Reconsidering: Since my original post... - Prostate Cancer N...

Prostate Cancer Network

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Reconsidering

Chrisopopolis profile image

Since my original post ( healthunlocked.com/prostate... ) an MRI was completed and the conclusion was “no significant change from previous MRI”; although the original MRI from 2 years ago scored a second, smaller lesion as PI-RADS-2, the comments in the current MRI repot said it should have been graded as PI-RADS 4, but hasn’t changed since the first MRI.

1st lesion is 1.3x1.1x1.2cm; 2nd lesion is 0.9x0.7cm

Dr. Carroll and Dr. Shinohara both recommended a full spectrum biopsy together with concentrated cores of the two lesions identified in the MRI.

I have still elected to forgo biopsy for now and indicated that I would prefer a transperineal biopsy when one is performed on me. Their back-up recommendation is an ultrasound plus PSA sample in 6 months with Dr. Shinohara.

I have been in the “No way I am getting another biopsy” position for two years now but it is harder than I thought to disregard Dr. Carroll’s recommendation. He is the reason I came to UCSF for treatment and as the PA I met with Tuesday said: “Dr. Carroll is the one who created the Active Surveillance protocol .”

So, as of now I am undecided but re-considering having a biopsy…

5 Replies

With PIRADS 4, it would be foolhardy not to get a biopsy.

Chris...

How did you end up at UCSF?

- I ask because I'm in the Bay Area too. (I assume you're in Bay Area based on UCSF and your photo is the Golden Gate Bridge)

I've had one opinion so far through a Urologist at Kaiser in San Rafael. I'll be seeking a second and UCSF is on the list. Current suggested course of action is Active Surveillance. Diagnosis was made 3 week ago. I'm getting answers to my follow-up questions.

Questions:

- Do you recommend Dr. Carroll?

- Do you recommend Dr. Shinohara?

Chrisopopolis profile image
Chrisopopolis in reply to santer

I started out with a urologist in Walnut Creek, but switched to Dr. Carroll at UCSF because my recommended treatment path was active surveillance protocol , which Dr Carroll helped pioneer, and also the recommendation of the Prostate Cancer Foundation was to seek the services of the most competent practitioner that I can. I am new with UCSF (1year so far) but absolutely love their system and their competence. To date, I have only received and ultrasound imaging exam and MRI through Dr. Shinohara, was very comfortable talking with both Dr. Shinohara and Dr. Carroll and had all my questions answered.

IMO, your biopsy should be a Transperineal 3-Dimension Prostate MAPPING Biopsy

grandroundsinurology.com/ca...

My 3D PMB yielded 100+ core samples that provided the exact boundary limits of the GL10 tumor in my right half.

My MRI showed Pirads-5 lesion. I had the biopsy done as well as targeting the lesion. I was treated at UCSF with Dr Gottschalk. I’d have to agree with Tall Allen, get the biopsy. With a 4 there is most likely something there that needs to be looked at and possibly treated

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