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Hi,
Just looking for some un-bias opinions here, as I recently went in for a check up with a new urologist & requested a MRI or color doppler ultrasound in place of another biospy. I have not had a follow up biospy since my initial 11/2011 biospy low volume gleason 6, 1 of 14 cores found with 15% cancer in that sample. Urologist told me that ultrasound prostate imaging would be a waste of time & money considering the small amount of cancer found in my prostate, just would not detect anything. Stated that there is no other test out their that is equivalent to the repeat biospy for a case like mine. Also, told me my prostate was somewhat enlarged at 45 grams for a male at 57 years old, is that a big concern as well?
I'd agree with your new urologist as to the value ofan MRI in your case, but wonder if you even need another biopsy at this stage, asuming there are no relevant changes in PSA level and no symptoms developing.
A prostate gland with a volume of 45 grams is 'large' since a normalgland is about 25 gm, BUT....how accurately was the size measured? During the early stages ofmy journey, I had estimates of 25 gm, 48 gm,78 gm and 120 gm!! My latest scan 15 years plus after these initial estimates is that the gland is 25gm. It is very difficult to accurately measure the size of a prostate gland.
You may want to consider a 3T MRI with contrast using an endorectal probe. From my personal experience, as well as from what I've read and been told by two radiologists (and other patients), that type of scan is the most likely to show lesions in the prostate (as well as possible problems in the seminal vesicles and with the capsule itself). If you go the MRI route, ask if its 1.5, 2 or 3T. There IS a difference in the quality and capability of the images.
Even if it does not find any notable lesions, that to most, would be good news and help allay your concerns - and be considered the best result. Should it find lesion(s), you could then decide if you want a targeted biopsy.
