Color Dopler on 1st Biopsy

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Veteran Member

Date Joined Nov 2009
Total Posts : 7269
   Posted 11/15/2009 8:34 PM (GMT -6)   
Another question. I am still awaiting results of my PCA-3 test and that will determine if I need a biopsy at this time. It would be my first. I keep reading about the color dopler. It seems to have worked for at least one (maybe more) poster who had a bunch of negative biopsies with a rising PSA.
Is it preferable to START with a color dopler? My biopsy is planned for Univ. of Mich and I don't know if that's what they do. I will ask, if you folks think that is advisable.
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
History of BPH/prostatitis.
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 11/15/2009 9:10 PM (GMT -6)   
Some of the people here seem to have benefited greatly from the use of color doppler. On the other hand, I have not seen any definitive literature on the cost/benefit for a first biopsy.

Trust your team at the UofM they most certainly know of the technique and you should rely on their guidance at this stage. We can advise about what to ask, but your doctors must advise about what to do.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 11/15/2009 10:02 PM (GMT -6)   
Knowing what I know now after 10 years of biopsies I would never get a biopsy unless it was done with a color doppler. The normal biopsy is 12 cores; a normal color doppler would be 4 to 6 cores as only suspicious areas are biopsied. If now suspicious areas are seen no biopsy is done, but a base line picture is obtained so any changes can be easily seen.
It's more expensive and only a very few doctors do them. Equipment cost is $250,000 and you need a lot of training and experience to be good at it. A normal urologist just doesn't do enough biopsies to justify the equipment cost and the time it takes to be good at it.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


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