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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: 157109" data-attributes="member: 16042"><p>Yes that is correct. A biopsy is required for a Gleason score. My first choice if I had your circumstances would be MRI guided in bore targeted biopsy to get a sample of that tissue and if higher than Gleason 6, I would want it ablated.</p><p></p><p>I hope you understand the type of biopsy I am referring to. t would be ludicrous to have a TRUS 12 needle biopsy with that MRI result. Targeted biopsy would be appropriate to sample that questionable lesion.</p><p></p><p>You may however get other recommendations to watch and wait: active surveillance.</p><p></p><p>Edit: BTW, UCLA is pretty cutting edge as an organization regarding prostate diagnosis and treatment these days. They even have been doing clinical trials for PSMA based PET scans that offer more comprehensive and accurate PCa imaging than just 3T MP MRI. PSMA is produced only in prostate cancer cells and contrast agents that illuminate PSMA can be imaged anywhere in the body, so not only do you get definitive info that what is imaged is cancer or not, it is specifically prostate cancer, and metastases can also be seen elsewhere in the body. Seems to me once clinical trials are done PSMA scanning will be the future golden standard. Seems it is a standard of care in parts of Europe now. <span style="color: rgb(184, 49, 47)">(Edit: I just read an interview about some of the drawbacks of PSMA imaging... not a magic bullet for initial diagnosis, but further development may improve its role)</span>.</p><p></p><p>If I was covered under insurance in CA, I'd try to seek a Doc I felt compatible with at UCLA or UCSF or Stanford, but still push for the most accurate targeted biopsy they would agree to. YMMV</p></blockquote><p></p>
[QUOTE="Blackhawk, post: 157109, member: 16042"] Yes that is correct. A biopsy is required for a Gleason score. My first choice if I had your circumstances would be MRI guided in bore targeted biopsy to get a sample of that tissue and if higher than Gleason 6, I would want it ablated. I hope you understand the type of biopsy I am referring to. t would be ludicrous to have a TRUS 12 needle biopsy with that MRI result. Targeted biopsy would be appropriate to sample that questionable lesion. You may however get other recommendations to watch and wait: active surveillance. Edit: BTW, UCLA is pretty cutting edge as an organization regarding prostate diagnosis and treatment these days. They even have been doing clinical trials for PSMA based PET scans that offer more comprehensive and accurate PCa imaging than just 3T MP MRI. PSMA is produced only in prostate cancer cells and contrast agents that illuminate PSMA can be imaged anywhere in the body, so not only do you get definitive info that what is imaged is cancer or not, it is specifically prostate cancer, and metastases can also be seen elsewhere in the body. Seems to me once clinical trials are done PSMA scanning will be the future golden standard. Seems it is a standard of care in parts of Europe now. [COLOR=rgb(184, 49, 47)](Edit: I just read an interview about some of the drawbacks of PSMA imaging... not a magic bullet for initial diagnosis, but further development may improve its role)[/COLOR]. If I was covered under insurance in CA, I'd try to seek a Doc I felt compatible with at UCLA or UCSF or Stanford, but still push for the most accurate targeted biopsy they would agree to. YMMV [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
PSA at 5.3
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