I had 12 random samples plus 2 targeted samples. Lot's of disease but no malignancy. This is the best site you'll find for prostate cancer information.
@@valentingrecea449 Only one biopsy but fourteen cores were taken. Originally I had high PSA test results. So my doctor decided I needed an MRI, which I had, and a lesion was seen in the left anterior portion of my prostate. That's why I needed the biopsy. But, after the biopsy and I got the results, I have complicated prostate disease(s) but no cancer.
2008...PSA was 6.4...I was 62 years old and I did nothing about it. 2023...PSA was 11.4.....I was now 76 years old and got an MRI....found a 10mm lesion PIRADS 4....Went for a biopsy and it was gleeson 4+3 with a lot of 4.....Next a PET scan and found no spread outside prostate.....Great relief! Next was treatment and because of my age and size of prostate, surgery was out of the question and so it was 3 months ADT + 7 sessions of intensive radiotherapy + another 3 months of ADT. Result.... months of after effects and suffering all I was informed about the possibility that they could occur. PSA levels very low and now at neary 9 months after R/T will get another PSA check. BUT all my suffering of after effects have almost gone and I am nearly back to normal. So now it is down to the PSA again....as long as it stays low, I am out of the woods. This 9 months check of my PSA level is of great concern, because if it rises, I will be back to square one..
The timing of the posting of this video is so perfect for me it is eerie. I received the original pathology report for my biopsy yesterday (Gleason 3+4) with 30-40% pattern 4, only in MRI fusion targeted cores. I received my second opinion from Johns Hopkins this afternoon (Gleason 3+3). So I spent 24 hours worrying about treatment options, and discovered today that active surveillance is an option. Your videos inspired me to seek a second opinion on the pathology report. Thank you so much.
Had a random done. Year later my psa still at 8. My prostate has been sore ever since biopsy. Two mri’s that are inconclusive. Neither two brothers or dad had cancer. Seems like a second opinion or just keeping watch seems the answer. I really disliked the biopsy. Hurts for days.
First let me say this channel is a Godsend. I have learned more from this and other channels than from the P.A. who gave me my biopsy results. I had one core out of 12 that was 3+4=7. I’m meeting with my Oncologist next month . I will be better prepared than earlier .
Thank you for this very helpful presentation. I am 73 years old, and have had BPH for about 15 years. Recently had a targeted biopsy with 14 cores taken, seven on the right side. Seven of those cores showed cancer with Gleason score of 6, and one with Gleason score of 3+4=7. That one core also showed "perineural invasion" present. Is perineural invasion an avenue for the cancer to spread beyond the prostate? My most recent PSA was 4.42 (actually 2.21, but I have been on Finasteride for years). Thank you!
MY PSA was 11.5 and I had the biopsy done on August 1st. waiting on Gleason score and next steps. I had a mp MRI along with scope done, don't remember name. I was shown the biopsy MRI scans and the radiologist showed me where the cancer was. Now, I wait until the 21st of August for results. Thank you for this information.
Over the last 6 years, I've have three biopsies. First was random samples and the next two were targeted based off MRI. All samples came back negative but with cronic inflammation. PSA 4.2 but my PSA bounces around. Seeing my Urologist every 6 months.
Fantastic channel can you please do more on met prostate cancer I had no symptoms but was diagnosed last October with a PAS of 485 and Gleason score of 9 I have had radiotherapy on my spine due to the cancer pressing on it I had 6 cycles of chemotherapy and currently on gen 1&2 hormone therapy PAS was done to 0.14 this week I have coped well so far with little side effects I am 57😊
I had an MPMRI identified lesion measuring 1 cm and a PSMA negative for spread. I had a trans perineal biopsy where 21 sticks were done. The biopsy identified 4+4. My initial PSA was 24.4, but I suspected I also had prostatitis at the time. I elected surgery which I had in July. My post op path downgraded the tumor to 3+4. My post op path read EPE with perineural invasion, but with negative margins. My first post op PSA is scheduled for September. I wish you would do a video with these circumstances with regard to negative margins with EPE. The final path report read "all resection margins were negative for malignancy". I read this means all of the cancer was removed. Is this accurate? I'm concerned about my prognosis. Thanks for your channel. It has really helped me through this journey.
The second opinion is so critical best thing I ever did. I’m going to go on a second generation drug alone, might use a first generation as well. The main thing is there are no injections just pills so it’s very easy to stop the treatment quickly if the side effects are too severe.
