Reasonable time to re-biopsy

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Philap
New Member


Date Joined Nov 2009
Total Posts : 15
   Posted 5/8/2010 7:49 PM (GMT -6)   
Last November I was diagnosed with a low grade/low volume PCa. It was less than 1% of 1 of 12 samples.

The biospy was done after my PSA went from 1.3 to 3.0 in an 8 month span. The biopsy was double checked and accurate. My choice: Active surveillance or surgery. Radiation not recommended (I am 55 yrs old).

I was set for surgery in March - but first asked for another PSA test. Well, I was blown away when it went from 3.0 to 1.67.

So there I was with low grade/low volume and a declining PSA. I decided to wait on the surgery. My Uro agreed - but recommended a re-biopsy to be sure it's as minimal as we first found. (This was in no small part due to the fact that I am on a low dose HRT that keeps my T level at @ 300. Everybody gets very nervous about testosterone supplement with PCa).

I am now 6 months from the first biopsy. Please, are there any opinions on how soon or how frequently to re-biopsy.

Thanks in advance.

profman
Regular Member


Date Joined Jan 2010
Total Posts : 55
   Posted 5/8/2010 9:12 PM (GMT -6)   
Hi and welcome to HW. My first biopsy was in August, and I had a confirmatory biopsy (to see if active surveillance was appropriate) about 8 weeks later (which was sufficient time according to my uro). Unfortunately, the second biopsy showed more cancer than the first, and I opted for treatment. My body seemed to fully recover from a biopsy in about three weeks - no more blood in semen by that time. Your biopsy results showed less tumor than mine, and the drop in PSA is encouraging - mine did not really do that.
Diagnosed 9/4/09, age 59
PSA 3.5, up from 1.8 year before
First biopsy showed 3/10 positive cores, Gleason 3+3, less than 10% involvement in all three cores, diagnosed as T2a; prostate size estimated at 32 gram
Thinking of Active Surveillance but
Second biopsy showed 5/10 positive cores, Gleason 3+3, left side (4 postitive cores) had 40% involvement
RRP on 12/15/09, home 12/16
Catheter out on 12/29/09 (failed cystogram earlier)
Path report was all good news, Gleason 3+3, no margin involvement, no perineural involvement, everything clean other than core of prostate, tumor on both sides, but more prevalent on left side, 5% involvement, 42 gram organ
Within two days down to one pad a day, pad free at six weeks
Back to work 1/4/10
First PSA 1/28/10 - nondetectable (<0.1), next scheduled June 2, 2010
ED present, although blood does flow after Viagra. working with pump now - still trying!


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 5/8/2010 9:54 PM (GMT -6)   
I had a biopsy about 6 weeks after a biopsy and had no problems. I would suggest a color doppler ultrasound guided biopsy. I think it would be very difficult to hit that spot again and a color doppler will give a good baseline if you continue on AS.
JohnT

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.

JohnT

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