Comments on: More data on the use of mapping biopsies http://prostatecancerinfolink.net/2009/10/28/more-data-on-the-use-of-mapping-biopsies/ Thu, 29 Jul 2010 01:22:24 +0000 hourly 1 http://wordpress.com/ By: Steve Z http://prostatecancerinfolink.net/2009/10/28/more-data-on-the-use-of-mapping-biopsies/#comment-6285 Steve Z Sat, 31 Oct 2009 11:04:14 +0000 http://prostatecancerinfolink.net/?p=7095#comment-6285 I'm with Chris, you hope that a mapping biopsy will give you the right Gleason score. From what I've read on this board, standard 12 needle TRUS biopsy undergrades about about a third of the time. John makes a good point as well. I went from a 51 needle mapping biopsy that only found two small (10% areas) of Gleason 6 cancer on one side to focal cryo treatment of those areas. The follow-up TRUS biopsy found two more small (10 and 15%) areas of Gleason 6 on the same side. Apparently, I've got a number of very small foci of cancer (1-3 mm) on that side that fit through the mapping grid. More biopsies will just find different small cancers. Since the doctors performing focal cryo continue to report a 90% success rate, I've got to assume that I'm more "multifocal" than most. Mike's comments are good to consider too. I've gone back to an active surveillance program for now, but with longevity calculators saying (at age 61) that I've got 30 more years, I may consider a nerve-sparing freeze of the entire right side if I don't like what PSA and the next biopsy say. With cryo, retreatment is an option, but treating a larger area will involve a greater chance of side effects. I’m with Chris, you hope that a mapping biopsy will give you the right Gleason score. From what I’ve read on this board, standard 12 needle TRUS biopsy undergrades about about a third of the time.

John makes a good point as well. I went from a 51 needle mapping biopsy that only found two small (10% areas) of Gleason 6 cancer on one side to focal cryo treatment of those areas. The follow-up TRUS biopsy found two more small (10 and 15%) areas of Gleason 6 on the same side. Apparently, I’ve got a number of very small foci of cancer (1-3 mm) on that side that fit through the mapping grid. More biopsies will just find different small cancers. Since the doctors performing focal cryo continue to report a 90% success rate, I’ve got to assume that I’m more “multifocal” than most.

Mike’s comments are good to consider too. I’ve gone back to an active surveillance program for now, but with longevity calculators saying (at age 61) that I’ve got 30 more years, I may consider a nerve-sparing freeze of the entire right side if I don’t like what PSA and the next biopsy say. With cryo, retreatment is an option, but treating a larger area will involve a greater chance of side effects.

]]> By: John E. Holliday http://prostatecancerinfolink.net/2009/10/28/more-data-on-the-use-of-mapping-biopsies/#comment-6273 John E. Holliday Thu, 29 Oct 2009 15:14:20 +0000 http://prostatecancerinfolink.net/?p=7095#comment-6273 What strikes me as interesting and significant is the fact that the majority of the cancers were multi-focal even in these "hard to find" tumors. This further encourages questions, in my mind, as to whether the already debatable "focal" treatment can ever reach the success rates realized by the more traditional radical forms. Of course, only time will tell. - John@newPCa.org (aka) az4peaks What strikes me as interesting and significant is the fact that the majority of the cancers were multi-focal even in these “hard to find” tumors. This further encourages questions, in my mind, as to whether the already debatable “focal” treatment can ever reach the success rates realized by the more traditional radical forms. Of course, only time will tell. – John@newPCa.org (aka) az4peaks

]]> By: Chris http://prostatecancerinfolink.net/2009/10/28/more-data-on-the-use-of-mapping-biopsies/#comment-6271 Chris Thu, 29 Oct 2009 00:14:02 +0000 http://prostatecancerinfolink.net/?p=7095#comment-6271 To me the most important question is whether or not the Gleason score was more accurately predicted with these types of biopsies. There is little doubt that you will find prostate cancer in most men of [over 50 by using mapping biopsies]. The question is are they better predictors of final pathologies after radical prostatectomy. To me the most important question is whether or not the Gleason score was more accurately predicted with these types of biopsies. There is little doubt that you will find prostate cancer in most men of [over 50 by using mapping biopsies]. The question is are they better predictors of final pathologies after radical prostatectomy.

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