I have been doing some reading up on the 3D mapping biopsy and it certainly does sound like it is a better option than the "old" kind. It was not made available to me at the time of my biopsy and I was not smart enough at the time to ask for it.
You have clearly studied this a lot and I have a couple of questions out of intellectual curiousity:
1. With more samples, doesn't that increase the probability of finding PCa? And, if so, doesn't that feed those who say there is too much overtreatment already?
2. In looking at your stats, I see that with an "old" biopsy in 2007, your docs found 3 of 12 samples. With the 3D mapping biopsy in 2008, they only found 1 of 45. I guess that's a little counterintuitive to me...I would have thought more samples would at least have found as many cancers as with 12 samples. Am I missing something?
I doubt if 3D would be offered to you. It's expensive and my insurance company initially turned it down. Reason being in the past a simple biopsy just indicating cancer anywhere in the gland was sufficient for the normal treatments to remove or destroy the prostate. The primary reason for a 3D mapping biopsy is to pinpoint the tumor for targeted focal destruction. My doctor who is the director of research won a peer to peer appeal to my insurance company I assume by illustrating it's necessity for the lumpectomy like treatment.
Because of its cost as of now it's only used on those who have had a prior normal cheaper biopsy indicating cancer already. So no at present it doesn't increase the detection any more just refines it. It is then just recommended for those with lower gleason and Psa numbers. Even after that the last I saw 43% are found to have more advanced cancer than earlier indicated and are told to persue radical treatments instead. I don't know how that compares to post radical surgical pathologies after surgery increases in further spreading and higher gleason scores, but I bet it's somewhat close.
I too asked the difference between the number of cores. I 'm trying to recall the answers for one thing the mapping biopsy is just that it's done on a grid to better locate the tumor. Compared to a normal biopsy which is kind of haphazard and not as exact at placement so a single tumor can be picked up by more than a single core. Then the university pathologist may have been better too. The fact the newsman in the video also had 3 initial cores done before his biopsy and his resulted like mine also was an explanation to me.This was over a year ago so I'm trying to exactly remember what more I was told then. I'll ask my doctor again when I see him next month before the final biopsy. Look at parts 2 & 3 video link and it will show the 3d mapping better than I can describe it.
I'm not against better detection but there's a problem I think at this time with an over reaction to it with radical treatments. Was I possibly over treated? Maybe but with TFT it has been much easier to accept and live with afterward. For one thing I still have all my valves so I'm as continent now as I've ever been. My ED problem was short lived and as my doctor stated a few viagara to kick start it and I'm back to how I was before. I will not be ordering anymore which with the current alldaychemist problems I'm fortunate. Although I took only 8 out of the 40 I ordered. I've given a few to friends and did use a couple on dates I'll admit. Hey I am turning 60 this year after all. I'm not 19 anymore. LOL Bottom line is supposedly my cancer is gone and I not only still have wet orgasms PCa for me has had the least negative effects on me compared to all others here who have had radical treatments here. Isn't that a goal for coming here? I feel so and is why I felt the need to return here to just let people know of a treatment I feel is the future. As I've said before if I had just gone with the normal treatments I'd would have left here last summer. I now still have a functioning prostate and even if Pca returns I have all treatment options still available to me.
Each part is anywhere from 4 -7 minutes.
part 2 Options for Treatment
part 3 Deciding on Treatment
part 4 Getting Treatment
5/9/2008 Final update
Diagnosed 11/08/07 - 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 - 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 - Not unexpected bounce after the 80% drop the quarter earlier. Along with urine flow readings, an acceptable amount left in bladder measured by sonic. Results warrant skipping third quarter tests, and to return April, 2009 for final biopsy scheduled to
complete clinical research study
Post Edited (realziggy) : 3/18/2009 9:58:06 PM (GMT-6)