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How would you manage a low risk patient with a negative fusion prostate lesion by biopsy but MRI shows apparent advanced disease?
Do you allow this finding to change your management, or ignore it, as the "lesion" was not malignant?
Answer from: Radiation Oncologist at Academic Institution
Assuming that the patient has NCCN low-risk features and MRI findings of EPE (which is the most common situation), I would think about this situation in two different subcategories: (1) active surveillance (AS) is still under consideration, and (2) the patient has decided he would like to proceed wi...
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Answer from: Radiation Oncologist at Community Practice
Agree with Dr. @Alexander Slade's qualifier that it matters what type of "advanced" you're dealing with. My first step is to check with the urologist about how confident they were that they got to the right area on the biopsy and, if I'm very concerned, explore a rebiopsy (folks usually are not enth...
Answer from: Radiation Oncologist at Academic Institution
These situations may benefit from a multi-disciplinary discussion with urology and radiology. All lesions that show up on MRI are not cancer. In terms of findings of advanced disease, how advanced is it? If the findings are suggestive of T3b or T4 disease, that would be more concerning than, for exa...