So I dropped the Uro who wanted to do TURP right out of the box without any further testing or even getting the PSA result back. The result is back and it's a 4.0. She said I should be around or under a 1 at my age, 56.
My new Uro wants to do a needle biopsy to rule out Prostate Cancer. Anyone think that's a bad idea? I've been told it's pretty painful and has a 1 percent chance of infection.
They said my bladder is holding more than 200 ML. She said she would NOT do an MRI "first pass." She said it would not find cancer if it's present. Is there any reason not to do the biopsy? Is it the only or best way to diagnose cancer?
Every URO or other doctor who has stuck his or her fingers up my butt has said my prostate is smooth but large.
Thoughts? Thanks.
If I were you I would wait and have another PSA done in 3 months. 4.0 and under is normal. Why he's she telling you that it should be under a 1 Never here that before. And why does she think you have cancer when you are at normal range Are you still being able to go to the bathroom. Have they told you how big your prostate was. I would not rush into any biopsy but that is up to you. Ken
Are you certain of those numbers of hers? I am 72 with a PSA of 2.2. (The test scale indicates age 40-49: .01 - 2.50 as a target acceptable range. And age 50-59 : .01-3.50. So yours seems only slightly elevated. Maybe another PSA is in order? (AND: I have read that it is prudent to avoid orgasms for at least three days before a PSA test as it can elevate the number. You may want to have another blood drawn with that in mind.)
Very best of luck to you.
I had a prostate biopsy 3 weeks ago. The only pain, and it was minor, was from the antibiotic shot in the butt. There were two tiny stings when he numbed the prostate with an injection. It was uncomfortable as he moved the probe around to position it for the next snip but it's all over in about 10 minutes. Fwiw, when I was 56 my PSA was 2. It was 3 until this year when it jumped to 11, hence the biopsy. Fortunately, the jump was due to prostatitis, not cancer. My only recommendation is to listen to your urologist, not a bunch of random strangers on the internet!
P.S. Age 60-69 "allows" a PSA as high as 4.5...according to the scale I have before me. You are essentially 60 years of age, so....
But a biopsy is perhaps good insurance. (I have had a liver biopsy and it's no big deal. No prostate biopsy...yet.)
DRE exam showing that the prostate is smooth but large is usually what doctors rely on as well as a PSA test. Though I understand that PSA levels can fluctuate from week to week sometimes. Perhaps you could get another PSA test or two during a period of time in order to see if there is fluctuation in the level.
A friend of mine who also has high PSA went for the needle biopsy. He said it was fairly uncomfortable. And also they're getting samples randomly within the prostate. That's because they don't know where there would be cancer is specifically located within the prostate. This friend of mine does a lot of bicycle sports which raised his PSA level he suspects.
Just cause the doctor says to get a TURP without exhausting all other tests and options doesn't sound good.
Good points re a jump in the PSA. I believe any significant change is what they are after.
After a AUR my PSA stayed around 10 for several months. The URO wanted biopsy and recommended TURP since I was not a candidate for the Urolift. I opted for MRI which came out well, declined biopsy against everybody’s recommendation. After a lot of thoughts and research I found a URO I trusted in and 8 months after the incident he did a combination of PAE and Rezum. All went well and almost a year later I am very happy with the outcome. Did a PSA test 5 months after surgery and it had gone down to 3.
I followed my gut feeling and trusted my body. You have to decide what you believe is right for you! As an advice, if you really trust your URO, you will take a good decision!
I had an MRI that saw something
“ suspicious “ in my prostate . I had the biopsy and it targeted the suspicious area . My PSA was 6 and I was 49 at the time . Turned out to be prostatitis. Biopsy was unpleasant but over quite quickly but with an infected prostate it was bound to be uncomfortable. A bit like putting a needle into an infected arm but I know other people who thought it was a walk in the park . I think it depends on your anxiety levels whether to go the extra mile for a biopsy . I don’t believe your PSA is that high at your ages.
Others may no more than me but shouldn’t u have an MRI first to target the right area of the prostate.
If your anxiety levels are low I’d agree with the others and wait to see if your level increases or not . Many things can raise the PSA .
