hello all... If an MRI is the be all/end all in determining prostate cancer...why do I need a biopsy...???...why can't I just go right to the MRI...??? Background: 67 years old. My PSA was at 5.5. My urologist performed a cystoscopy; & said that everything was normal, but wanted to keep an eye on my PSA. It went up to 8.2, so he ordered a biopsy. He tells me that if the biopsy comes back clean, but my PSA remains high (or goes up)...then I will need an MRI. So...why do I need to put myself thru such an invasive technique, if an MRI can fully determine prostate cancer. Biopsy side effects range from blood in the urine to not being able to urinate & a bunch of other scary things. please help...thanx, mark4man
You’re asking the right questions. If I were you, I would avoid the biopsy, and go for a 3T MRI first.
It is my understanding that a 3T MRI can see lesions but not the grade. There is no substitute for taking actual tissue samples and sending them to the lab for grading. The goal is that someday imaging will be all that is needed, but we are not at that point yet. A rising PSA if often a symptom if BPH, enlarging prostate size. It is not always a reliable indicator of cancer. My PSA was 4.6 and I had a 12 core biopsy and cancer was found. I had a second 12 core a year and a half later and that showed “progression” so I decided to have treatment. I am not a fan of the biopsies - but, you can always refuse to have one and then live with the uncertainty that accompanies that decision.
3T Mri first then biopsy ..
your answer. get the MRI if a lesion is observed by a specialized Interventional radiologist then you have a focal single needle biopsy of the specific lesion . urologist do not typically do this or have the ability to do it so they do not mention it or sell it it is the way to go . MRI first then make a decision as to whether you need a single focal needle biopsy
You can get the MRI CD disc and if you want it read by the best, send it to Houston via his web site and send it to him. He does not charge and has a portal setup on the site.
Dr. Karamanian
You can get the MRI CD disc and if you want it read by the best, send it to Houston via his web site and send it to him. He does not charge and has a portal setup on the site.
Dr. Karamanian
It’s prostate laser center. Look it up you have his name now. And then call.
When I was suggested biopsy I asked for MRI. After MRI it was obvious that there is no cancer and thus no need for biopsy. BTW, my PSA was 24 - other factors beside prostate size play factor, like autoimmune condition that can cause inflammation throughout of the body.
What your urologist is saying is that he will do sample from 12 different places in prostate and if you are “lucky” he will hit the cancer spot. However, in case he misses , and the PSA still goes up, then MRI is needed to find the reason.
Bottom line biopsy is blind collection of samples from prostate. If cancer was NOT found that does not mean you don’t have a cancer. After MRI, if there is any suspicious area, then TARGETED biopsy will be performed , Much better way to go.
Good question. Have the 3T MRI first. if that shows one or more suspicious areas,then have a targeted biopsy. I believe there is an area if the prostate that the MRI cannot see, so if you need a biopsy, you can have a targeted biopsy along with a random biopsy if that particular area.
I would get a 4K, PCA3, or Select MDX test first, followed by a 3TMRI. If those look suspicious, you can then go to a targeted, ultrasound-guided, or fusion (not random) biopsy. Biopsies have a lot of potential hazards, so should be a last and not a first resort, although they are quite definitive.
Best of luck,
Fred
Get a 3T MRI and remember sex and bicycle can raise your PSA.
Biopsies can lead to cancer … called ’ needle tracking ’ cancer .
PSA tests are like chemotherapy … just quackery … money making by misguided medical doctors.
High PSA can be the result of recent sex amongst others such as infections .
My one time supervisor had a PSA of 19 , had a biopsy , which showed NO cancer.
Apparently the only real way to check for cancer is the good old digital rectal examination .
I suspect that many men have their crown jewel mutilated by doctors who allege cancer due to high PSA results / or the doctor does the procedure anyway , to be ‘safe’ … its a case of who will ever know the truth… even the doctor.
Wrong, wrong, right, right, wrong! Donald?
I had PSA of 4.2 which went up to 7.11 so was referred for a biopsy, the uro decided to do a 3T MRI first and biopsy second on the basis that if the MRI showed anything he would know where to target. The MRI came back negative so no biopsy but showed I have a 60cc prostate. Suggest you ask for the MRI first.
Had 2 Biopsies one with Sepsis after, and in between a 3T scan which was inconclusive. In the end Prostate removed and was found to be far worse than any of the previous tests showed. Don’t think the 3T is really the answer but who Knows ?.
Every urologist who pushes a patient to have a biopsy before an MRI is committing malpractice. Anywhere from 4-6% of men who get biopsies will get infections including sepsis, and about 2% of them will die from it. Basically a prostate biopsy has somewhere between a 1-in-500 to 1-in-1000 chance of death. There is zero risk of dying from an MRI.
Get the MRI first. If a biopsy is then required, lower your risk by insisting that it be done in a hospital, in an operating room, with a medical team just like any regular surgery. Have a rectal swab done beforehand so that they can match the antibiotic they give you prior to the biopsy with your own biome. Do not get a biopsy in a doctor’s office or some outpatient clinic. Insist that the doctor takes the absolute minimum number of core samples; don’t let them do a “saturation” biopsy where they take dozens of core samples, which can leave you with permanent urinary problems.
When my PSA went from 3 to 11, I had a biopsy (the only painful part was the antibiotic shot) and it came back as prostatitis but negative for cancer. Six months later I had a TURP and 15% of the removed tissue showed prostate cancer (Gleason 6) so the 12 biopsy samples missed it. I guess that suggests the MRI may be better.
I asked the same question after I had a biopsy, then MRI. Uro told me because insurance worked that way. I dont know, hopefully she wasn’t lying to me.
I had my first 12 core biopsy in 2012. MRI was not an option at that time, was never told about it, didn’t know anything else was an option, not covered by my insurance. Your PSI goes over 4 (was never told the lab was taking it), my doctor called me and referred me to a urologist, who did a 12 core. Cancer was found, Gleason 6. This all came as a complete surprise to me. IF I had known about the MRI option and it was offered to me and was covered I would have done that. A 3T MRI is an advanced option and not normally done, so it’s something you have to ask for.