I was diagnosed in 7/06, Gleason was 6 and psa 4.2. I had 1 core positive 5%,1 millimeter of cancer. I chose to do active surveillance. I have my psa checked every 3 months . It has been going down steadily.My last psa was 0.88 (in fact, 1.76 since I take avodart). I should also tell you that 5 months after I was diagnosed I had another biopsy (14 hits- all samples negative). I had an MRI in 10/06 which showed very little cancer in prostate-no indication that cancer had spread beyond the capsule.Does it make sense now to have another biopsy 31/2 years after being diagnosed when my psa is not doubling but in fact halving.

 

I would not be a fan of doing a blind biopsy. However, it would be reasonable to have a repeat endorectal MRI and if a cancer is detected you could have biopsies done that concentrate on the area with cancer in it. I also often send patients for a color Doppler ultrasound as it sometimes identifies cancer missed by the endorectal MRI, as I mentioned in my two recent newsletters on Active Surveillance, Prostate Forum Vol. 11 # 9 http://www.prostateforum.com/back-issues.aspx?id=3011#9 and Prostate Forum Volume 11 # 10 http://www.prostateforum.com/back-issues.aspx?id=3011#10 At AIDP, we typically send patients for these imaging studies every 1-2 years, but some go less frequently.

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