Our rationale to attempt to avoid a prostate biopsy--attempt failed!!

After my husband's last 2 psa readings were high, his jerk of a doctor met with us to go over the results and the next step.  Husband is having no symptoms, just that all-important psa number was elevated.  I had been reading about biopsies spreading cancer cells, making prostatitis worse, and worst of all, biopsies not finding the cancer and coming back false negative, which results in even more biopsies.  To top it off, when we went to this family doctor, I asked him about biopsies not always finding the cancer the first time--and, his smart*!* answer was, "well, if we find it the first time..then you'll know". The urologist we went to told us that we would do 12-18 samples and since the tissue was tougher in/around the prostate, (and in his words, "insensitive in the rectum) my husband would not need anything--it wouldn't be painful, he wouldn't feel it, and wouldn't need even a local anesthetic.  As I learned from other messages, this doctor must be a barbarian, because everypne else offers at least a local!!!

So, we began researching other ways to determine if cancer is present, and then proceed with a targeted biopsy if something is found.  That led us to the MRI-spectroscopy study, which studies the relationship of the creatine, choline, and citrate in the cells.

My husband went through the mri-s and ultrasound, and something suspicious was found.  The doctor who did the study said, and I quote:  "we can treat the prostate cancer and prostatitis we found without a biopsy"...but unfortunately, the treatment he recommends is HIFU, to the tune of $25,000 to $30,000....unaffordable by a long shot.  The doctor said he would do a targeted biopsy if we wanted, and would only sample 5-6 times, directly around/in the suspicious areas.  I have been reading that a biopsy with less than 10 samples is pretty much useless...so we might be spending more money on another test that will turn up useless.

We looked into the US trials for HIFU---and other treatments, too--however, no one else will even touch my husband without a biopsy because they say they need the results of the Gleason score from tissue sample--the MRI-s doesn't sample the tissue, and you cannot assign a Gleason score without it.  Without a Gleason score, no one will discuss the options because they don't know what stage the cancer is in.

So that is where we are now--we cannot afford the HIFU, the trial won't accept us without a biopsy, and no other doctor will talk to us without a biopsy.  So, after spending a lot of money on the MRI-s and ultrasound, to avoid a biopsy, we are back to square one....husband will have to have a biopsy so that we can find out our options.

 My reason for sharing all this is to give you some background on the steps we tried to take to avoid a biopsy--but all we did was spend money on something that no one else will accept the results of.  We are still waiting to see if the insurance company will reimburse us for this.  So far, it has been a very expensive lesson learned.  Now we can add frustration and anger to the confusion and worry....

 

On 8/17/2009 dymo2009 wrote:

After my husband's last 2 psa readings were high, his jerk of a doctor met with us to go over the results and the next step.  Husband is having no symptoms, just that all-important psa number was elevated.  I had been reading about biopsies spreading cancer cells, making prostatitis worse, and worst of all, biopsies not finding the cancer and coming back false negative, which results in even more biopsies.  To top it off, when we went to this family doctor, I asked him about biopsies not always finding the cancer the first time--and, his smart*!* answer was, "well, if we find it the first time..then you'll know". The urologist we went to told us that we would do 12-18 samples and since the tissue was tougher in/around the prostate, (and in his words, "insensitive in the rectum) my husband would not need anything--it wouldn't be painful, he wouldn't feel it, and wouldn't need even a local anesthetic.  As I learned from other messages, this doctor must be a barbarian, because everypne else offers at least a local!!!

So, we began researching other ways to determine if cancer is present, and then proceed with a targeted biopsy if something is found.  That led us to the MRI-spectroscopy study, which studies the relationship of the creatine, choline, and citrate in the cells.

My husband went through the mri-s and ultrasound, and something suspicious was found.  The doctor who did the study said, and I quote:  "we can treat the prostate cancer and prostatitis we found without a biopsy"...but unfortunately, the treatment he recommends is HIFU, to the tune of $25,000 to $30,000....unaffordable by a long shot.  The doctor said he would do a targeted biopsy if we wanted, and would only sample 5-6 times, directly around/in the suspicious areas.  I have been reading that a biopsy with less than 10 samples is pretty much useless...so we might be spending more money on another test that will turn up useless.

We looked into the US trials for HIFU---and other treatments, too--however, no one else will even touch my husband without a biopsy because they say they need the results of the Gleason score from tissue sample--the MRI-s doesn't sample the tissue, and you cannot assign a Gleason score without it.  Without a Gleason score, no one will discuss the options because they don't know what stage the cancer is in.

So that is where we are now--we cannot afford the HIFU, the trial won't accept us without a biopsy, and no other doctor will talk to us without a biopsy.  So, after spending a lot of money on the MRI-s and ultrasound, to avoid a biopsy, we are back to square one....husband will have to have a biopsy so that we can find out our options.

 My reason for sharing all this is to give you some background on the steps we tried to take to avoid a biopsy--but all we did was spend money on something that no one else will accept the results of.  We are still waiting to see if the insurance company will reimburse us for this.  So far, it has been a very expensive lesson learned.  Now we can add frustration and anger to the confusion and worry....

