Posted 9/14/2018 12:26 PM (GMT -7)
I’ve been on AS for 2 years - my PSA is stable. My AS protocol is a PSA every 6 months, DRE every year and biopsies every 2-3 years -based on the PSA results.
I can’t have an MRI because of my defibrillator. I know that MRI’s are part of the standard AS protocol. I asked my doctor(s) – local urologist and MSKCC consult about an MRI workaround and I was told there isn’t any.
My urologist told me that he would take 16 samples during the next biopsy. I was awake for the first 2 biopsies and although it wasn’t fun, it wasn’t too bad. I already told my doctor that I want to be knocked out for the next biopsy – especially if he is going to take additional samples.
Question: Being knocked out; with a TRUS biopsy, will my doctor be able to take samples from areas of the prostate that he wouldn’t otherwise “reach” if I was awake? I really don’t want a saturation biopsy or a template mapping biopsy – although I may ask my doctor about them.
For low and intermediate grade cancer, I understand that the cure rate for surgery, IMRT and SBRT is the same – around 75%. Therefore, the probability for recurrence would be 25%.
Questions: Assuming that HT/SRT is the follow-up treatment for recurrence after surgery, what is the cure rate after HT/SRT? I understand that an MRI is done as part of the simulation for SRT. For men that can’t have an MRI, is there a work around?
If radiation (IMRT or SBRT) is done as the primary treatment, if there is a recurrence, what is the secondary treatment and what are their respective cure rates?
PSA - May 2014 - 2.1, Oct. 2015 - 3.4, April 2016 - 4.0, Oct. 2016 - 2.5, April 2017 - 2.9, Oct. 2017 - 3.4, May 2018 - 3.5
Age 68 - Active Surveillance
Prostate: 54 grams
TRUS Biopsies: May 27, 2016 & July 29, 2016
May 27, 2016: Gleason 7 (3+4) in 1 core, less than 5%, Dr. Epstein review - inconclusive, MSK review - Gleason 6.
July 29, 2016: Gleason 6 in 1 core, less than 5%, 3 Path. Agree.