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What Does My Prostate Biopsy Report Indicate?
Question: HI i'M AN ASYMPTOMATIC 65 YEAR OLD. THICKENED AREA RIGHT PROSTATE ON DRE. PROSTATE BIOPSY SHOWED INTRADUCTAL CA INVOLVING ALL CORES OF RIGHT PROSTATE GLAND. INVASIVE CA NOT IDENTIFIED. HIGH GRADE AIN IN CORES OF RIGHT BASE. LEFT BASE AND LEFT MID GLAND HIGH GRADE PIN AND LEFT APEX BENIGN PROSTATE TISSUE. CORES OF RIGHT SIDE SHOW AN IN SITU COMPLEX ATYPICAL CRIBRIFORM PROLIFERATION EXPANDING LARGE GLANDULAR SPACES. BASAL CELLS ARE IDENTIFIED BY ROUTINE HISTOLOGY AND ARE CONFIRMED BY IMMUNOHISTOCHEMICALSTAINS FOR BASAL CELL MARKERS ON REPRESENTATIVE SLIDES. THE LARGE CRIBIFORM GLANDS SHOW QUITE VARIABLE PLEOMORPHISM. THE IN SITU PROLIFERATION INVOLVES 33, 15 AND 25% OF THE TOTAL CORE LENTGHS RESPECTIVELY. THE FINDINGS ARE CONSISTENT WITH INTRADUCTAL CARCINOMA. INVASIVE CARCINOMA IS NOT IDENTIFIED. PLEASE ADVISE RE MANAGEMENT AND TREATMENT. I AM A FAMILY PHYSICIAN AND WANT AN OPINION. THX XXXXXXX
Brief Answer:
Prostate cancer can be managed surgically or conservatively.
Detailed Answer:
Hello XXXX and welcome to HCM.
As an Urologist, i must advise you that, radical prostatectomy is best option.
It's possible, if you're in otherwise good health, and there're no metastasis.
Also, you should be a good risk case for G.A., with organ confined lesion.
The standard procedure is a laporoscopic radical prostatectomy.
Today, many centres have facility for robotic surgery, as you may be aware.
The main advantage being,less bleeding and being nerve sparing,for having sex, and better continence.
If your MRI pelvis doesn't show lymph nodes,prognosis is even better.
But, in case you're not fit for G.A., or high risk for radical surgery, then you'll have to consider conservative options.
Conservative options are Radiotherapy to prostate gland( 3-d conformal), Androgen blockade with Leuprolide injections, or bilateral orchidectomy, and hormonal treatment with Bicalutamide.
PSA and LFT, with creatinine, have to be monitored.
Hope your doubts have been clarified.
Wish you good health.
Prostate cancer can be managed surgically or conservatively.
Detailed Answer:
Hello XXXX and welcome to HCM.
As an Urologist, i must advise you that, radical prostatectomy is best option.
It's possible, if you're in otherwise good health, and there're no metastasis.
Also, you should be a good risk case for G.A., with organ confined lesion.
The standard procedure is a laporoscopic radical prostatectomy.
Today, many centres have facility for robotic surgery, as you may be aware.
The main advantage being,less bleeding and being nerve sparing,for having sex, and better continence.
If your MRI pelvis doesn't show lymph nodes,prognosis is even better.
But, in case you're not fit for G.A., or high risk for radical surgery, then you'll have to consider conservative options.
Conservative options are Radiotherapy to prostate gland( 3-d conformal), Androgen blockade with Leuprolide injections, or bilateral orchidectomy, and hormonal treatment with Bicalutamide.
PSA and LFT, with creatinine, have to be monitored.
Hope your doubts have been clarified.
Wish you good health.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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