Are we sick or what

I believe that you are well justified to be concerned about repeated biopsies -- infection, cancer migration and prostate scarring are all real possibilities.

On the other hand, there is currently no other way to determine with any certainty the extent of the cancer in the prostate. There are "active surveillance" programs (and certain studies in the past) that have used annual biopsies to track the course of the cancer BUT (although the risks exist) I haven't read anything about any negative effects of such a program (or study) involving repeated biopsies.

My "feeling" on this is that "routine" annual biopsies are unnecessary and that a re-biopsy should only be done if your PSA scores suggest a growth of the cancer. This does not place a specific time limit on when a re-biopsy would occur and should still give you the info you need to act further without unnecessary delay.

However, I'm with you about the continued "worry" involved in the need to take repeated PSA tests but the only thing you can do is go on and live your life w/o dwelling on it too much.

In my case, I've been taking quarterly PSA tests since my treatment almost 2 years ago and each test has been worrying for me because my scores were initially so erratic and still have not dropped below 1 (which is the primary indicator of "success" for radiation treatment).

I find that I do not think about it all that much until I take each quarterly test and then have to assess the result. Is it up, down or about the same and what does that mean?

I've already suggested to my RO that I get a re-biospy after my PSA test in September (which marks the 2nd anniversary of my treatment w/CyberKnife). He's not all that hot about the idea BUT (after 2 years of inconclusive PSA test results) I want to know if there's still any evidence of cancer in my prostate or not.

My PSA scores do not indicate a growth BUT there doesn't seem to be any explanation for why my scores still have not dropped below 1 except for the fact that my prostate still seems to be "functioning" because I am still able to ejaculate a fair amount of fluid (which is NOT supposed to happen after "successful" radiation treatment).

A negative re-biopsy would reassure me that the cancer was destroyed, even though there is the possibility of a false negative result and even though my prostate is still producing fluid.

We'll see . . .

Swingshiftworker said:

I believe that you are well justified to be concerned about repeated biopsies -- infection, cancer migration and prostate scarring are all real possibilities.

On the other hand, there is currently no other way to determine with any certainty the extent of the cancer in the prostate. There are "active surveillance" programs (and certain studies in the past) that have used annual biopsies to track the course of the cancer BUT (although the risks exist) I haven't read anything about any negative effects of such a program (or study) involving repeated biopsies.

My "feeling" on this is that "routine" annual biopsies are unnecessary and that a re-biopsy should only be done if your PSA scores suggest a growth of the cancer. This does not place a specific time limit on when a re-biopsy would occur and should still give you the info you need to act further without unnecessary delay.

However, I'm with you about the continued "worry" involved in the need to take repeated PSA tests but the only thing you can do is go on and live your life w/o dwelling on it too much.

In my case, I've been taking quarterly PSA tests since my treatment almost 2 years ago and each test has been worrying for me because my scores were initially so erratic and still have not dropped below 1 (which is the primary indicator of "success" for radiation treatment).

I find that I do not think about it all that much until I take each quarterly test and then have to assess the result. Is it up, down or about the same and what does that mean?

I've already suggested to my RO that I get a re-biospy after my PSA test in September (which marks the 2nd anniversary of my treatment w/CyberKnife). He's not all that hot about the idea BUT (after 2 years of inconclusive PSA test results) I want to know if there's still any evidence of cancer in my prostate or not.

My PSA scores do not indicate a growth BUT there doesn't seem to be any explanation for why my scores still have not dropped below 1 except for the fact that my prostate still seems to be "functioning" because I am still able to ejaculate a fair amount of fluid (which is NOT supposed to happen after "successful" radiation treatment).

A negative re-biopsy would reassure me that the cancer was destroyed, even though there is the possibility of a false negative result and even though my prostate is still producing fluid.

We'll see . . .

"Cancer Migration"
"I believe that you are well justified to be concerned about repeated biopsies -- infection, cancer migration and prostate scarring are all real possibilities."

There is absolutely no evidence to support the theroy of "cancer migration" from a biopsy. This is an opinion and not a medical fact.

Swingshiftworker said:

Fact vs. Opinion
I think I made it clear that the statement you've quoted was based on my personal opinion and "belief."

The original poster's concern was the possible effect of annual biopsies in conjunction with an Active Surveillance program and, in that context, I expressed my "feeling" that annual biopsies were not warranted given the risk of infection and the possibility of cancer migration.

I don't know of a study that has established a connection between prostate biopsy and the spread of cancer elsewhere in the body. However, just because there's no "proof" of it, doesn't mean that it might not actually occur and, unless you can prove that cancer migration following prostate biopsy NEVER happens (which I don't think is possible), it's still a legitimate cause for concern.

That concern didn't stop me from getting my initial biopsy nor has it stopped most other men from theirs either. It also won't stop me from getting the follow up biopsy (2 years after treatment) that I've already requested from my RO but, again, that doesn't make it any less a cause for concern.

However, IMHO, if annual biopsies in conjunction with an Active Surveillance program (or medical study) are proposed, the risks of infection and the possibility of cancer migration should be carefully considered.

Just my 2 cents. Take it for what it's worth to you and, if that's nothing, so be it.

Ciao!

Input
This is my personal experience on the above. I had a biopsy and 4 weeks later surgery to remove prostate. The surgery report came back indicating that there was some trauma to the prostate and the doctor indicated that this could of been caused by the biopsy.

When I was preping for the biopsy the doctor was very clear about taking the antibotics and explained that this was due to infection risk.

As far as cancer migration that is good question.

Right now I am post surgery and under an AS program, which is intense at times. I find my self living from psa test to psa test. My psa levels are slowly moving, but is still considered to be undetectable.

laserlight said:

Input
This is my personal experience on the above. I had a biopsy and 4 weeks later surgery to remove prostate. The surgery report came back indicating that there was some trauma to the prostate and the doctor indicated that this could of been caused by the biopsy.

When I was preping for the biopsy the doctor was very clear about taking the antibotics and explained that this was due to infection risk.

As far as cancer migration that is good question.

Right now I am post surgery and under an AS program, which is intense at times. I find my self living from psa test to psa test. My psa levels are slowly moving, but is still considered to be undetectable.

wait time for surgery after a prostate biopsy
http://www.youtube.com/watch?v=iyVyxfy4MjY

4 to 6 weeks according to Dr. Samadi, m.d., a prominent robotic surgeon.