Biopsy repeat

I have been under Active Surveillance for the previous 4 years after my first biopsy showed 3+4=7 Gleason score.

My PSA has been regularly checked and has currently come down from 9.2 to 8.4  yet my consultant has organised for me to have another biopsy. Why would this be?

  • Hi Kayak and welcome

    I was on AS for 4 years and just had the one biopsy relying more on MRI which shows more about growth than a biopsy. If your psa has come down there should be a question mark about why another biopsy now or have u had a recent MRI which shows something?

    How many MRIs have u had in the last 4 years and when was the most recent?

    What has your psa history been over the past 4 years, an upward trend except for the latest one or have there been periods when it has remained the same?


  • Hi Grunds I did have an MRI a couple of monts ago but that was the first one of ever had so there is nothing to compare it with. My PSA has stayed pretty constant from 6.6 to 9 and recently down to 8.4. Due to see consultant later today so will see. Just wanted to find out more from this group first so I can go armed with questions. Thanks.

  • Try and get hold of a copy of the Mri report, this should tell u location and size of tumour,  Unbelievable that this is your first MRI.


  • Hi. Had meeting with consultant this afternoon and all was explained. MRI showed growth of lesion so they wanted to do biopsy to clarify grade. Position of growth is in difficult position to get to as over and right next to urethra. Anyway I had transperinial  biopsy after the consultation. Bit uncomfortable but now at home feeling bruised but not too bad. Thanks Grundo for helping today, much appreciated. 

  • I was just thinking that maybe the location had spurred them into action - this is what happened with me in effect as the MRI showed it was pushing on the back of the prostate into the rectum and some cancer cells could have already migrated.  nearly 4 years post HT and Radiotherapy now and will be having a PSA test at the end of the year so far all good so don't think that any had already left the prostate as for past 5 tests it has been undetectable.  My MRI was 3 weeks after my first biopsy and after PSA had raised to 13 - a year previously it was 9 and at age 71/72 my rad.onc when I saw him before radiotherapy said they really should have started being more concerned when it reached 9 - as I had always had prostatits, etc and had already had a procedure to shave prostate as it was playing havoc pressing on my urethra.  I had asked for more frequent PSA tests but my GP refused - should have gone private and paid for a couple of tests that year.  Hindsight is marvellous eh?  I can't believe this is the first time you have had a MRI either.  

    Hope all goes well for you.


  • Thanks for that Des. They confirmed it hasn't migrated at all in my case. They will be be discussing treatment when full results are back. Not looking forward to that and worried about making wrong decision. Was your rad every day and has it sorted it?

  • Ok, well at least the biopsy is over, let's hope a low Gleeson or at least no higher than before.

    Does make u wonder if they had done a MRI a couple of years ago it might not have got to a difficult position.

    Best of luck , keep us posted


  • Cheers, will do.


  • Hi,  My PSA was 13 and Gleason score 7 (3+4).  Radiotherapy was decided on as it would most likely pick up any rogue cells which may have escaped.  The radiologist was concerned that they could have escaped but were not seen as too small to be picked up on PET Scans etc and better to be safe than sorry - a prostatectomy would be less likely to do this and anyway I had urinary problems that a prostatectomy may have aggravated so even urologist suggested radiotherapy and he was doing himself out of doing the operation!  I had nine months of HT having my last 3 monthly dose about 2 weeks before radiotherapy started.  I had 20 days of radiotherapy so 5 days a week for 4 weeks.  I continued to go to the gym 3 or 4 times a week all the way through treatment.  At my cancer centre many men attended later at night and continued to work as normal during radiotherapy.  I don't know whether this is so at other centres.  I did have some minor bowel problems 5 months post radiotherapy but I think this was aggravated because I had a gastroscopy and endoscopy  procedure for an unrelated matter.  I think if I had put that off for a month or so making it more than 6 months post radiotherapy it would not have been so bad as I did see the irradiated area on the screen as they did the procedure and even the gastroenterolgist said he was surprised the area was only mildly inflamed but that evening my bowel started acting up.  the treatment is 1 immodium and 1 fybogel a day and things are fine.  They did tell me to expect bowel and bladder problems around day 10 to 13 of radiotherapy and I was lucky I only had one night where I had to get up to pee about 30 times - well I lost count but it felt like 30!  No bowel problems at all during radiotherapy - other men I talked to in the waiting room had various different problems with bowel and bladder from about the half way point just showing how we all react differently to the same thing - though of course because the tumour is in different places you can expect different side effects.  So, considering my tumour was pushing on the back of the rectum I have fared very well.  PSA is now undetectable and has been ever since my radiotherapy, to all intents and purposes a cure as the urologist and radiologist stated - however believe me you never feel safe again and each annual PSA test has me concerned but my wife is beside herself with worry for about 2 weeks before the test and whilst waiting for the results.  I really think our other halves worry more than we do.

    All the best


  • Wow you have been through it.... But great result in the end. Thank you so much for sharing your experiences it helps greatly towards any decisions I will have to make in the near future, knowing what I might face.

    Best regards