Waiting for prostate biopsy results

Hello Busboy

A biopsy early July should be coming up to results time in the near future I would imagine, so not too long to wait.  It is an awful time waiting for results but once you get them things will ease - to treat or not to treat…

if you have not already done so I would recommend having a look at the information available on the PCUk website- the Toolkit is very good.  When you have more information about Gleason Score, the TNM analysis you will be in a better place to understand what may lie ahead.

Please do not Google - use this site or MacMillan for information for trusted information.  Search AI will pick up an aggregation of information which may be out of step with current modern practice. The Triplet Therapy I am on has only really been around for a few years but is getting great results.

if you click on the name or roundel next to it you can see our individual profiles to give you an idea what pathway we have been on, and given time you can use this to let us know your own story if you wish.

Hi again, busboy.

Of course, it would have been great if the biopsy had come back all clear. However, Gleason 6 is a pretty decent second prize. 

Initially, I had a very similar diagnosis to yours. Gleason 6, T2a, PSA 5.6. Statistically, if going on active surveillance, with figures like that, you have about a 50% chance of not needing further treatment in the following ten years. I liked those odds and took a chance. 

Unfortunately, during the following two years, they discovered disease progression and I opted for surgery. Three and a half years later, its been successful, but I still have a chance of BCR. 

Although my active surveillance ultimately failed, if I were in your position, I'd still give it a go.

The beauty of active surveillance is you can change your mind, and if things go awry, you can opt for a radical treatment. You may find it difficult knowing that you've cancer and worry that the cancer might grow. I appreciate that, I had the same concern, but I find the checks for BCR just as worrying. As far as I'm aware, even those with low risk cancer and have RARP, still have between have about 15-20% chance of BCR. I believe  this recurrence rate is similar for most other treatment options.

My thoughts are, why immediately go for radical treatment, which is not always successful, and often comes with side effects, when your cancer may never need invasive treatment. Why try and fix something that might never need fixing?

My only real concerns about active surveillance is it being largely based on biopsy results which can be inaccurate. I believe that my initial biopsy missed the more aggressive cancer cells.

I would also be reluctant to have AS, if there were multiple tumours, or the tumour was situated near to the outer prostate wall.

It must also be ACTIVE surveillance. You must ensure that your follow up PSA checks, MRI scans and possible biopsies are done in a timely fashion. Mine weren't.

I hope, whatever treatment path you chose, it works for you.

Good luck. 👍

Edited by member 24 Aug 2026 at 16:54  | Reason: Additional text

Hi, again, Busboy.

You said earlier that you had a very enlarged prostate, this is known as a non cancerous conditions called Benigh Prostate Hyperplasia or BPH. It often elevates PSA. If your prostate is double the normal size, it can double your PSA level, if it's 3 times as big it can treble it. This could explain your elevated PSA level.

Dr Scholz explains this in this video.

https://youtu.be/eCeJPLJ0PdM?is=LE1v38NJBTJhvuG6

Here's a video on Gleason 6 prostate cancer. In it, Dr Scholz explains that in his opinion 'true' Gleason 6, in this day and age, would not be classed as cancer. He also states that 'true' Gleason 6 will never metastasise. 

https://youtu.be/a0sjUallZQU?si=222MsOzAkSM8sKke

The problem is being sure that you are 'true" Gleason six, as biopsies can sometimes miss more cancerous cells.

I hope viewing these videos will explain things better for you, and put your mind more at ease.

Edited by member 27 Aug 2026 at 08:22  | Reason: Add link

In a large prostate it is possible that a biopsy may miss a small tumour and it is possible that tumour is more aggressive than 3-3. However this is all ifs and buts. It may be that your MPMRI identified all tumours.

Were you diagnosed with one tumour? Did they advise on size and location? Is the tumour close to the prostate edge or not. There is research that says large prostates tend to harbour less aggressive tumours. 

Regardless given your diagnosis you are in no immediate rush. If and that is a big if something has been missed by the MPMRI it is likely at this stage to be small.

Active surveillance has many benefits over radical treatment in terms of avoiding potential incontinence problems, impotence, long term potential side effects of radiation if you choose radiotherapy. Active surveillance however may not suit someone who can not live with some uncertainty or who cannot fully trust their doctors judgement. There are no certainties in life, there are probabilities and the probability I would suggest given your medical team’s recommendation is that you will do very well with active surveillance. 

Perhaps  some questions to ask is how long do you feel I could remain on active surveillance? What PSA reading would change the  course of my treatment? What is the possibility that a more aggressive tumour has been missed given my large prostate? When would I have a repeat MPMRI?  Even what would you do or recommend to a family member in my circumstances? 

Good luck. Please don’t panic. I think other posters would tell you that despite your understandable concern at this precise moment given the circumstances you are in a good position.