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Impact of template biopsies on RP

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User

Posted 22 Oct 2014 at 20:38

I am 60 years old. Diagnosed July 2013 with a Gleason 6 and PSA 8.3, and also with an enlarged prostate. Back then it was agreed that active surveillance was a viable option, but now @ October 2014 my PSA is 11.4 and the consultant wants me to have a template biopsy to see if Active Surveillance is still appropriate.

I am unsure whether to go along with this or just to admit defeat and go for a radical prostatectomy. I've read that template biopsies can cause problems and complications during a prostatectomy and if this is going to be inevitable in the next 2 years I'm wondering if I should just go for it now.

Has anyone any experience of this?

User

Posted 24 Oct 2014 at 12:42

O.H. had a template biopsy after clear results from previous biopsies. He had an infection which cleared with antibiotics(almost drain cleaner!). Afterwards had brachytherapy and radiotherapy which was equally valid treatment as prostatectomy. Only side effect slight flow issues ,treated with Tamsulosin. I know this is not identical to your situation but may help. Hope you have looked at the Tool Kit from this site. Best wishes,El.

User

Posted 24 Oct 2014 at 19:57

I have never read anything about template biopsies affecting the surgery and there seem to be regular posts on here from men who have had both.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Oct 2014 at 15:36

I had had two templates the last being 7 months before my prostectamy,it was never mentioned that it could have an impact on going down the brachy route if I had chosen this when offered.

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User

Posted 24 Oct 2014 at 12:42

User

Posted 24 Oct 2014 at 19:57

I have never read anything about template biopsies affecting the surgery and there seem to be regular posts on here from men who have had both.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 24 Oct 2014 at 23:07

I had a template biopsy before robotic surgery. The only complication was going into retention after my template biopsy and having to go into hospital in agony the next day. The catheter had to stay in for one week. The reaction of the prostate to the template biopsy, I was told, made me unsuitable for brachytherapy.

Stay Calm And Carry On.

User

Posted 25 Oct 2014 at 18:23

Template biopsies can very accurately locate from where the tissue was taken and accesses areas of the prostate often missed by standard TRUS biopsies. However, it requires a general anaesthetic and may produce more bleeding and subsequent complications such as urine retention. A possible alternative may be the new high-powered MRI scans known as 'multi-parametric scans'. But these require a powerful MRI scanner with the correct software and are not available on the NHS in many areas. Certainly there are private facilities which do this investigation.

I was just a year younger than you when diagnosed 6 years ago. I would certainly have opted for a multi-parametric MRI done by and reported by a specialist with good experience of such scans before a matrix biopsy. However, it would have come at a financial cost.

User

Posted 26 Oct 2014 at 15:36

I had had two templates the last being 7 months before my prostectamy,it was never mentioned that it could have an impact on going down the brachy route if I had chosen this when offered.

User

Posted 26 Oct 2014 at 18:14

Barrie, I think it was the complications Sf2 experienced that ruled out brachy, not the template biopsy itself.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Oct 2014 at 21:00

That's right, Lyn. It was going into retention that meant I couldn't have brachytherapy.

Stay Calm And Carry On.

User

Posted 05 Feb 2015 at 21:22

Hi I'm just new.
Interesting thread as going now just through this. I must agree with all I read since 2011, TRUS Biopsies bring so many unknowns, so I support the 3T MRI. This whole PSA thing is a nightmare as even high readings bring no certainty. Had PSA, PSA Free, PCA3 tests, DRE's, MRI's with all in "equivocal" grey area, neither one nor the other. Even current MRI is score 8 and yet again can be inflammation or potential cancer. The one advantage I see is at least with MRI Guided Biopsy they can target exact area and know with more certainty.
I thought that the MRI Guided reduced infection and other side effects, at least that is what I have read on TRUS v MRI Guided. Are some of you inferring otherwise?
I pray and hope that the biopsy is the 80% benign and inflamed version.
Dean

My journey started in 2007, then PSA was 1.40
2009 Dec, had 4 hernias repaired which is only main change.
In 2010 during regular checks it was 3.30 which was somewhat high for my age. PSAFree not taken.
2011 it was higher 5.30 and Free was 27%
3T MRI in 2011 no timor but transition zone was low 2. MRI Volume 27
2011/12 was in the 3.0's range No PSAFree taken
2013 was 5 tests in 4.0's as high as 5.19 but PSA Free in 13-15% range which was worry.
2014 was low 4.0's and also 3.64 but PSA Free in 12% area
ALL DRE's Normal. PCA3 in 2011 was 27 which was told is good. 3T MRI no timor.
ALL within GREY ZONE which is very hard to have clear outcome.
Jan 2015 PSA was 4.04 and Free Ratio 13%
Dr concerned ONLY by low PSA Free
Redid 3T MRI in Jan 2015
Results of 3T was "equivocal" PI-RADS score of 8 which implies 19% chance of timor. Score was due to change compare from 2011 benchmark.
MRI Targeted Biopsy planned March 2015

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