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Meaning of a "clear" biopsy

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Old 09-24-2012, 03:50 PM   #1
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Meaning of a "clear" biopsy

While I am elated to find my prostate biopsy found no tumor, no atypical cells, and essentially no cancer, I'm a bit at a loss.

In discussion with a PC survivor yesterday he told me that even though the results were good that I would likely find cancer would show up eventually since my PSA had doubled and my prostate was slightly enlarged.

It now feels like I'm living with "tension and ambivalence" until my next DRE/PSA in six months. It's something I now have to follow, and that feels a bit frustrating.

How should I view what happened? Should I continue to follow it as recommended, follow it less closely, or just plain ignore this roller coaster that was triggered by a high PSA level? Is PC an inevitability based on my symptoms?

I'm looking for views and opinions on this issue. Thank you, everyone who has kindly answered the questions I've been asking.

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Old 09-24-2012, 04:15 PM   #2
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Re: Meaning of a "clear" biopsy

Congratulations on your negative biopsy. It sounds like you don't want to take no for an answer.

Not every PC survivor is a PC expert. Evidently your friend did not know that PSA is not specific to prostate cancer, and, more commonly, PSA increases in response to BPH and prostatitis (which also explains your prostate enlargement). If you have urinary symptoms from the enlargement, there are several treatments available. If not, enjoy your healthy functioning prostate.

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Old 09-24-2012, 06:43 PM   #3
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Re: Meaning of a "clear" biopsy

To be frank, your biopsy report, based on the information provided, means that no cancer was found in the cores taken thru the biopsy. On the other hand, an elevated PSA doesn't mean you have PCA.

If your physician hasn't told you, there are a number of reasons for elevated PSA and enlargement. One diagnosis may have been BHP.. or merely an enlarged prostate. Another reason may be prostatitis or an infection of the prostate. I am surprised your physician hasn't said this to you or perhaps you haven't shared your physician's comments on the board.

In any event, your pathology says no cancer was found, so be happy with the pathology report. If you're still concerned, then get another opinion.

Old 09-24-2012, 06:50 PM   #4
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Re: Meaning of a "clear" biopsy

I would go ahead in 6 months and repeat your PSA, but in the meantime, relax and enjoy the good news. Were you put on treatment for the BPH? That would seem reasonable, especially if you have any symptoms. That tends to worsen as you age and early treatment may keep you out of trouble with the urinary obstructive problems that enlargement can create.

Old 10-27-2012, 03:32 AM   #5
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Re: Meaning of a "clear" biopsy

My urologist was at pains to warn me that a clear biopsy may be the result of the needles missing a cancerous area. That said, a needle biopsy detected my PCa before anything was detectable on a DRE.

One consolation is that, if you tinker with (doctors use, patients tinker) the Sloane-Kettering nomogram, you will find that a previous clear biopsy indicates a higher probability of the disease being contained should a later biopsy detect the disease.

As others have said on this thread, a clear biopsy is a good thing to have on your medical history

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