Diagnosed with Prostate Cancer 11 years ago. Radiation.. PSA was .2 for 11 years. Suddenly my PSA climbed to 5.0 over the last year. So... I had 4 biopsies over a 8 month period, 2 Prostate (one Fusion) and 2 lymph node biopsies. ALL were Benign!. Now my Urologist Team says I do have Re-current PC... but they just can't find where (2 PSMA Pet scans done before the biopsies that only lit up the prostate and a "maybe " in the lymph) SO.... My TEAM of Urologist have given up and said "Hormone Treatment " ... Is this correct? Why can't they find EXACTLY where my cancer is... and focally treat it? Do I need the rest of my Prostate removed?? I don't want to be chemically Castrated. I need help.
Definitely go with MRI I had a random biopsy. The doctor did 19 biopsies. Gleaton score was 3 + 4 when I had my prostate removed 6 months later they said it was still not healed up.
Definitely try to find a local support group and get in it before making any decisions. This man has been through it and they can guide you the right way and write doctors and write hospitals trust me it's the best thing I did I wish I would have done it before I made any decisions
Do biopsies take a toll on the prostate? . I’m going in for my third and doctor insists that no harm but how many times and holes can be punched into it? Also a three month recovery before surgery or other treatments so it does do some damage that needs to heal.
I have a question about stem cell treatment in the prostate which I'm it's being done on some patients in Miami. Any information about that form of treatment?
I had an MRI last year that showed a potential PI-RADS 4 lesion, but my trans-perineal targeted biopsy of 26 total cores showed no cancer. No random biopsies for me.
@@schmingusss roger that. Since the MRI indicated a possible PI-RADS 4, they did a standard 12 core (systematic, not random) plus 14 targets. Fortunately, no cancer was found.
Thank you for an informative video for a very complex medical issue. 10 years ago I had a biopsy with a Gleason score of six and I did not react well to the biopsy and avoided them.. my PSA now is 9 and MRI showed two areas of interest 3 to 4 mm. I had another biopsy at 72years old and luckily Gleason score of six again. I have a huge prostate top 10%.. I have only a slow stream that I’ve always . Unfortunately, my prostate presses on my bladder and my urinary bladder capacity is only 100 to 125 milliliters. It seems my prostate is inflamed somewhat since before the biopsy I had a capacity of 200 to 250 mL. Considering my age, probably watchful waiting maybe the best bet since biopsies are not the best thing for me. Hopefully everything stays the same for the future and will keep monitoring. I’m very active cross country skiing and bike riding which does affect my PSA.
Im 63 Psa 13.7 Mri priad5 Random biopsy 3+3 7% 3+3 5% 3+4 59% 16mm 12CORES They want me to do ex beam radaition 28 treatments am i on the right track ???
My biopsy was a Gleason 7, 4+3. Based on that and other factors just had a radical prostatectomy. The Gleason score on the removed prostate was still a 7 but it was a 3+4, had I known or had a better biopsy I would still be intact and active monitoring it and not pissing myself every time I move. I regret not getting a second opinion or targeted biopsy. It's another case of misdiagnosis. I'm not very happy at all. Can't trust anyone!
When a biopsy finds cancer with low PSA (2.5 in my case), should the pathologist employ a stain that detects neuroendocrine cancer? Mine didn't and I feel like it leaves a question hanging.
I had a random biopsy yesterday so I am still waiting for the results. My only issue was the pain was greater than I had been led to believe it would be. If I need a second opinion do I need to do another biopsy or can they use the same tissue?
Besides protecting valuable information on prostate cancer and everything associated with it, Doctor is a fashion model for ties. What is the name of the tie manufacturer? I very rarely wear one but would if I had some of the ones he wears.
I am really confused. I have PI-RADS 3, my doctor did a targeted plus 12 random biopsy. It turned out the targeted was benign, but 2 of the 12 cores turned out with Gleason score 3+4. So if I only did the targeted , I would not be diagnosed with prostate cancer.
@@wormsnake1 Thanks! Since only less than 5% (which is the smallest percentage they can quantify) of both both cords have cancerous cells, and my PSA is less than 10. My urologist said I have 3 options, surgery, radiation or active surveillance. But I would need biopsy every 6 months for active surveillance (since my cancer was not delectable by MRI). A second opinion would send my samples for genetic test, and a confirm biopsy 6 months after the first one. If everything comes back OK, then maybe we don't need to do biopsy that often.
