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Thread: Not great news...

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  1. #13
    Quote Originally Posted by Nonquixote View Post
    Neither of them have any idea what my treatment choice will ultimately be. My question to both was, "would you have the biopsy done?" To which both responded with an unequivocal "yes".

    Obviously a biopsy can present a less than complete picture, especially a random biopsy. To that end this next biopsy will be a fusion biopsy across the entire prostate, 16 needles. This will be the last.

    No doctor has suggested that my PCa shows any indication of being aggressive. Yes, younger men have a higher chance of having aggressive PCa, but there is no evidence that mine is aggressive. The half dozen docs that have given me a DRE have all said that they feel no abnormalities. Is it possible because of the volume of PCa that mine is aggressive and formed recently? It's possible, but no core shows that. It's also possible that my PCa has been slowly growing over years. Hard to know for sure since my last PCA was my only PCA. Ever.

    So what is it specifically that annoys you the most? Taking some time to research and gather additional information before making a decision? Or is it my tentative method of treatment?
    Just chiming in to say that you can feel only a small portion of the prostate on a DRE -- it's even been proposed that it be eliminated from PCa screening entirely! (That seems foolish to me--my doc felt a nodule, and we went on to another biopsy which found G10 cancer. When I asked him if he would have insisted on a biopsy based solely on my PSA increase if he had not felt the nodule, he shook his head side to side in a "hmmm" gesture and he paused, looked at my PSA rise and said "Well, we certainly would have discussed it.") So a positive DRE is fortuitous for finding canse; the opposite, a clear DRE, means little.

    You say "No doctor has suggested that my PCa shows any indication of being aggressive" That was, and probably still is, true of G6 on the average. However (1) we know from G6 men who opt for RP that a fair number of them are at diagnosis already harboring higher-grade lesions, and (2) genomics is revealing that some men have G6 with characteristics that make them high-risk for higher-grade lesions currently or in the future. Uros do have intuition base on experience, but they don't have psychic powers. The larger the prostate and the more G6 tissue found, the less good a AS candidate you are.

    Knowing what I know now, if I had had a B6 biopsy and been told I was a candidate for AS, I would have a genomics test done first thing.

    Last edited by DjinTonic; 07-14-2019 at 10:29 PM.


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