A subsequent biopsy isn't necessary. You have a G7 and a 2nd opinion of your biopsy slides would be very worthwile if they are sent to Epstien at Hopkins or Botwich labs.
some think that perineural invasion is significant, but many other doctors think it is of no value.
I know of no cases where the Brachytherapy needles have caused any damage or any case where biopsy needles have caused damage. the biggest risk from an additional biopsy is infection and may take additional time to heal before a surgery, about
The side affects of Brachy are:
Slight risk of incontinence, about
Slight risk of bowel issues, about
Urinary constriction in about
10% of cases that is usually resolved in months.
ED in about
40% of patients that is resolved with viagra.
Urinary frequency and urgency for about
4 to 6 weeks that is tolorable and won't affect daily activities.
In general the side affects are much less than surgery or conventional radiation, with a large number of patients having no permanent side affects.
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.