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Biopsy Reliability

Healthy 61 y/o with no prostate cancer symptoms. Truly feel like I'm 40. Very healthy sex life and still employed and physically active. Had regular physical exams, including DRE and PSA for 20 years.

Went to my primary doctor for occasionable spotty blood in my semen. Refered to an urologist. DRE performed and urologist ordered prostate biospy due to enlarged, firm left-side prostate. Also ordered cystoscopy, PSA and ct scan.

Results:
PSA 3.78 (always has been under 3)
B F G H I
Gleason score 4+5=9 4+5=9 4+5=9 4+5=9 4+5=9
positive/total cores 3/4 1/1 1/1 1/1 1/1
cent. of involvement 1.9 0.8 0.9 0.4 0.9
perc. of involvement 35% 60% 80% 25% 70%
HPIN yes yes yes no no
Perineural invasion yes no no no yes
Extracapsular extension no no no no no

11/02/2016

Bone scan - no metastatic disease and ct scan negative

Requested a second opinion from a urologist and second reading of biopsy slides. My question is, has anybody experienced a wrong biopsy report?

Re: Biopsy Reliability

Steve:
From my layman's perspective you appear to be in need of some form of treatment (in all likelihood a fairly aggressive form).
A second opinion on your slides is never a bad idea.
If I were you I would concentrate on researching my treatment options.
In any event please accept my best wishes Don O.

Re: Biopsy Reliability

Steve,
Yes, there is some unreliability in a biopsy. Examples would be 3 and 4 might really be a 3 and 3 which could make a difference between going with active surveillance or a prostatectomy. In your case it won't make any difference because if you downgrade a 4 and 5 to a 4 and 4 you would still need treatment ASAP. I would focus on which treatment to choose and waste no time in getting it.

I was training for another triathlon when I was diagnosed; I'm not sure why but my prostate cancer support group looks more like an old men's running club than a group of cancer survivors.

P.S. - You should go to a PC support group. You can find out about the doctors and treatments from a patients perspective.

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