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Repeat Biospy

Posts: 9
Joined: Mar 2013

On active surveillene.  PSA just under 4 has increased by a little over 1. in the last year.  First biospy showed 5% andricarcinoma (forgive spelling) in 1 out of twelve cores. It ws in the right medial apex.  One other supicious and one inflamed.  Second biospy showed 1 out of twelve positive only this one was in the Left Lateral Mid.  It was also 5% with another inflamed and another suspicious.  The right medial apex showed benign.  Is this normal to have the same cancer show up in different places or am I looking at two different small tumors?  Tried asking urologist, but he has not responded to my inquiry. Thanks. Confused.

hopeful and opt...
Posts: 2335
Joined: Apr 2009

I see that you are still on AS.


Here is an answer to your question.

Since I guess that you had a random blind non targeted biopsy, the two cores that are found can be two small cores or one gigantic one...most likely they are two small cores.  There is a multiparametric tesla 3.0 MRI that will show suspicious lesions that are in the prostate, how large they are, etc, and maybe extracapsular extension. You will have a better idea of what's in the prostate, and how extensive your cancer may or may not be.

There iare also  MRI guided type biopsies that are available in limited facilities; there is a multiparametric mri that finds suspicious lesions , then a biopsy in real time to target the suspicious lesions. Thus  the biopsy is more effective in  identifying  cancers within the prostate if they exist, and improve the AS protocol.


D47, you have posted a few times with limited specific questions. The quality of our answers will be improved for you if you post every thing about you and your case that is germaine; and the links to the other posts that you started

Posts: 79
Joined: Nov 2011


it is quite common for prostate cancer to have multiple foci. From your description sounds like a low volume cancer ,areas positive first time are negative second time or vice versa. Please try to get a second opinion from Johns Hopkins. Also, please share with us your age, DRE etc. Please do not jump into any treatment modalities at this time. It' s a slow growing tumor.  I'm 68 on AS past 3 yrs. My PSA hovers between 2.6 to 3.8 past 3 yrs. The last one is 3.1 ( volume 38cc) unchanged over the past 18 months. I have had 4 biopsies over the past 3 yrs and my numbers are like yours- usually one core < 5% positive  GS 6  or just ASAP , every time a different core. I have a slight asymmetry on the LLL on DRE. My Urologist & I have decided no more biopsies for at least 2 yrs unless PSAs shot up or DRE showed further extension of the asymmetry. 

VascodaGama's picture
Posts: 3392
Joined: Nov 2010

Absolutely agree with above answers. Guys on AS need to add means of surveillance apart from the traditional biopsy. Multi-parametric MRI or other sophisticated non invasive image studies are now more reliable in detecting any progression and they should be done periodically to compare with previous images.

Congratulations for the courage you guys on AS demonstrate by sleeping with the enemy in the same bed.

I admire and envy you.



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