1 year AS-what Now

Diagnosed bout a year ago with very low volume/low risk G6. As my stats show a number of scans including MRI which dont show anything. My PSA is basically flat(other than this I have no PSA history. chose AS at Penn Medicine which is PSA every 6 mo and annual biopsy.

Well got my first annual biopsy (15cores-some extra at the location of the positive result). All came back negative-this is a verbal have not seen the report yet. Have an appointment with Uro in July to discuss.

Question does it make sense to either skip doing biopsy or do it just every couple years given that there is nothing other than that first biopsy that shows anything negative.

Part of me say gee why should I continue does not look like anything is there but at the same time dont watn to be stupid and ignore the situation. Nonethe less would like to avoid (sensible) invasive biopsy.

So any comment

Thanks in advance


Quick rehash of my story
As a result of a phycical which returned a PSA result of 4.3 was referred to A Uro at delaware valley urology. DRE showed a nodule and recomended a biopsy. Scheduled biopsy but called back and asked if an MRI could be done first and was told my insurance(medicare) would not cover and is not needed. Not happy with this called Penn Medicine and made an appt but earliest was over 2 month out so decided to go thru with the biopsy. Biopsy came back with 0.5% G6 in 1/12. Recomended AS. Did do oncotype DX but due to screw up on Uro's part took over 3 month to get result. These people very diffucult to deal with and communicate.
At Penn did MRI,chest xray,abdominal CT scan and chest Xray. Spoke to 2 uro's at penn final recomendation is AS(PSA every 6mo and bisopsy every year.). PSA is techniclly down to 3.1 but I kind of consider it flat cause on original was not told about no sex or agressive activity effecting the groin. As a matter of fact for the last one even avoided the gymn for about a week before.

I'm on AS and did some research on how often to have biopsies because I had a Uro that had a flat policy of doing them every year, regardless of anything else. I got several opinions from good, academics up on all that latest research. They said that:
1. When to do another biopsy is a case by case call depending upon what the MRIs show and the PSA does.
2. A rote policy of a biopsy every year, regardless, is contrary to best practices and should not be done.

In my case, my PSA has continued to rise, but my MRIs are negative, so my Uro will do one two years after the last.

I'm pretty much in the same boat as you, and my doc seems to have settled into a pattern (after the second biopsy came up negative) of PSA tests every few months and an annual MRI. It's been over two years since my last biopsy -- maybe he has one in store for me next year. If he pushed annual biopsies I'd be pushing back.