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repeat biopsy timescale for suspicious finding.

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User
Posted 05 Feb 2019 at 14:37

Hello to everyone. Im just after a little advice on options for a repeat biopsy if possible. Had psa of 3.65 back in may 2018 aged 46. MRI a few weeks later which didnt show anything so then had repeat PSA in Sept 2018 of 3.77. Recommended to have biopsy in Sept 18 which resulted in 1 of the 10 samples as 'suspicious' (2nd opinion agreed). Had PSA in January of 3.82 so being advised to have 2nd biopsy asap. It will be 6 months in March since i had the 1st one..is this an appropriate timescale in between the 2? Advice that i'm getting seems to be that I will have to have one so why defer. Thank you kindly!


Stuart

User
Posted 06 Feb 2019 at 02:48
Hi Stuart,

You evidently had a TRUS biopsy in the first instance. They are liked by the NHS as they are cheaper but are very inaccurate and do not require a general anaesthetic.

We often find that TRUS biopsies have to be followed up with a much more accurate template biopsy later. Try and make sure your next test is a template, as it’s particularly relevant in marginal cases or where there is ‘suspicion’ such as yours. My template took 42 core samples, for example. It still confirmed cancer though..........

Best of luck.

Cheers, John.
User
Posted 06 Feb 2019 at 22:46

My husband had a TRUS biopsy which showed up PCa but we sought a second opinion because weren't impressed by the doctor .Second doc said minimum 4 months between biopsies because the prostate has to heal. Second biopsy was a template one. Very precise  You can go ahead now as enough time has elapsed. Make sure you get a template or fusion biopsy .They take more cores but much better result. Good luck  

User
Posted 06 Feb 2019 at 22:58
That doesn't quite make sense - I can see how an MRI result may come back as 'suspicious' or 'inconclusive' but not a biopsy core. The cells are graded from 1 to 5, with 3 / 4 / 5 all being 'cancer' and 1 / 2 being benign. Have you got a copy of the biopsy report? Does it say that the one core contained PNI perhaps?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 07 Feb 2019 at 10:44

Sounds like the cells are somewhere between a 2 and a 3 - the good news is that they apparently didn't identify PIN which is considered to be a pre-cancerous stage although not everyone with PIN goes on to develop full blown PCa.


In the circumstances it seems a bit ridiculous to suggest you have a second TRUS which could potentially come to the same conclusion or worse, not find anything. If you were my brother or dad. I would suggest you hold out for a template biopsy in this case, unless there is a medical reason that GA is inadvisable for you.

Edited by member 07 Feb 2019 at 10:46  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 06 Feb 2019 at 02:48
Hi Stuart,

You evidently had a TRUS biopsy in the first instance. They are liked by the NHS as they are cheaper but are very inaccurate and do not require a general anaesthetic.

We often find that TRUS biopsies have to be followed up with a much more accurate template biopsy later. Try and make sure your next test is a template, as it’s particularly relevant in marginal cases or where there is ‘suspicion’ such as yours. My template took 42 core samples, for example. It still confirmed cancer though..........

Best of luck.

Cheers, John.
User
Posted 06 Feb 2019 at 22:46

My husband had a TRUS biopsy which showed up PCa but we sought a second opinion because weren't impressed by the doctor .Second doc said minimum 4 months between biopsies because the prostate has to heal. Second biopsy was a template one. Very precise  You can go ahead now as enough time has elapsed. Make sure you get a template or fusion biopsy .They take more cores but much better result. Good luck  

User
Posted 06 Feb 2019 at 22:58
That doesn't quite make sense - I can see how an MRI result may come back as 'suspicious' or 'inconclusive' but not a biopsy core. The cells are graded from 1 to 5, with 3 / 4 / 5 all being 'cancer' and 1 / 2 being benign. Have you got a copy of the biopsy report? Does it say that the one core contained PNI perhaps?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 07 Feb 2019 at 09:29

The report said that 1 of the 10 samples is showing 'atypical cells', which are suspicious but not diagnostic for cancer. Ive been put forward for a 2nd trus biopsy (which I may need to contest?) . I had a PSA 4 months after the biopsy which went from 3.77 to 3.82 and met up with the consultant who said it was probably best to get the 2nd trus as soon as possible. He seemed to be saying atypical cells have a 50% chance of showing low grade cancer on the repeat biopsy. Not great odds, but best to know now than be stuck in limbo im sure! Thx

User
Posted 07 Feb 2019 at 10:44

Sounds like the cells are somewhere between a 2 and a 3 - the good news is that they apparently didn't identify PIN which is considered to be a pre-cancerous stage although not everyone with PIN goes on to develop full blown PCa.


In the circumstances it seems a bit ridiculous to suggest you have a second TRUS which could potentially come to the same conclusion or worse, not find anything. If you were my brother or dad. I would suggest you hold out for a template biopsy in this case, unless there is a medical reason that GA is inadvisable for you.

Edited by member 07 Feb 2019 at 10:46  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 26 Jun 2019 at 10:45
Seems like a good result to me - ask for 6 monthly monitoring of your PSA so that the whole process can be repeated in the future if there are any concerns.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
 
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