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Dad awaiting biopsy results - any advice ?

User
Posted 04 Nov 2025 at 00:10

Dad had a transperineal biopsy almost 3 weeks ago. 

Urologist said mri he had prior to biopsy showed 2 small spots on prostate so took 3 samples from one and 2 from the other. Although he used the phrase small spots he did say psa was high at 14.7. 

never got prostate size, pirads score or anything from mri.  Haven spoken to his gp he said looks confined prostate but most likely cancer so we’re assuming it’s a pirads 4/5. 

They were very pleased that he had no urinary complaints or anything like that. 

 after biopsy he had no blood in his urine or anything - is this strange? 

Would the fact he only had 5 samples taken indicate the lesions were small and likely contained to prostate, or were such little samples taken because it seemed obvious to be highly significant cancer so don’t need many samples to confirm? 

another week or so waiting for results and dreading them - anyone similar  ? 

User
Posted 04 Nov 2025 at 20:56
Concerned daughter, biopsies are different from other tests (like PSA in blood, or an image by MRI) where the read-out comes pretty quickly. There is a lot more processing, the samples need to be treated in a way they can be viewed on a microscope slide and the analysis needs an expert pathologist. It all takes time.

It sounds as if the tests so far mean there isn't much doubt about whether cancer is there, but to plan the best approach they need to know how aggressive it is (and where, the cancer can be different in different parts of the prostate). I realise the wait is stressful for you and your father, but at this stage it is about homing in on the best treatment which should be reassuring (somewhat). Although cancer is scary, it doesn't grow so fast that waiting 4 weeks makes a difference.

When I was being diagnosed transperineal biopsy wasn't a thing, I had a transrectal one which carries risk of infection (and wasn't a bundle of fun though I doubt the transperineal one is either). However because the sampling is from the back of the prostate it is easy to take a larger number of separate ones; going transperineally from the bottom of the prostate there is a smaller target which maybe is why they don't take as many samples. (Sorry if that sounds confusing, if you look at a diagram of the prostate you will see that its shape gives it a different profile from those different angles).

I hope that once all the detail is known your father can get the best possible advice, and treatment with a high chance of success.

 
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