Biopsy 2 years post treatment

[WilsonPickett]

One year ago I was successfully treated with MRI guided SBRT for a PIRADS 5, Gleason, 3+ 4 fully contained lesion on my right anterior. I was just told by my oncologists office (Zelefsky) that it is now standard practice at MSKCC to perform a 14 core biopsy to check for any residue cancer cells even if the PSA has been trending in the right direction (8.5 one year ago, 1.35 now), at the 2 year mark. Is MSK the only one advising this?

[Jpl506]

I had a two year post MRI guided SBRT biopsy from treatment at UCLA but I’m on a clinical trial for very high risk. It wasn’t too big of a deal save for the fact that it was supposed to be an in bore MRI biopsy but due to the shrunken size of my prostate it failed. I had to them get a standard TRUS. All cores showed successful treatment BTW.

[Tall_Allen]

How will they know if it is "residual" cancer or just zombie cells? How can a biopsy know what is going on on the DNA level?

[WilsonPickett in reply to Tall_Allen]

Good questions, with no answers. I will certainly have some before I subject myself to another biopsy.

[addicted2cycling in reply to WilsonPickett]

Was PSA doing any upward trending and even if not why not have a PSMA or MRI first??

[maley2711 in reply to WilsonPickett]

Any hesitance about questioning someone with his bio???

[NYC_talker in reply to Tall_Allen]

This came up earlier in the year from Hope4Happiness who also had SBRT at a similar time as you did with Zelefsky. In this post here.

healthunlocked.com/prostate...

I'm not sure if it's now standard MSK practice since I had LDR brachy at the same you did at MSK, with Dr. Shasha. And I have not been told of any biopsy in the future. Could just be Zalefsky or just SBRT.

[WilsonPickett]

I would really have to have a conversation with Zelefsky first, before I would consider going ahead with another biopsy, unless, of course, there were indications, like a rising PSA.. I haven’t heard of one other oncologist that’s doing this at the two-year mark as a matter of policy, so it’s curious to me.

[cancerfox]

Maybe business is a little slow in the biopsy department. 🙂 🦊

[WilsonPickett in reply to cancerfox]

That would be disappointing. He doesn't seem like the type, although it could be for research purposes, but then he should be upfront about it. We'll see. I still have a year to worry about it.