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Thread: What I Need to Know About About Prostate Biopsy

  1. #171
    Moderator Top User HighlanderCFH's Avatar
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    Hi Gard,

    Has the doctor said anything about having an enlarged prostate? BPH is an infamous, but benign, condition that often elevates the PSA.

    The main thing is that your biopsy was negative. The key now is to have regular PSA tests to ensure that there is no upward trending, etc.

    Sounds like you are just fine, though, and I'm glad to hear it!!
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  2. #172
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    Quote Originally Posted by ASAdvocate View Post
    I know several men, including my 58 yo nephew, who have had PSA over 8 for ten years or more. Multiple biopsies have been negative. Itís fairly common. But, you canít just walk away and ignore it. You need to have a urologist and do PSA or PHI/4K/PCA3 tests at least once a year.
    Doc wants me back every four months to monitor.

  3. #173
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    Quote Originally Posted by organic farmer View Post
    Congratulations.

    I would look at some of the herbs that address prostate health.

    You are fortunate.
    Thank you.

  4. #174
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    Quote Originally Posted by HighlanderCFH View Post
    Hi Gard,

    Has the doctor said anything about having an enlarged prostate? BPH is an infamous, but benign, condition that often elevates the PSA.

    The main thing is that your biopsy was negative. The key now is to have regular PSA tests to ensure that there is no upward trending, etc.

    Sounds like you are just fine, though, and I'm glad to hear it!!
    Thanks Chuck. No we haven't talked much about BPH but I have done some reading. I'll have a PSA and DRE every four months until the mystery is solved. And of course the biopsy is not perfect so he may want to do another one in due course. I saw an interview with Ben Stiller on YouTube. His first biopsy was negative and the second one positive at age 48. Appreciate the support from you and others on this forum. God bless. I'll stay in touch.

  5. #175
    Quote Originally Posted by Gard View Post
    Thanks Chuck. No we haven't talked much about BPH but I have done some reading. I'll have a PSA and DRE every four months until the mystery is solved. And of course the biopsy is not perfect so he may want to do another one in due course. I saw an interview with Ben Stiller on YouTube. His first biopsy was negative and the second one positive at age 48. Appreciate the support from you and others on this forum. God bless. I'll stay in touch.
    Excellent plan, Gard. While biopsies do miss cancer, they can be essential. And each repeat biopsy greatly reduces those odds.

  6. #176
    Moderator Top User HighlanderCFH's Avatar
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    Good luck, Gard. One of our past members had to have about TWELVE biopsies, over a period of years, before his tumor was finally tracked down. Hopefully that won't be the case here. LOL

    Sounds like you have a good plan in place. So hang in there and things should be fine.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  7. #177
    I thought I would add the information below to this thread. The two main points are that (a) cleaning the biopsy needle between cores can greatly reduce the chance of serious infection; and (b) a transperineal approach (as opposed to transrectal) has almost no risk of serious infections.


    Regarding needle washing:

    COMBINATION OF A CEPHALOSPORIN/FLUOROQUINOLONE ANTIBIOTIC REGIMEN AND ISOPROPYL ALCOHOL NEEDLE WASHING IS SIGNIFICANTLY ASSOCIATED WITH REDUCED RISK OF SEPSIS AFTER PROSTATE BIOPSY [2018]

    Antibiotic prophylaxis and complications following prostate biopsies – a systematic review [2017]

    Also you might want to consider:

    Update on techniques to prevent infections associated with prostate needle biopsy [2018]

    The transperineal approach has shown a near-zero rate of PBIs, and should therefore be considered for the highest-risk patients.
    Last edited by DjinTonic; 12-22-2018 at 11:31 AM.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3 -
    2013 TURP (90→30 g) path neg. then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day check)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015

  8. #178
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    A 3D scan is a newer option. Biopsies only grab cells from one side as far as I am aware.

  9. #179
    Quote Originally Posted by Flourish View Post
    A 3D scan is a newer option. Biopsies only grab cells from one side as far as I am aware.
    When my biopsy was done, they took twelve core samples. Six from each side.
    At age 55, PSA 22, Gleason: 9 (4+5), 8(4+4), 7(3+4), 6(3+3)
    8 out of 12 cores positive
    DaVinci 14 October 2014
    Pathology of surrounding tissue samples was negative, though they annotated it as stage 3.
    Post surgery PSA:
    Jan 2015 <0.04
    2016 <0.04
    2017 0.05
    2018 0.1


    In 2018; 45 radiation treatments and hormone treatment [with Lupron for the next 2 years].
    In 2019; on Lexapro to deal with the Lupron.

  10. #180
    Quote Originally Posted by Flourish View Post
    A 3D scan is a newer option. Biopsies only grab cells from one side as far as I am aware.
    Detection of prostate cancer with three-dimensional transrectal ultrasound: correlation with biopsy results [2012]

    However the above study found

    The abnormalities detected by 3D ultrasound were associated with moderate- and high-grade prostate cancers. However, based on the number of false-negative TRUS results, the use of systematic prostate biopsies should not be eliminated.
    Biopsies take cores from both sides (lobes) of the prostate.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3 -
    2013 TURP (90→30 g) path neg. then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day check)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015

 

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