First post-biopsy appointment

MichaelF1002 Member Posts: 54
edited April 2013 in Prostate Cancer #1

I had my post-biopsy appointment with my urologist today.  I asked all the questions that were suggested here.  Some issues, like a referral to a radiation oncologist, he brought up himself.  He also offered that he would have no problem with me obtaining a second opinion from another urologist, which I don't feel I need.  (As a Medicare patient I can go outside the HMO if I choose to.)  I have an appointment with the radiation oncologist in the works and am getting a second opinion regarding the biopsy slides at Johns Hopkins, as soon as I fill out the ton of paperwork required by both them and Kaiser.  The doc gave me my options – Active Surveillance, Radiation (Branchytherapy or external beam,) or surgery (robotic laprascopic).   He didn’t recommend one option over the others but explained them to me in a nutshell and told me to spend some time researching them.  (The Branchytherapy option scares me a bit – pieces of metal remaining in my body and taking 12-18 months for the radiation to dissipate.)  Right now I am leaning toward active surveillance for a while and then maybe surgery, which, if I was a younger man, I might not consider.  My Gleason is 3+3=6, my core involvement was 10% of 1 core and my stage is T2C.   I am wondering about the fact that there was no indication on the biopsy report about PNI invasion.  He said that if PNI invasion was present the report would have indicated so.  Is that something that is supposed to be mentioned even if it is negative?  If so, I am hopinig that the second opinion from Johns Hopkins will rectify that.

I have a lot of research to do in the coming weeks.

Thanks to everyone who responded to my postings.  It is much appreciated.



  • Kongo
    Kongo Member Posts: 1,166 Member
    Good Advice

    I think your doctor has given you good advice and I agree with your choices given the information you have at this point.  You should be aware that Kaiser offers a much more limited scope of treatment options than some other insurance coverage plans.  You may wish to pay on your own to seek a consult outside of the Kaiser network which will only recommend options they cover.

    I wouldn't worry about the PNI if it wasn't mentioned.  My biopsy did say PNI not present but I think it is more a function of the lab.  Johns Hopkins will give you a report you can feel confident about.

    Good luck as you begin to educate yourself.