biopsy results

Mozir

Hi everyone...I would like to share the results of my biopsy which I did on April 14th 20025

Biopsy URONAV MRI fusion ultrasound transrectal and I have cancer.

If anybody needs details how biopsy goes… you can ask me

Diagnosis

K Prostate (ROI 1), core biopsy:

Prostatic acinar adenocarcinoma, Grade Group 2, Gleason score 3+4=7Tumor present on two of five cores, involving approximately 10% of overall core length Percentage of Gleason pattern 4: 40%

Cribriform tumor architecture: Present

L Prostate (ROI 2), core biopsy:Prostatic acinar adenocarcinoma, Grade Group 2, Gleason score 3+4=7Tumor present on three of three cores, involving approximately 15% of overall core length Percentage of Gleason pattern 4: 30%

Cribriform tumor architecture: Present

Present A-J Prostate (sites as indicated), core biopsies:

No carcinoma identified

I have follow up appointment with urologist on April 22d and I would like to ask you what important questions should I ask ? What test should I request?

and also : Guys who had same diagnosis…give some advice….what treatment you went and any advice or mistake I should avoid.

Thank You.

Wheel

Mozir,

Saw your post. I am sorry to hear results, but although certainly some concerns, those concerns can guide you. Cribriform pattern is often resistant to radiation, not necessarily but due to that can lean towards surgery. Also in your favor is the Gleason 7, not above. Once you reach Gleason 8 often protocols even with surgery recommend ADT plus additional radiation. Surgery at this point is still a gold standard. However with a Gleason 7 favorable of (3+4), you may very well be offered active surveillance. I would though want more information from Decipher testing and Pet scan before considering that. The decipher will tell you whether its likelihood of being aggressive.

I would say your next steps are to ask your urologist for Decipher testing of your biopsy tissue and for a PSMA Pet scan to confirm for it has not left the capsule, although mine was supposedly intact, during surgery they determined on initial pathology I had positive margin.

Also no need to rush, studies have shown from initial diagnosis (like now from your biopsy) to treatment, a delay of up to six months until treatment has no impact on outcome of treatment. That is if the cancer needs treatment now, if you are a candidate for active surveillance that 6 month window is not relevant.

You are on the bubble at a Gleason 7. I admit I was Gleason 8, only one core and my others were 6 and favorable 7’s, but I so much wanted to do active surveillance for how long as I could, but my Gleason 8 precluded it and fortunately that one core led me to treatment. I was also fortunate that it did, since although scans showed it had not left the capsule, indeed it had.

I am sure the members will offer great questions for you to ask. Best of luck!

swl1956

What was your pre-biopsy MRI results? Gleason 3+4=7 Intermediate favorable sometimes Active Surveillance might be appropriate, but with Cribriform present probably not going to be recommended. Cribriform might be associated with a more aggressive cancer and may be resistant to radiation treatments. In my unprofessional opinion, I would absolutely want a PSMA PET scan before making any decisions. It's currently the best (and easy) test to indicate if there is any spread outside of the prostate gland. If none is found, you'll likely have more options for treatment. There are many factors that can influence the decision process and it can be a difficult task to sort through them. After your doctor recommends a treatment you might want to consider a second opinion and preferably at a center of excellence cancer center. Even at the best places researching who's the highest rated doctors is also wise.