 

dymo2009 if I could do it over, I never go near a biopsy, you see from 1998 to 2007 I had a PSA that went up and down every year but never went higher as a PSA of 3.5 any way but in 2007 I had a PSA of 4 some thing my doctor said, I should have a biopsy, I did ,they found cancer in two of them little needles. after this my PSA rose to 6. it was about here is when I felt a pain in my ribs and my lower back that turned out to be prostrate bone met's cancer. And all this started, after I had that biopsy, after this My PSA just went up and up to a PSA of 13.8. I all so had urine retention, so I could not pee very well, the worse it got is when I could not sleep at night, because of the pain, it lasted for a month, until I went and seen a naturopath, who know how to treat cancer, she put me onto Zeolitte, high dose vitamin C, and Zinc. I stayed on this for a while, then went onto red clover tablets and the Budwig diet for cancer, it been nearly 12 months since I went on this holistic alternative therapy, I now have a PSA of 8 now I'm als on a no sugar diet and a lot of vitamin and mineral supplements, I've ask my uros about the biopsy pushing cancer tumors into my blood streem, he said no way the biopsy would have cause my cancer to get worse, but why did it get worse, after I had the biopsy. Ever doctor I've have ask said it impossible. But if it imposiblre why did it happen to me ,I really wish a lot of times that I had left it alone. but I was waried. and not sure if I had cancer by the time I seen uro who could not help me eather because I was to over weight or my insurance would not pay for the treatment I was told it was to late any way the turmors were now out side the prostrate all the best and God bless Ray

http://orthomolecular.org/resources/omns/v04n19.shtml

http://www.sciencedaily.com/releases/2007/11/071127161824.ht

The other option is to have a color doppler targeted biopsy. It is far more accurrate than a normal biopsy and only targets suspicious areas, so a 6 core sample is usually enough. The color doppler looks at blood flow as all tumors need a blood supply to function.

JohnT

Hi  dymo2009

I  understand  your  plight, since  I  am  trying  to  avoid  a  biopsy  at  all  costs  too.

However, I  agree  with  JohnT  if  your  husband's PSA is  rising  a  biopsy is  necessary  if  only  to  see  how  aggressive  it  is and  plan  treatment  accordingly.

I'm  from  the  UK  and  like  you  I   had  a contrast  MRI  which  showed  areas  which were  suspicious  for  cancer. They  were  graded  on a scale  of  1 to 5  with  1  being  no  cancer  and  5 definitely  cancer.

I  had  a  couple  of  areas  of  4 but  was  loathe to  having a   template  biopsy where  a  grid  with 40 to  50  holes is  used  to  guide  that  many  needles  into  the  prostate from  the  perineum  rather  than  via  the  rectum. This  is  90%  accurate  in  locating  the  cancerous  parts , but

I  didn't want  to  go  through  that  degree  of  bodily  insult , although it  is being used  more  and  more  in  this  country.

Going  in  via  the  perineum  rather  than  through  the  rectum  has  less  risk  of infection also.

So  my  consultant  has  agreed  to  do  a  targeted  biopsy  through

the  perineum  of 4 or  5  needles  in the  areas  located  from  the  MRI.

A  local  anaesthetic to  be  used  in  the  perineum area. I  certainly  felt  happier  with  that  approach ,  so  I  can  get  a  Gleason  score  and  see  what I  am  dealing  with.

I  suppose  in your case  it  depends  on  how  many  suspicious  areas  showed up  in  your  scan ,  as  to  how  many  samples  are  taken.

In  the  U.K.  Hifu  is  available  and covered  by  health  insurance, but

have  you  considered  Cyberknife  which  I  believe  is covered  by  most

insurers  in  the  U.S. ?

Good  luck.

 

HIFU should not be ignored.There are clinical trails ongoing.

http://clinicaltrials.gov/ct2/results?term=hifu

Here is some examples of men who have had HIFU done.

http://www.yananow.net/Experiences.html#hifu

Relax and investigate, knowlegde is king.

HIFU should not be ignored.There are clinical trails ongoing  But it  no good  for patients living miles away and cant get to them even with HIFU it would be grate if med  insurance would pay for it Hay  who has a spare $20,000.00

I just aked my husband, he had a local for his biopsies.  He was diagnosed in June.  He is going to have Proton Beam Therapy in Jacksonville, Florida.  When you are doing your research check it out.  I went with him for his consultation visit and took the tour.  I am convinced it is the best treatment available for him, he is only 52.  If you have questions I will be happy to answer them.

I read this article and thought of you. I still think you should get the biopsy because at least you'll get a baseline. But this is something to consider, maybe, when/if determining treatment options?

http://www.forbes.com/2009/08/31/prostate-cancer-screening-b

PS My husband has had prostate cancer for 11 years. You name the treatment, he's had it or done it, including RP, radiation, rods, homone therapy, natural/alternative treatment, meditation, skidan's book, hypnotherapy, etc. His PSA still rising. We credit the combination of all of the above for him staying so healthy and strong for so long. Whatever it takes, medical, alternative, I'm all for it.