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Old 08-12-2010, 09:26 AM   #1
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Results of Saturation Biopsy

With rising PSA (from 6 to 9 in 18 months) and "positive" PCA-3 (47 where the "cut-off" is 35), I went through saturation biopsy last week. I was under general anesthesia. My urologist took 26 needle biopsies. The pathologists found in one of the four specimens adenocarcinoma, Gleason score 3+4 =7. I learned about the report yesterday.

I will be see a medical oncologist for his opinion on treatment options for my case. My urologist is a specialist in robotic prostatectomy. I know his inclination. For now I am trying my best to stay calm, but I am worried and overwhelmed...

 
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Old 08-12-2010, 01:34 PM   #2
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Re: Results of Saturation Biopsy

I have two recommendations before making a treatment decision. Get a 2nd opinion on your biopsy slides and a ploidy analysis from either Dr Epstien at Hopkins or Dr Bostwich at Boswich labs. 2nd get either an MRIS or a color Doppler ultrasound to better identify the size of your tumor and it's exact location. Tumor location is probably the most important factor in knowing the probability of a positive surgical margin. Tumors in the Apex, and transition zone as well as tumors near the nerves or seminal vesicles are problematic for surgery as are tumors extending through the capsul. Also review all other options such as radiation and Brachytherapy with IMRT as many studies have found this combination therapy to be more effective than surgery with less side affects.
I don't know that I would consider a 26 core biopsy a saturation biopsy. I had a 26 core biopsy along with 12 other biopsies, between 10 and 16 cores that failed to discover a 16mmX18mm tumor. I would consider a templated 50 core biopsy that over sampled the anterior as a good stauration biopsy.
JohnT

 
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Old 08-12-2010, 08:54 PM   #3
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Re: Results of Saturation Biopsy

Quote:
Originally Posted by Johnt1 View Post
I have two recommendations before making a treatment decision. Get a 2nd opinion on your biopsy slides and a ploidy analysis from either Dr Epstien at Hopkins or Dr Bostwich at Boswich labs. 2nd get either an MRIS or a color Doppler ultrasound to better identify the size of your tumor and it's exact location. Tumor location is probably the most important factor in knowing the probability of a positive surgical margin. Tumors in the Apex, and transition zone as well as tumors near the nerves or seminal vesicles are problematic for surgery as are tumors extending through the capsul. Also review all other options such as radiation and Brachytherapy with IMRT as many studies have found this combination therapy to be more effective than surgery with less side affects.
I don't know that I would consider a 26 core biopsy a saturation biopsy. I had a 26 core biopsy along with 12 other biopsies, between 10 and 16 cores that failed to discover a 16mmX18mm tumor. I would consider a templated 50 core biopsy that over sampled the anterior as a good stauration biopsy.
JohnT
Thank you for your post. Another pathologist confirmed the findings. The location of the tumor is on the anterior apical of the prostate, involving about 10% of the examined prostate tissue.

The term "saturation biopsy" was used by my urologist when he planned to take 24 core samples. The fact that I had to be under general anesthesia left me in no position to argue that it was not saturated enough. My first biopsy ago which was negative had 12 core samples. This time after 8 days there is still blood in my urine.

 
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