About 9 months ago you suggested that after a finding of early stage adenocarcinoma in a single lobe that I repeat a biopsy after a year to see if tumor volume is increasing.

 In two weeks I am having my fourth  blood draw after the original finding of cancer. The high P.S.A. level a year ago was 4.03 with subsequent  scores were 2.9 , 3.6., and 4.03. Of course,  I am following through with a biopsy the third week of January.

 Dr Catalona suggests that if the biopsy indicates additional spread to two or three lobes that I immediately initiate treatment, ( In that event I have chosen seed implantation), to commence at Barnes Siteman. My radiation oncologist Jeff Michalski favors an intergration of the Calypso System with Intraoperative brachytherapy.

 My question; if my upcoming bioposy shows no aggression, and during  the following four quarters my P. S. A. does not exceed your cut off number of 6.5 ng/ml, do you feel that the annual biopsy could be reasonably extended to say every 18 months?