do multiple biopsies during watchful wating present a risk?

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gary.miller12@comcast.net - 24 Aug 2006 07:36 GMT

do biopsies every 6 months cause more of a problem then they prevent?
my doctor claims that there is no research that indicates that to be a
problem.
i have a gleason score of 6, t1c, psa jumped from 2.5 to 5.7 in 6 mths,
3 cores had less than 10% cancer and i am 66 yrs old.
i forgot to add that the doctor said that the cancer is stage 3.

gary

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Steve Kramer - 24 Aug 2006 13:03 GMT

> do biopsies every 6 months cause more of a problem then they prevent?
> my doctor claims that there is no research that indicates that to be a
[quoted text clipped - 4 lines]
>
> gary

I don't understand. Your Stage is T1c. Which means it was found by biopsy
and is not palpable. Stage 3 is palpable and penetrate the prostate walls.

I might have to backtrack a little on my last post. When you said "Stage 3"
on this one, I recalled in that back of my mind that Walsh had a lot to say
about T1c in particular. I glazed over it because I was T2c (later T3).
But, I think you should get yourself today to a bookstore or library and
look at page 156 of Dr. Patrick Walsh's "Guide to Surviving Prostate
Cancer." You just may be in that very small group that needs no treatment
at all.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
Non Illegitimi Carborundum

--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
Non Illegitimi Carborundum

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Info@DrYew.com - 24 Aug 2006 15:28 GMT

Stage 3 and t1c don't coincide. I'm going out on a limb, but perhaps
you
meant to say "Grade 3"? If your biopsies showed all "Gleason" 3 grade,
then you'd have 3+3=6 score.

Regardless, the risk of biopsy is just from the procedure itself. Keep
in
mind that until recently, (and still currently?) many urologist only
took
6 biopsy cores. Now, with the use of sedation and peri-prostatic
lidocaine
anesthesia block, many advocate an expanded pattern biopsy with as
many as 18-24 cores. To my knowledge, there have been no documented
adverse cancer events or adverse events associated with these
"extra poke holes". I don't know your other conditions or overall
health,
but based on age alone, I'd consider you young and would try to be more
"curative" .. given your cancer parameters listed.

Conversely, if you are set on no treatment (due to age or illness?),
then
you have to ask yourself why you are doing the repeat biopsies at all?
Or ever? Think about how you will act differently based on various
scenarios. Ex. if you next biopsy shows no cancer? if your next biopsy
shows Gleason 7? what if it shows 8? At what point will you say "ok, I
better get this out now"? If never, then I'd just say no more biopsies.
You
might as well just check PSA, and if it rises rapidly or you become
symptomatic, start hormones. If you are also ruling out any possibility
of
medical/hormonal therapy, then there's probably no point in even
checking PSA. In other words, if you are at the extreme of "do-nothing"
belief, then biopsy and PSA can only serve 1 purpose.. to cause anxiety
and potential biopsy side-effects (blood in urine, stool, retention,
infection,
pain, etc).

Given your parameters, you have a high probability of cure with either
radiation or surgery. From a "cancer cure" standpoint alone, both are
probably equal. In my (biased) opinion, in terms of side-effects,
tolerability, recovery, etc.. I think daVinci robotic laparoscopic
Prostatectomy (dVP) is the best choice.

Re. "very small group that needs no treatment" True!
But, until we discover better tests or genetic analysis profiles,
there's
no way to know for sure. Also, keep in mind biopsy sampling error. In
as many as 20-25% of cases where the biopsy shows 3+3 or less, the
final surgical path of the prostate removed ends up being Gleason 7
(3+4 or 4+3) or worse.

===
http://www.DrYew.com
http://www.SanDiegoRoboticProstatectomy.com

> > do biopsies every 6 months cause more of a problem then they prevent?
> > my doctor claims that there is no research that indicates that to be a
[quoted text clipped - 15 lines]
> Cancer." You just may be in that very small group that needs no treatment
> at all.

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