Second Step

The next step is to determine if an elevated PSA score really indicated the existence of prostate cancer and if so, the extent and aggressiveness to guide you in your plan of action. If there is low volume affected, the cancer is low grade or not aggressive and no sites are near the capsule, you may make major changes in diet and watchful wait. Otherwise aggressive forms of cancer with Gleason scores 7 and above may encourage you to evaluate treatment choices and make plans sooner rather than watchful waiting.

1. Do I really have prostate cancer
2. How much of the prostate has cancer
3. How aggressive are the cancer sites
4. How close are any cancer sites to the capsule or edge of the prostate gland

At this point it is important to select a physician who is up to date with modern prostate biopsy goals. Traditionally urologists want to know only one thing: is there cancer in the prostate. The technique used to answer this question is a random biopsy. However, this traditional random biopsy is only hit or miss since the doctor is unable to identify all potential regions of cancer using this technique. Like throwing darts at a dart board, the chances of landing in a region of cancer to obtain a sample are not good. In addition, an accurate map of affected areas cannot be obtained by this technique. Modern biopsies guided by MRI images and Artemis technology are able to map the regions of cancer with high accuracy. A word of caution regarding prostate biopsy of any type. There is the threat of spreading residual cancer cells beyond the prostate capsule as the needle retracts. Newer analysis methods using MRI to positively identify cancer without biopsy and Artemis technology are under investigation. Take the time to understand these two biopsy methods to identify prostate cancer and how each affects your ability to make an intelligent choice of treatment.