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Biopsy explained please

Posted 26 Jun 2021 at 23:03

Hi All

I hope you are all doing OK.

I am just reading latest Onco  letter to our GP and can anyone please explain to me what the following means:

1.  TRUS Biopsy - right 4/4 cores 4+5, left 3/3 cores 4+5 up to 14mm

2.  MRI - 19cc gland bilateral changes 5/5 with both T3a and T3b features.

3.  Also can anyone explain to me what the term neo adjuvant means when talking about chemotherapy.

and lastly,

4.  OH’s PSA has been 0.1 for the last five months since he started back in HT and Enza but this latest one is 0.01. I think 0.01 is lower than 0.1, am I correct?

Any explanations for any of the above would be very helpful because I don’t know what the hell any of the above means!!

Thanks Debbie x



Debbie xxx
Posted 27 Jun 2021 at 01:04

When they did the biopsy, they took 7 samples (cores). A core is like sticking a drinking straw into the prostate and then pulling it out with a thin spaghetti of prostate left inside each straw. In your case, all 7 cores had cancer in them and some of the 7 cores had quite a lot of cancer. The 4+5 tells you how distorted and therefore how aggressive the cancer is - the most aggressive is 5+5 and then 5+4 so in all 7 cores, your OH's cancer was of the 3rd most distorted group.

It seems that the MRI had already identified the suspicious area and that determined where they took the 7 scores from - in other words, they knew where to look. The T3 means that it looked on the scan like the cancer was already breaking out of the prostate - they would have been able to confirm that with the biopsies which is possibly why he is on the treatment plan he has.

Neo-adjuvant chemo means the chemo is being given before another treatment, to make the second treatment more successful.

Yes, 0.01 is smaller than 0.1. It may be that your OH's PSA levels has dropped further or that it is exactly the same as before but has been measured differently this time. Is there a little < before the number?

Edited by member 27 Jun 2021 at 01:05  | Reason: Not specified

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

Posted 27 Jun 2021 at 01:20

Hi Debbie, I can't add much to lyn's answer. The only thing I would say is that, these details about the biopsy and MRI probably relate to the tests done 4 years ago. My letters to the GP always start with my history, which is similar to your OH, then they go on to explain the current situation. 


Posted 27 Jun 2021 at 07:26

Thank you Lynne. Your explanations are very helpful and I can confirm that there is no < on the PSA result from what I can see. 

Debbie xxx
Posted 27 Jun 2021 at 07:29

Thanks for your response Dave. You are correct, the results are from my OH’s original diagnosis back in 2017. 

Debbie xxx
Posted 27 Jun 2021 at 18:56

HI Debbie,

0.01 is very low.  Most of us would not be told it was so low.  For example the lowest I'm told is <0.05 (lower than 0.05) and many hospitals use <0.1.

That there isn't a < sign means it's an actual reading of 0.01, as < means lower than. 

GP's sometimes don't show the < sign but if it's a letter from the consultant they would usually show the < if it was there.

I'd say 0.01 is very low and a good result for someone on hormones although I'm not an expert.

All the best, Peter

Posted 27 Jun 2021 at 20:10

Thanks Peter. That’s good to hear xx

Debbie xxx
Posted 28 Jun 2021 at 10:27
My surgeon, two oncologists, and a prostate cancer nurse, all told me what is termed ‘super-sensitive assay’ i.e. readings to multiple decimal points below 0.1, usually cause more trouble and anxiety than what they are worth due to ‘noise’ and lab error margins.

I take comfort in the fact that my local billion-pound super-hospital only tests PSA to 0.1, so <0.1 is classed as ‘undectectable’, particularly as all my tests have been undetectable, including one last week, since my surgery three years ago.

Some GP receptionists don’t seem to have studied sums to a very high level, so the ‘less than’ < symbol escapes them when they input the results.

Best of luck to your old man.

Cheers, John.

Posted 05 Jul 2021 at 22:24

Thanks John and delighted to hear your doing well.

Debbie xxx
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