I’m 60. I had a biopsy with a PSA of 4.5 and was neg. 6 months later it went to 7.2 and had an MRI which was also neg. prostate is 75ml. They put me out for my biopsy. My oldest brother had prostate cancer so that affected our decision for both.
From my experience I believe MRIs ahead of biopsies have a better chance of locating Prostate Cancer (PCa) if it is present. My MRI directed 2 biopsy positive 3+4 Cancers. The other random biopsy hits were clear. Sure I believe MRIs do not always detect present Cancers but the odds are better. I think the reluctance for Prostate Cancer MRIs in Australia was cost based. I believe that has now changed. I suspect PET scans may be an even better option. I had a friend who died from bowel cancer shortly after diagnosis. He was told, then, he should have had a PET scan every 2 years???
I think they need a biopsy confirmed positive PCa result ahead of treatment but a Gleason 6 or under is generally an “active surveillance”situation. It seems the “active surveillance” can vary a lot between Uros and is dependent on differing PSA considerations. Some use high volume follow up biopsies others rely more on PSA fluctuations. Careful if you have recently taken 5ARI drugs as they can half PSAs. Check out biopsy PCa spreading risk at some time when evaluating what you are up for.
Barrie Heslop
Motto. I forgot to tell you when I was 47 My GP sent me to a Urologist because she told me I had Prostate cancer. My PSA was 426. I had every test done that they do ending with a 12 needle biopsy. Turned out to be a prostate infection. I will never go through all that again. Have a good day Ken
What are ur symptoms and history ?
Timothy did you find out why your PSA was high ? Or was it a false result ?
Hello Motto, I'm new to prostate hell, only since Sept 1st.
Got lots of great insight from people here.
I was very much in your situation and my uro said pretty much what yours, which I now consider not my first choice, especially given my age, and that an 1.5T MRI take 2.5 months to get. After considerable research, I posted my "plan", which was not easy to execute because three older doctors refused to requisition the least invasive test: Hi-res ultrasound. Finally, a fourth, young doctor did what I asked. My US results are in a thread here.
There are only two 3T MRI machines in my city. One is private, and the other in the city hospital "for research" mostly, and a few top gun uro's have "rights", from what I'm told by friends. So, I'm trying to see one of the top gun uro's, which I'm told could get months/years.
Imo, the PSA raw number is rather useless. Lookup what the discover of the PSA has authored recently.
Hello Kenneth, your ordeal highligts a recent study I saw that most of the surgeries based on PSA's were allegedly "unnecessary".
Thanks for informing us about the PSA's unreliability.
How was your infection treated? Which drug? Dosage?
It doesn't seem like your PSA is overly high esp. if you are 60. My former urologist always wanted to do a biopsy anytime there was a rise in my PSA to around 6 or 7. Every time I said no and that it was more likely prostatitis. Every time a course of antibiotics dropped the PSA back down to around 3.0. DREs were always normal.
Having said that, this last time I also had him do a free PSA test and a PCA-3 test. These tests are more specific for prostate cancer. My test results were negative for prostate cancer. Had they come back showing a risk for prostate cancer, then I probably would have had the biopsy performed. Although, as someone else mentioned, conventional prostate biopsies are hardly full proof in locating cancer.
Finally, urology as related to BPH/cancer seems to be one area where getting the right doctor does seem to make a big difference. If I were you I would get other opinions and also have the prostate size measured. DO NOT RELY on the prostate size as determined by DRE. My former urologist was low by 350%. This was outrageous to me and is the reason why he is my former urologist. A number of prostate procedures cannot be done if the prostate is too large. The incompetence of my former urologist has now precluded a number of potential procedures for me. Further, had I known my prostate was so large, I would have tried the prostate size reducing medicines much, much earlier.
I'm sorry what did the Discover of the PSA author recently? Do you have a link or can you give me a name or something I can Google? Thanks
He wrote a book. I don't post links, especially that of the big online bookstore - mods don't like it. Just use DuckDuckGo search engine, or go to the online bookstore with the same search. It's quite a stir. Read the reviews, too, because there are useful "gems" in there, in our mutual search for the best treatment for BPH. If you find one too, please share. Cheers!
I totally agree with Kenneth's advise.