If not treated they will survive and you will have your cancer continue to grow. So my R/Os stated we treat the entire prostate and the margins to make sure we don't miss something.

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