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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
PSA at 5.3
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<blockquote data-quote="Blackhawk" data-source="post: 157040" data-attributes="member: 16042"><p>Hey, I am on a similar trajectory, looks like MRI next week, and have thought through the next couple steps. Fusion or in bore MRI guided biopsy would be my next step for PIRADS 4-5. I would really want to know Gleason score for that tissue. Guided is harder to find covered by insurance. My own preference would be to pay out of pocket for guided out of state by a Dr with a ton of expertise and experience. I already know several options high on my list, Dr Joe Busch would be first choice, but he is in transition to a new practice and his pricing went through the roof with this change, so other options are Karamanian, Walser, Desert imaging in S. CAL or another Cal Radnet operation, or possibly Sperling. But this deserves research on your part to make your own decisions. I have not by any means researched all available.</p><p></p><p>These findings are VERY promising:</p><p>Suspicion for extracapsular extension: 2 (1 = very low suspicion, 2 = unlikely, 3 = intermediate suspicion, 4 = likely, 5 = definite)</p><p>Suspicion for neurovascular bundle involvement: 1 (1 = none, 2 = possible, 3 = highly likely)</p><p>Suspicion for seminal vesicle invasion: 1 (1 = very low suspicion, 2 = unlikely, 3 = intermediate suspicion, 4 = likely, 5 = definite)</p><p></p><p>Withe the major size at 0.7cm, you may receive a recommendation for biopsy or active surveillance, and if biopsied, if you are Gleason 3+3, you may have the active surveillance option. If Gleason score is higher next consideration for me would be what focal treatment to choose. I would want that tissue ablated being close to capsule margin.</p><p></p><p>You may reach different decisions.</p></blockquote><p></p>
[QUOTE="Blackhawk, post: 157040, member: 16042"] Hey, I am on a similar trajectory, looks like MRI next week, and have thought through the next couple steps. Fusion or in bore MRI guided biopsy would be my next step for PIRADS 4-5. I would really want to know Gleason score for that tissue. Guided is harder to find covered by insurance. My own preference would be to pay out of pocket for guided out of state by a Dr with a ton of expertise and experience. I already know several options high on my list, Dr Joe Busch would be first choice, but he is in transition to a new practice and his pricing went through the roof with this change, so other options are Karamanian, Walser, Desert imaging in S. CAL or another Cal Radnet operation, or possibly Sperling. But this deserves research on your part to make your own decisions. I have not by any means researched all available. These findings are VERY promising: Suspicion for extracapsular extension: 2 (1 = very low suspicion, 2 = unlikely, 3 = intermediate suspicion, 4 = likely, 5 = definite) Suspicion for neurovascular bundle involvement: 1 (1 = none, 2 = possible, 3 = highly likely) Suspicion for seminal vesicle invasion: 1 (1 = very low suspicion, 2 = unlikely, 3 = intermediate suspicion, 4 = likely, 5 = definite) Withe the major size at 0.7cm, you may receive a recommendation for biopsy or active surveillance, and if biopsied, if you are Gleason 3+3, you may have the active surveillance option. If Gleason score is higher next consideration for me would be what focal treatment to choose. I would want that tissue ablated being close to capsule margin. You may reach different decisions. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
PSA at 5.3
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