mp mri contrast toxicity

[Mufj]

Afternoon all

hope everyone is doing well or at least as well as expected this new year

I am currently on AS, profile show the details

In 4 years have really seen no chang, currently with Pennmedicine in phila

so far happy with whats being done but now want to make some changes and reviewing

Concerned about toxicity of contrast agent FDA has made recomendations that repeated use be avoided

I have read the contrast agent is only useful under certain circumstances and bpMRI can be equally effective

add to that I consider myself in very low risk with 4 biopsy and no pattern 4 found and the most pattern 3 is 5% in 1 core out of 12, on top of that have 3 mpMRI with no change and provides a good basis for comparison(T2 and diffusion weighted ),

would like to eliminate contrast agent on a regular basis but use if really neccessary and would like to spread biopsy to every other year and as I get older to every 3 year.

Another sidebar is I have been Dx with dupytrens disease(thiickening of tissue in hand leading to contraction of fingers) it is a mild case but symptom seem similar to what can happen with gadolinium toxicity. I have found no evidence that the gadolinium is the cause(I am at risk cause of genetics) but just want to be cautious so this is a balance of risk

My doc is discouraging this cause of increased risk but seems unaware of FDA recomendations. He is older(70's )and though experienced may not be ups to speed and penn being a big organization may be locked into a certain procedure

Evaulating whether switching to another AS program would be a good idea so any recomedations on programs

thanks all for any input, opinion and experience

[RMontana]

Mufj, I am way beyond AS, but your situation had something in common with a couple of studies I saw lately and with my experience with Biomarkers I used that helped make up my mind for the treatment that I followed. I dont know if you have had your tumor tissue classified via any of the current Biomarker labs; I used Decipher. These two presentations are pro and con regarding use of Biomarkers...if you have not used any of the current tests, check them out...Cheers

Grand Rounds: The Role of Currently Available Biomarkers Genomics in Risk Stratification of Prostate Cancer

youtu.be/HwIk5U5IqKw(Not working as expected?)

youtu.be/-d1nbOIb2Qc(Not working as expected?)

[Mufj in reply to RMontana]

Thank for the comment will check them out. on my orignal biopsy had the oncotype done. This was my orignal urologist whom I fired(wont get into that) Anyway the folks at penn tell me that in my cast they dont take it too seriously cause of the small amount found. They feel that due the small amount of material available it does not give reliable result. I presume they were talking speifically about oncotype but may apply to others. Thanks for the info