TRUS Recommendation

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bates
New Member


Date Joined Jun 2009
Total Posts : 8
   Posted 12/26/2009 11:58 AM (GMT -6)   
My year started with a trip to the Urologist to check if my increased urination was normal.  PSA was 0.9 and doctor did DRE which showed a small bump ner right side of apex.  This was followed by a TRUS that revealed nothing and a biopsy of 12 samples in 6/09 that also showed no cancer. I was asked to return to the Urologist for a re-check this December.  My PSA was 0.8 and the DRE showed the same abnormality, no changes in size or feel.  Doctor says it's neither hard like cancer but not soft like normal tissue.  Now the doctor is asking me to get another TRUS.  Does this seem necessary?  I am all for being conservative but since the TRUS can't diagnose PC and my biopsy in June was normal, why get another TRUS?  Thinking of getting a second opinion.  I am 46, in good health and have no family history.  Any advice?

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 672
   Posted 12/26/2009 2:39 PM (GMT -6)   

Hi bates,

Is the doctor wanting you get another TRUS or another TRUS biopsy? A TRUS biopsy actually will determine if cancer is present because a pathologist looks at the tissue samples. However, the biopsy can miss. All my DREs were pretty normal except the last one before surgery. I think that was the interpretation of the surgeon who did it (and my open RP)...he didn't feel anything necessarily abnormal except for some "firmness" in a couple places. That firmness was found in the peripheral zone near my rectum.

Maybe another TRUS biopsy is in order or not? Ask your Uro.

Mike


-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving significantly with Trimix at 7 months post-op. Oral ED meds didn't do much.


bates
New Member


Date Joined Jun 2009
Total Posts : 8
   Posted 12/26/2009 3:41 PM (GMT -6)   
Thanks for the reply Mike.  My Uro is just asking for another TRUS, no biopsy unless they see a lieson.  Last time I had a TRUS the hospital didn't see anything but afterward my Uro still did the TRS biopsy.  I guess I could understand doing another follow up biopsy at some point, maybe a year from last but why just do a TRUS? 

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 672
   Posted 12/26/2009 4:56 PM (GMT -6)   
There are variations on TRUS. Some are more advanced like color doppler... I don't have experience beyond color doppler, as part of a study, but some here do. I think you should try and pursue all imaging available, if you can along with biopsies in the future.

Your standard PSA is low and there are also other PSA related tests you can look into. You have an anomally that was detected on DRE. That seems it was a concern to your Uro and should be a concern for you, also. Ask your doc.

Maybe a 2nd opinion is in order?

I'm sure lot's more will chime in here.

Good luck and keep us posted.
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving significantly with Trimix at 7 months post-op. Oral ED meds didn't do much.

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