With a PIRADS 5 there is a 20% chance that the worse area was missed. If the missed area was GL4+3, a PET scan is usually advised to detect spread. If you rely on random biopsies to direct treatment, you might miss treating disease outside the gland.
Great topic. There was no mention of ‘fusion’ biopsies that are now commonplace. To me, they are a blend of somewhat ‘targeted’ along with random. Are trans perineal random or targeted? To me, the only true ‘targeted’ biopsies are in bore mri targeted biopsies because those are the type where a doctor knows he is actually hitting the target. I think a follow up video would be good.
My first biopsy detected 3 plus 4 4 years ago {I am 64 yrs old} and have been on AS since. MRI and PSA. they did a random 2 years ago but it was a random. This Dec I get a Trans perineal targeted this Dec. My question. Do I have to ask my DR for a second opinion for my biopsy and how do I get it to John Hopkins for that second opinion? Also do I ask for Ge3nome DNA analysis? Thanks,
PSA 5.4. I'm going in for a Targeted biopsy in 10 days. My MRI showed two "spots" on the prostate. My question: Do I need the additional samples taken? Or just the two spots? How important are the additional cores to make a total of 12? Is this necessary?
I'm a bit disappointed with the lack of age in this great discussion. Age 85 was the only mention. If 2 patients have similar elevated scores (PSA, Gleason) but one is age 50 and the other is 80, I suspect the treatment will be more aggressive for the age 50 patient. I was diagnosed at age 80 with Gleason 3+4, PSA 6.6 and 18 months later nothing is being done and have not been referred to an Oncologist. Health is otherwise great. No presciption meds.
Please can someone please help me with this biopsy report. I don't understand it. Here's how it reads: "It involves approximately 90% of the sample. The grade 4 is 4 mm". Another one reads: "
Whatever you do, don’t let anyone talk you into the Urolift procedure for BPH. The Urolift implants block the view of the prostate in MRI imaging, so you’re stuck with the random biopsy. Targeted biopsy from imaging isn’t possible. The urologist who sold me on Urolift never let me know about this issue.
I didn't finish the last report. I pressed the send button. Anyway it reads:"It involves approximately 80% of the sample. The grade four is 5mm". What does the 5mm mean?! I'm trying to figure out the volume of my 3 + 4. And it doesn't say anything about the length of the core on this report so do you just assume that they're 10 mm? Or 12mm. And this 5mm might be considered..... 50%?! Please anyone help me! Thank you. I am getting so stressed over this thing it's it's ridiculous. Obsessing about this. I want to do active surveillance.
@ricknowak4582 contact the doctor the report should indicate the % of 3,4 etc in the sample..I had 80 % of 4 in a sample and lots of 3 but the presence of 4 was concerning to my doctor...treatment followed
Hi, It sounds like you are little 28:20 Sholz says, there are lots of options for treatment. I was diagnosed with 3+4 biopsy and went for focal treatment. Got rid of most of the cancer but not all, so I am on active survalence. Done the PMSA screen which will tell you if it's matastisized. If not, odds of living a long life are very good - so relax. I am learning to live with cancer and with a doctor you have confidence with do the active survalence and live a stress free life.
@@robertmartin2604 I agree. I mentioned my cancer above in this chat. I have not stress over this. Many hear the word cancer and they think death, what to just get it out and then live with the after affects, Of all cancers if you get cancer of the prostate, that's the one you want. You can Active survil at 3 plus 3 and in my case 4 years now with 3 plus 4 favorable, If you have higher then there is treatment. As Dr says 99 percent of folks dent die of Prostate cancer, they die of something else. So just get smart. Read, follow this channel and others out there. Talk to your Dr. I fired 2 Drs until I found the one I liked. Its your body and your final decision but as Robert says, get smart buy relax.
Can a biopsy possibly spread cancer outside the prostate? Prostate removed. Margins clear, meaning cancer had not escaped the prostate. 4 years later, prostate cancer found in the lungs. So how did it spread? Biopsy or cancerous cells left behind from the prostatectomy? Surgery over surveillance was a life and death mistake that cannot be undone.
He just said it is a matter of availability and experience. Trasnp are safer when done by “experts”….otherwise they want you to be under general anesthesia which for some is a greater risk
My initial biopsy had only 1 core but 3 months later did a targeted biopsy which showed 4 core at 4+3 score Since the time difference between two biopsies was so short I know the targeted biopsy is a better method hands down However if biopsies were say 12 months apart I may be thinking that the cancer is spreading
