Thursday, October 27, 2016

Biopsy Results, Finally

I arrived early for my 3:55 appointment on October 5th, as usual. After a long wait, I found out that my urologist had run out of time to see the remaining patients. Fortunately, he was able to squeeze me in later that afternoon. He described the results, primarily in terms of the Gleason score.

Of the 20 cores, two had mostly or entirely missed the prostate, eight were clear, two had “atypical small acinar proliferation (ASAP),” four had some suspicious cells, and four had definite cancerous cells. Three of those last four had Gleason scores of 3+4=7, and the fourth was 4+3=7. The Gleason score therefor was essentially the same as in the previous biopsy. Two of those four had “perineural invasion.”

I didn’t see the biopsy report itself until I got a copy after the appointment. Because of that delay, I didn’t get a chance to ask about notes mentioning the cores with no prostate tissue, ASAP, or perineural invasion. I also didn’t know that the core locations would be described in the form of a grid system, with no explanation of how the grid coordinates related to the locations of cores taken in the first biopsy.

A Google search told me that ASAP is nothing to worry about, and perineural invasion probably isn’t. I also searched for prostate biopsy grid system images and figured out more or less how the grid was used in my biopsy. Comparing it to the locations of the cores in the 2015 biopsy, I found that basically it was the same regions that were problematic. Conclusion: not much had really changed in the last year and a half, although it certainly hadn’t improved.

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