Well, yeah, it IS just poking around in the dark.  It's been compared to
looking for a basketball on a beach and six years ago when I was DX'd I
recall the figure for false negatives with a biopsy was somewhere near
25%-30%.  Not good when you're dealing with PCa.

AFAIK, there's nothing more definitive than a biopsy but, like the RRP,
etc. it is a skill,

There is a doctor at Crittendon Hospital in Rochester, MICHIGAN.  Name
of Fred Lee, I believe, and his specialty is diagnosing PCa using the
color doppler ultrasound.  It is said that he can diagnose PCa where
most others have failed in spite of numerous biopsies.

I have a good friend whose PSA has been in the 50-75 range for a number
of years and who had undergone repeated biopsies at a university
hospital in Chicago - not some backwoods clinic - and they could never
find anything wrong.  He went to Lee and was examined with the
ultrasound (which Lee uses to then map out a precise plan for a
subsequent needle biopsy) and was told that there is no cancer and that
it appears he has a abnormally high, but benign, PSA level.  Lee said
that there was no need to undergo another biopsy and sent him on his
way.  He (Lee) isn't guaranteeing anything but does have him come back
for period ultrasounds and Jim's still on annual PSA screenings to
detect any change from the status quo.

The stories of Lee's expertise are out there, there are many who claim
he found their PCa when many others had failed to do so after numerous
attempts via biopsy alone.

Good luck,

Bob  RRP 03/16/2000 and < 0.1 ng/ml ever since

Hi Wayne...There are parts of the prostate that can contain cancer, but
that cannot be sampled by a trans-rectal biopsy.  Bob's suggestion of a
color doppler ultrasound (cdus) by an "artist" is a good one.  The cdus
can image the entire prostate, then, if something is seen, a targeted
biopsy can be performed.  Dr. Fred Lee, mentioned by Bob, is probably
the best at it, Dr. Duke Bahn is another cdus artist.  Similar to the
cdus is magnetic resonance imaging with a 3T magnet; Dr. Shinohara is
the best at this...ron

Duke K. Bahn MD
Medical Director, Department of Radiology
Prostate Institute of America
Community Memorial Hospital of San Buenaventura
168 N. Brent Street, Suite 402
Ventura, CA 93003
888-234-0004
805-585-3082
Fax: 805-641-3965
dkbahn@cmhhospital.org

Fred Lee, MD
Crittenton Hospital
1135 W University Dr, #420
Rochester, MI 48307
(248)650-4699

Katsuto Shinohara MD
1600 Divisadero Street, 3rd floor
UCSF
San Francisco, CA 94115
Tel:415-476-1611
Fax:415-476-8849
kshinohara@urol.ucsf.edu
Assistant, Mary, at 415 353 9877

How many needles have they used in your past PSAs?

I recommend getting the happy juice and using as many needles as they'll do.
20 is a good number I think.