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Medical Forum / Diseases and Disorders / Prostate BPH / November 2003Prostate biopsy and PVP
Patrick has once or twice mentioned that he had a biopsy before his PVP, and urged other people to do likewise. I assume he means not just anyone, but those whose PSA score falls in the 'possibly suspicious' area by the most rigorous standards (there is some dispute over what *is* suspicious, but some people now put the cutoff point at 2.5 rather than the 4.0 which is still widely used). Given that I've had two procedures already which led to reduction of PSA-producing tissue, my current score might fall into the 'just possibly suspicious' category, and I do take Patrick's point that vaporisation would not be a good idea if there was any problem lurking. I've sounded out three urologists about the desirability of doing a biopsy; one is definitely for, one says maybe, and the other says he doesn't think it's necessary. Not for the first time, the decision seems to be up to me rather than the experts! I'm leaning towards doing it. There are some minor risks, but I suspect that after at least one yes vote for the biopsy from someone whose opinion I respect (and who would definitely not do it, so he can have no ulterior motive!), I wouldn't now feel totally comfortable if I went ahead with the PVP without having checked things out as fully as I could. Does Patrick, or anyone else, know what minimum period would need to be left between a biopsy and the PVP? Richard Slessor > Does Patrick, or anyone else, know what minimum period > would need to be left between a biopsy and the PVP? I have agreed to take part in study on the effectiveness of Avodart to reduce the blood supply to the prostate. This involves my taking Avodart for one week prior to my PVP. According to the information sheet, they will then do a biopsy of the prostate while I am under the general anaesthetic for the PVP. The samples will then be sent for examination. (BTW, I have already had a biopsy for cancer earlier this year and it was negative). So the answer to your question would seem to be somewhere amongst the lower minutes rather than days, if your concern is simply what is possible!<G> The only limiting factor I can think of is that as the biopsy in your case will be to detect possible cancer, it must depend on how quickly the laboratory comes back with the report and how quickly they can schedule you for the next step, be it PVP or other treatment. Derry Richard, I will answer you last question first: I had the PVP 1 week after I had the biopsy. The minimum interval between the biopsy and the PVP is determined by how long it takes the pathologist to give your doctor the biopsy report. I think one week is as short as one can expect. I got the biopsy results two days before the PVP, it showed no PCa, and BPH in all eight octants and inflamation in the transition zone. So for me, the biopsy confirmed pathologically that I had BPH and no PCa. As for your second question whether to get a biopsy or not, well that is really up to you. After going through the biopsy I would advise doing it as it isn't painful. But I got to tell you waiting for the results was awful. I knew that if it was positive for PCa, I would not have PVP and would have to instead be looking at a radical prosectomy. As it turned out it was negative for PCa so the PVP cured my BPH. I would get the biopsy for another reason. It give clear indication that you don't have PCa at the time of the PVP. So three months after the PVP, a PSA test sets your baseline. Then year after year you can use PSA to determine if there is any changes. Note that my PSA before PVP was 3.2 and One year after PVP it was 1.6 So 10 years from now I have something definite to compare it with. So go for the biopsy and let it be negative. Take care and good luck with your PVP. Patrick > Patrick has once or twice mentioned that he had a biopsy before his > PVP, and urged other people to do likewise. I assume he means not just [quoted text clipped - 23 lines] > > Richard Slessor > As for your second question whether to get a biopsy or not, > well that is really up to you. After going through the > biopsy I would advise doing it as it isn't painful. Whether a biopsy is painful or not depends on the individual patient. Personally, I found my first biopsy very unpleasant and requested some sort of anaesthetic for the second. A nice malt would done fine but they opted to give me a general. Can't think why... Derry Derry and Patrick, thank you for your useful comments. I've decided to go for the biopsy, and it appears that it can be done three days before the scheduled PVP. In fact I've had one once before (negative, as you would probably guess from the fact I'm still posting here), in a similarly marginal situation where I had a score of a little over 4 just before my radio frequency treatment in 2000. My experience was towards the undramatic end of the range which has been reported here; a thump and a momentary sharp sting each time the needle went in, but no real pain. (That was with no anesthetic as far as I know - certainly nothing injected.) I'm hoping for the same this time! I agree that the period afterwards waiting for the result is nail-biting time - as before I'll try to stay positive and focus on the subsequent scheduled procedure! At least the wait should be only three days rather than the week some people have reported. Richard Slessor Richard, Good luck to you and my hopes of another negative biopsy and a successful PVP. Patrick > Derry and Patrick, thank you for your useful comments. I've decided to > go for the biopsy, and it appears that it can be done three days [quoted text clipped - 15 lines] > > Richard Slessor > I agree that the period afterwards waiting for the result > is nail-biting time - as before I'll try to stay positive > and focus on the subsequent scheduled procedure! Richard, I know it is probably not much help but try to forget all about it! My PSA was 9 and the biopsy was negative. Others have reported far higher PSA's, also with negative results. Having a biopsy is just a precaution, like looking both ways before crossing the road!<G> Good luck, anyway, and I hope everything goes smoothly for you. Derry > Derry and Patrick, thank you for your useful comments. I've decided to > go for the biopsy, and it appears that it can be done three days > before the scheduled PVP. Don't know where you are, but in central Virginia, USA, it takes 5 to 7 working days to get the results of a biopsy back to the doctor Jack |
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