Biopsy timing

[mike__c]

Hi all, I am 53. After seeing a urologist for pelvic pain and having an abnormal DRE and very high PSA (26) I was scheduled an MRI. MRI shows a lesion (right side of prostate with a PIRADS score of 5. So, it's very likely i have a tumor, probably aggressive. My biopsy is set for 12 days from now. Anyone feel like that is too long to wait for a biopsy (from a clinical significance standpoint)?

[Tall_Allen]

Not too long for a biopsy, or for treatment. Even high-risk PC is slow-growing. PIRADS scores may be confounded by inflammation, and by reader errors, so don't jump the gun.

prostatecancer.news/2016/08...

If the biopsy confirms PC, your next step is to have a bone scan/CT to check for distant metastases.

[mike__d__c in reply to Tall_Allen]

Thanks. Good to know.

[ODave]

I am 55 I was PiRads 5 also due to Covid it was a month in between each thing. MRI, a month later Biopsy, a month later Surgeon etc. I’m at the 5 months

since diagnosis and I am starting treatment end of the month into Sept. the RO and Surgeons all said best to treat within 6 months.

[Hidden]

Will your biopsy be guided from your MRI imaging (also called a fusion biopsy)?

This link has a relative discussion youtube.com/watch?v=MREZbvV...(Not working as expected?)

[mike__c]

I'm fairly certain my urologist will not be using fusion. However, the lesion is somewhat large.

[Hidden in reply to mike__c]

Then the second best is somewhere in between. Ask him to take the 12 standard needle samples plus an extra 4 to 6 from spots he thinks are close to the ones revealed by the MRI. A large lesion is no guarantee that the actual Gleason score will come into light. With a PIRADS of 5 the biopsy has no meaning confirming PCa. Its only usefulness is for staging it. You are playing the odds, the more samples from the right spot, the more accurate the pathology.