So your biopsy was clean....read this!

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/16/2008 4:32 PM (GMT -6)   
Up to 40% of negative biopsies are false negatives.  And to think some institutions are concerned about false positives with PSA screening...Posted at the ZERO website:
 
 
Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Todd1963
Veteran Member


Date Joined Oct 2008
Total Posts : 3211
   Posted 12/16/2008 4:34 PM (GMT -6)   
Thats comforting.
dx:06/03/06
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 12/16/2008 5:25 PM (GMT -6)   
Doesn't surprise me. After comparing my saturation mapping biopsy to a normal 10-12 core one. Then factor in the skill and experience of the pathologist and....That said I have less confidence in PSA readings. Mine were 2.3 to 2.1.
Diagnosed 10/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32
 
11/10/08
Psa.62
 
April, 2009
Final Biopsy scheduled to
complete clinical research study 
 
 
 


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 12/16/2008 7:38 PM (GMT -6)   

Hi all,

My recollection was the doctor (Radiologist, not a Uro as I was told) worked with the ultrasound tech during my TRUS biopsy. The doctor operated the probe and fired the core needles. I overheard them both talk about the shadows they were seeing on the display as they did my biopsies. The last couple were painful as the doctor was trying to get to get to a specific area, while both observing the display (the worst pain was mostly from the probe manipulation, not the core shots).

This was done at my local hospital in the nuclear/ultrasound med lab.

Maybe it was because of the size of the discrepancies in the ultrasound echoes they were seeing, that they were able to target well. Maybe it was the facility, equipment and medical personnel. My signature includes the results. 5 of 8 positive with 30%-65% cancer.

However, it's there and while I'm unhappy about the diagnosis...I'm happy it was found. Now it can be dealt with.

With all the advances in medical technology, things are still very much hit and miss...hence, false negatives. I'm sure in a few years, these tools will be much improved.

Even with some of the latest technology that wasn't as refined 5-10 years ago, I go to find out the results of my bone scan tomorrow morning. If negative, I may have the surgery only to find out later it had already spread. Some of what I've found states that the bone scan is sensitive to maybe 10% uptake of the markers that were injected. Less than that may not be detected...

I've had a couple of close meltdowns. I've had a chance to do a lot of looking and reading, since.

Next step tomorrow.

Mikey 

 

 

  


 
Lower left groin hernia; mesh and large scar: surgery early 2006
Nov/Dec 07 and March 08 and now Dec 08: Severe perineal pain (between scrotum and rectum). Septra/Bactrim for 8 months for diagnosed prostatitis previously.
PSA start of 08: 5.3
PSA June of 08: 7.3
6 DRE all benign or nothing felt
TRUS Biopsy Nov 08: Got copy of pathology recently (see below).
General Health: pretty good, 5' 10", 180 lbs, slim.
Bone scan Dec 08: waiting for results
 
Biopsy Pathology: 5 of 8 cores positive, adenocarinoma in both lobes
1) 30%, GS 3+3, perineural invasion identified
2) 40%, GS 3+3
3) 60%, GS 3+3
4) 65%, GS 3+3
5) 30%, GS 3+3
 
Open RP recommeded. Looking at nerve sparing da Vinci in London, Ontario.
Wonderful wife...and 1st grandchild on the way.
 


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 12/16/2008 9:13 PM (GMT -6)   

Hi all...I meant to add to my last post that it was THIS site and all the supportive posters, that helped me to start looking and reading more. I'm probably not going to sleep well tonite, with tomorrow's bone scan results coming...and may sleep worse tomorrow.

 

Mikey

 


 
Lower left groin hernia; mesh and large scar: surgery early 2006
Nov/Dec 07 and March 08 and now Dec 08: Severe perineal pain (between scrotum and rectum). Septra/Bactrim for 8 months for diagnosed prostatitis previously.
PSA start of 08: 5.3
PSA June of 08: 7.3
6 DRE all benign or nothing felt
TRUS Biopsy Nov 08: Got copy of pathology recently (see below).
General Health: pretty good, 5' 10", 180 lbs, slim.
Bone scan Dec 08: waiting for results
 
Biopsy Pathology: 5 of 8 cores positive, adenocarinoma in both lobes
1) 30%, GS 3+3, perineural invasion identified
2) 40%, GS 3+3
3) 60%, GS 3+3
4) 65%, GS 3+3
5) 30%, GS 3+3
 
Open RP recommeded. Looking at nerve sparing da Vinci in London, Ontario.
Wonderful wife...and 1st grandchild on the way.
 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4828
   Posted 12/17/2008 5:33 AM (GMT -6)   
Last nights NBC Evening news had a story on Colonoscopies and how a large number are done poorly and miss stuff. Looks like we can't win for loosing...The key to the above was to Not let your GP do the test and to go to a Specialist.
Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Gleason - 6
(biopsy done March 4, 2008-> 2 of 12)
 
06/25/08 - Da Vinci robotic laparoscopy
10/03/08 - 1st Quarter PSA -> less then .01
 

Surgeon - Keith A. Waguespack, M.D.

Las Colinas and Plano Offices

 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/17/2008 10:32 AM (GMT -6)   
I have left a message for Skip Lockwod at ZERO about this article. I believe this article is true, but what I am interested in is making people aware that they have options after the basic needle biopsies. I know a lot of guys here and elsewhere that had elevating PSA's but negative biopsies, and I know guys who ended up with advanced cases as a result.

Guys,
If you have had a negative biopsy and your PSA keeps climbing, ask about a saturation biopsy or stereostatic biopsy. There are side effects to this type of biopsy, and there is more expense as general anesthesia is required as well. But 40% does indicate some of these guys could become advanced cases by the time a 16 core biopsy picks it up.

Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 

Post Edited (TC-LasVegas) : 12/17/2008 9:35:31 AM (GMT-7)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4203
   Posted 12/17/2008 12:15 PM (GMT -6)   
I wish I had known this 6 or 7 years ago. I could have saved myself a lot of grief. All the docs I saw kept telling me to keep getting a biopsy at least once per year. My 13th biopsy finally picked up a cancer that turned out to be insignificant, but it led me to a doctor that wasn't satisfied with the results and put me through a few more tests. Using a color doppler ultrasound and targeted biopsies the real source of my PSA was finally discovered, a large tumor in the transition zone that has a high probability of lymph node involvement.
For all the guys with rising PSA and negative biopsies a saturation biopsy or color doppler ultrasound administred by an experienced radiologist is the next step. Don't stop until you have positively identified the reason for the PSA rise.
Tony, thanks for the info and keep it coming. I've learned a lot on this site and have much more to learn.
JohnT
Diagnosed 10-08 at 63 with PSA of 33
PSA was 4.4 in 1999 and has risen steadily.
Had 13 biopsies and an endorectal MRI, all negative until 10-08. Two cores out of 25 with a gleason 6
2nd opinion with an oncologist said cancer found was insignificant, but suspected larger tumor somewhere.
Doppler ultrasound with target biopsy indicate a large tumor in the transition zone, gleason 7.
Bone and CT scans negative.
PSA3= 43; high normal is 35
Currently evaluating treatment options, surgery is not an option as a high probability of positive margin exists.
John T

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