Biopsy Scheduling Wait Time?

tbjhc

57 y.o. male: My MRI showed a Pi-Rad Lesion 3 and my urologist scheduled me for a biopsy. It is not scheduled until Nov 1. My concern is how long the wait time. My PSA rose to 6.78 in early July, was referred to urologist and had MRI on 8/27. Now two months wait until biopsy on Nov. 1st. Is this normal? I tried to get appointment moved up but was told doctor was not in at all during the month of October and was booked for all of September.

Pre -MRI - PSA rising - 2.88, 3/23 - 5.02, 7-9-24, 6.78, 7-9-24

Free/Total done on 7/29 /24 - Total 6.3, Free 20%

MRI findings: Volume: 4.5 x 3.6 x 5cm for a volume of 42 mL, mildly enlarged. Based on a PSA of 6.2 ng/mL, the density is 0.15 ng/mL/cc, top-normal.

Hemorrhage: None

Peripheral Zone: Diffuse linear and wedge-shaped hypo intensities.

Transition Zone: Moderate heterogeneity consistent with prosthetic hyperplasia.

Lesion 1:

Location: Left posterolateral peripheral zone of the apex. Size: 9mm, T2: Heterogeneously hypointense area of signal change, DWI: Mild restricted diffusion, DCE: Mildly Positive, Prostate Margin: Abuts the prostate margin for less that 2 cm. Lesion overall PI-RADS 2.1 category 3.

Wheel

call and make sure the Dr doing the biopsy is going to do a MRI fusion targeted biopsy. This important to accurately get several cores from the lesion. My biopsy was a month after my MRI. I don’t know that an extra month is going to make that big of a difference. They often talk about a six month window from initial diagnosis to beginning treatment, due to additional time to get PET scans and schedule 1st and 2nd opinion consultation’s with Surgeon’s or Radiation Oncologist’s. A test you could get your Urologist to order is a kit sent to you for an ExoDx Urine marker test. Its a urine test you do at home and send back in to the diagnostic center. You can google the test. It helps determine how aggressive your cancer might be if you have it. A low number under 15 could give you some reassurance. Your free number is good.

Old Salt

Yours doesn't look like an emergency situation (only one locus with a low PI-RADS value identified by MRI). Hence postponing the biopsy until Nov shouldn't worry you. Easier said than done, I know. Moreover, it is often stated that prostate cancer is slow growing, but that may not help your anxiety either…

Good luck though and we can provide some assistance interpreting the biopsy report, if necessary.

tbjhc

So after getting a second opinion from another urologist, my biopsy is scheduled for tomorrow. Whatever the results I am looking forwarding to know what I am dealing with.

stihlbr49

I am 74 years old. I had no rise in PSA and only discovered prostate cancer after seeing blood in my urine on August 1, 2023. I had the following to discover the source of the blood. Cystoscopy, MRI, Cat Scan, and finally a biopsy of the prostate on Dec 21,2023. So it took almost 5 months to get the diagnosis (insurance approvals/scheduling procedures all take time). Pet Scan to determine if it had spread since the Biopsy showed me at T3. No spread to surrounding tissue. Too old for removal of prostate. Had surgery to put in Fiducial markers and Space Oar Hydrogel in March. Had 45 EBRT (radiation treatments) over a nine week period ending May 28, 2024. Started Lupron injections in December 2023 and have completed 4 of 8. These are every 3 months. I have just had my second follow up with the Urologist and lab results show no indication of any PSA. I was impatient and wanted things to move faster. I will now be on a wait and watch protocol that will require every 3 month visit to Urologist/Surgeon (includes lab work for PSA testing) and every 3 month visit to Onocoligist/Radiology Dr for the next 2 years and then every 6 months until 5 year mark. This process is a marathon.

I wish you the best, try to be patient with process.

f

mbluth

https://csn.cancer.org/discussion/328466/biopsy-scheduling-wait-time

Honestly, if your urologist is not putting in enough urgency find another. I was a PI RAD 5 after the MRI. It felt like to me that there was no urgency on my doctor’s side. I found a second urologist and when he had no urgency I found a third. The third one gave me the confidence, explained the options including the side effects. He and his staff have been more responsive taken the extra time to explain. They even told me that I would have trouble at the pharmacy with getting two different dosages of the same medication. If I did I was to call the insurance, if I could not resolve it have them call the office. There are doctors that still care you just have to find them. With the medical charts on line you can just add another institution to the chart. I did not even have to get CDs of my MRI or Pet scan they were online and I could pass them to the new institution electronically.

I hope this helps and I wish you the best…