Postponed Repeat Biopsy - puzzled

That does sound a bit odd I must say.

It looks like tumour contained so wonder what they want to re biopsy.

Do u know the tumour size in mm as the MRI should show that?

Best wishes 

Steve 

Hello Pura Vida .

I can't comment on the cancellation of the biopsy - my husband has had 3 and all carried out by the same person, although the 3rd one was carried out under general anaesthetic because the suspicious area was in a particularly difficult and potentially more painful area to sample.

With reference to the Cambridge Prognostic Group I think you are in the realms of the CPG4 due to your initial PSA being above 20, which is high risk. This means that treatment will more likely be recommended and the repeat biopsy has been requested to clarify the type of prostate cancer you have, and yes there are several types. A biopsy only samples about 1% of the prostate so cancerous cells can easily be missed. The Pirads 5 is a highly suspicious area of more than 1.5cm. Analysis of the prostate material will give a better idea of how aggressive the cancer is and so better direct the treatment pathway, plus it might change your Gleason score. It is safe to have a repeat biopsy provided there has been at least 6 weeks since the last one.

I have attached information on the CPG grading system.

https://www.cancerresearchuk.org/about-cancer/prostate-cancer/stages/cambridge-prognostic-group-cpg

Hi Alwayshope,

Thanks for your comment.

I have had six biopsies, basically one a year over the last six years. I hadn't appreciated how little of the prostate is sampled in a biopsy. Although cancer was only found this year, it has felt like being on active surveillance without actually having a cancer diagnosis.

I don't want to continue on AS. I'm worried that a Gleason 6, means the MDT will recommend AS. It is stressful living with the idea of steadily growing cancer even if it is not aggressive. Especially as there is a bulge in the prostate wall in the Pirads5 area. If the chances are high that I will need treatment in a few years, why would I not take that option now, while I am younger and healthier?

I know whatever the treatment route, there will be an impact on continence and ED, but it seems there are so many positive outcomes, there's a good chance those impacts could be short to medium term. To me it's a quality of life issue and the chance to be rid of the endless rolling dark clouds of rising PSA, MRIs and biopsies.