Biopsy - Managing the medical conveyor belt.

Hi Paul

Your experience is very similar to mine.

I had a 38 core biopsy in 2017. I was out of hospital the same day but the problems started afterwards. I had bleeding for several weeks and nothing worked as well as it did before. I get flare-ups of prostatitis ever since the biopsy.

The biopsy found one spec of Gleason 6, but not in the PIRAD4 zone identified by the MRI.

Now I'm seven years into active surveillance. I have been offered more biopsies and various treatments (private sector) but I have refrained from them all. I have had annual MRIs and only once did they say PIRAD4, so I had a re-review and the second opnion was PIRAD3.

Try not to get stressed. Gleason 6 is just something you need to keep an eye on. I found an NHS paper which says one in 3 men over 50 have some cancer cells in their prostate.

You can read a bit more in my profile if you want.

Best wishes

David

Be positive ! Your disease has been detected at an early stage so your prognosis should be very favourable. I think an annual MRI would be sensible only followed by a biopsy if there is a change in the imaging or every 2 years for routine monitoring.

Biopsies do cause trauma to the prostate and given your experience you are right to try and avoid unnecessary procedures.

I had a 24 core biopsy trans perineum and did get some immediate bleeding but this mostly cleared in a matter of days.

Gleason 3+3 is low risk disease and may never develop into something that needs treatment. So count your blessings !

Hi Steve

Thanks for taking the time to reply.

It would be 3 biopsies. The 1st one was nul and void, as it was done by an NHS outsourced company, and came back with no cancer, which did not tally with the MRI, so was done again, inhouse to the NHS.

The most recent MRI says: "there is an improvement in the abnormality of the prostate. The previously demonstrated right peripheral zone is Likert 4 with small right mid gland Likert 3 lesion."

and the one in July said: "for localised prostate carcinoma Gleason 3+3=6 since May 2022 with a PSA of 11.2ng/mL. MRI scan at that time confirmed Likert 4 lesion with focal atrophy in the right lobe of the prostate.

I think the consultant wants to do another biopsy to compare with the last one.

So to date, I have just the one biopsy gleeson of 3 + 3 = 6.

all the best,

Paul

Ok Paul, a bit clearer.

So it is a low grade cancer, that's obviously good.

Suppose one way to avoid another biopsy is to start treatment as u will probably have to go down that route at some stage 

Difficult one but I do remember I declined a second biopsy , just didn't want to go thru it again.

Best wishes

Steve 

Thanks David. It is really helpful to read other's experience. all the best, Paul

Hi Paul

As I said in my original post : Gleason 6 - PSA.8.9. Listen to your medical team. I am aware all is well at present but the PSA is up. At some point medical intervention will required - my view and Grundo above is start to get it treated before it gets too bad.

Honest opinion - not a medical one!! Best wishes - Brian.

Thanks for your support and sharing your experience. all the best, Paul

Thanks Steve, I'm getting there.

Many thanks David. Helpful to hear about your experience, and these posts are helping me on my way.