Biopsy or not? Does Biopsy spread Cells

Update
Had consult with Urologist at MRI Centre. He was very good and thorough. Showed me the MRI comparisons on computer. He explained the white contrast on both 2011 and 2015 as being present, but 2015 was just clearer which he explained could be due to me being better hydrated at time of MRI.
For sure there is inflammation but NO visible tumour which in part is good, but as the white area is present he explained why this "may" mask PCa. I asked why Gleason score 3+3 and 3+4, he said the 3+3 would be if potential UNDER the mask for lion of 4-6mm and the 3+4 is due that 5% of lesion at 1-2mm can be a 4, he said its statistical and based on the contrast white showing greater area.
He agrees that inflammation should be treated first then re MRI. He also recommended to avoid biopsy unless absolutely necessary. He says no urgency as he does not think its aggressive and anything is clearly contained. Also size is good and slightly increased but this can be the points taken, but as PSA is stable then density is higher which also is good thing. The only worry is PSAf but again its boarder line. The cyst is from birth, no inflammation but he said the biopsy may also cause damage here so its best to avoid until we are sure. MRI is just another tool and yes there is contrast area but it is grey area. Cheers Dean

No options in reality. The MRI suggests you have prostate cancer but is not certain. Only a biopsy can tell you that there is cancer there, what Gleason score and which type of cancer. There are 27 different prostate cancers and some do not respond to usual treatments so it is essential info. The members here tend to be those who have had problems, there are hundreds of thousands out there who have had biopsies and treatment and then got on with their lives - there are many more who had negative biopsies and apparently have not had cancer rampaging through their body as a result of a few needles. Just do it.

Lyn. Cheers appreciate all comments. Then you might also question how did it spread? I assume he had biospy? you are correct the MRI indicates this, however, it states Inflammation with "may be". All I'm trying to review is the inflammation first. I have 8mm cyst which "maybe" part of this inflammation. I have also read that others had lower PSA, but also they had 4 biopsies all negative, then later found it spread. Why this? The Prostate is within a capsule and if it leaks it spreads. If you bleed when you have AIDS or other disease to other with open wound then chances is that you may also get this. Point being is that Biopsies are cores, then there is blood and the capsule is penetrated. There is no hard evidence yet that this is from Biopsies, but even if there was, do you think they would come out and announce it? All I am trying to do is close all loopholes and check all possibilities. I have made appointment with Urologist also at the MRI centre whom is specialist, then if he clarifies the MRI or options or none, then of course the next logical process is Biopsy. I was also told back in 2011, by also the same people, that even if there was PCa, that it would be such slow moving that I would most like die before that of PCa. So what changed from 2011 till 2015? Oh, yes that Cyst has grown which was small and not even mentioned in 2011 but is compared within the report as being present in 2011. So my point here, which I'm clarifying is does this impact on PSA? yes or no? Its a long road that I have been on since 2007 and each time they say do not worry. Do they really know? I'm not sure but then again I also wish to ask and clarify. Hope maybe this explains why.

Bri you are correct it can only be confirmed from this list. MRI's use same scoring as Gleason in scores out of 5, so based on MRI and the contrast pumped in veins they get image, then they score like that of pathology...though it is not pathology. In 2011 I was 1's and some 2's and with only PSA of 3's and PSAf of 28% then the Gleason was 1+1 or 2+2. Due to the high potential of inflammation then the radiologist and urologist stated that most likely BHP or Benigh. Yes I want to know if its fast spreading as then of course you wish to mitigate, however, slow spreading then treatment options are not so much fun as then sometimes best not to know as many die without even having known of potential PCa, in this case testing makes it worse. My entire point here is that this Cyst which is noted is benign....but then what change as the MRI score is 3+3 or 3+4. My Urologist said they are over cautious. Why he say this? maybe due to cyst, but he never mention this to me as I only got report after the consult. I've read lots now on this Cyst and even here 2% have shown that they can contain cancer cells, but it means also 98% does not. Likewise the MRI and the PIRADs of MRI state even with MRI study of 143 people (yes small sample) that for MRI assumptions of 3 only 19% had PCa and 81% beneign....unfortunately as Lyn mention there is not many gone down MRI route as this is relatively new with limited locations...maybe I am lucky and maybe not, but also as time goes there maybe more technology to assist. My original question was around others if similar as unfortunately PSA is not black nor white, neither is biopsy as we have seen, so why make more grey unless necessary. I hope Im around to tell the tales...cheers

Hi Dean

These sites may help:

http://www.cancercenter.com/community/questions-and-answers/prostate-cancer/can-needle-biopsies-spread-prostate-cancer/

http://prostatecancerinfolink.net/2014/08/01/needle-tracking-of-prostate-cancer-cells-during-prostate-biopsy-a-review/

They told me I also have a Cyst in my bladder recently and I hope to find out more about this next month (had train to catch so didn't ask any questions) although I don't think it has any relevance to my PCa. The specialist seemed to think it was nothing to be concerned about.

dl