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Do I need a biopsy?

Posted , 12 users are following.

david53732
david53732

Today I visited an urologist recommended by my primary doctor because he found a hard spot on my enlarged prostate .  The urologist did an examination and confirmed there is a hard spot and that my prostate is enlarged. My PSA score is .40, a score that hasn't changed in 15 years (I'm 72 years old).  The urologist feels that it would be best to do a biopsy to make sure there is no cancer.  He did not mention any other tests like an MRI that several on another thread recommend.  I just wonder, given my constant PSA score, if I really need a biopsy.  Any thoughts would be greatly appreciated.  

0 likes, 49 replies

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  • geoff90305
    geoff90305 david53732

    Posted

    Hi David. Is the hard spot on your prostate an area that is hard or an actual hard 'lump'? The low PSA is good, but..some very rare cancers do not raise your PSA.

    I am not big into having a biopsy for the sake of it. As for the MRI, depends on your finances. Here is Australia, they cost approx $500, non rebatable. BUT, they do give you a accurate image of what is going on in your prostate and if you have any Gleason 4 or 5 areas. If you have a lump, then maybe a single needle biopsy into that lump 'maybe' ok.

    My PSA had suddenly risen to 13, but a subsequent MRI said nothing appears wrong and no lesions to biopsy. My Urologist wants to do a blind biopsy, which I refused, so now we try cipro antibiotic to see if it is an infection issue.  

    • david53732
      david53732 geoff90305

      Posted

      Thanks for your reply.  I think it is a hard spot on the prostate.  Neither doctor used the word lump.  I think I'll make another appointment and see if an MRI is possible before having a biopsy.  Good luck to you and thanks again for helping me.

  • rolf61809
    rolf61809 david53732

    Posted

    The doctor isn't taking the chance of infection or death by sepsis, is he? I would demand a 3 t MRI and the new 4w 4k? Test and or the pca3. If they find something bad with the mri they can use it for a fusion biopsy which is planets better than a blind one. And a transperineal rather than the transrectal biopsy common in the USA. My attitudes have hardened having just gone through this ,( all except the biopsy). I'm no doctor, just a patient who thinks he got incomplete and misleading info. Like that transperineal and transrectal infection rates are the same. I'd get the MRI without question.

    • david53732
      david53732 rolf61809

      Posted

      Thanks for your information.  I will make another appointment, ask about an MRI, and find out more about the type of biopsy the doc uses.
  • Supertractorman
    Supertractorman david53732

    Posted

    The 3T MRI does not work in all cases as mine was inconclusive and had to have Biopsy after plus the added free gift of Sepsis.
    • geoff90305
      geoff90305 Supertractorman

      Posted

      And what sort of biopsy did you have and was the result of the Biopsy?, other than the free dose of sepsis that is

      Geoff

    • Supertractorman
      Supertractorman geoff90305

      Posted

      I have had 2 Biopsies the first under local anaesthetic which was very painful as I also had Haemmoroids which made it painful but I was able to see Antibiotics given, The second was under general Anaesthetic which was pain free, but I got Sepsis next day. They claimed I received A/B while under anaesthetic. Each was 1 : 16 Cancer so elected for Active Surveillance.
    • geoff90305
      geoff90305 Supertractorman

      Posted

      Can you explain this for me please...Were your biopsies blind 12 needle or guided single needle and were they rectal? Also, you said your cancer ""Each was 1 : 16 Cancer "" I am used to seeing gleason 2+2 etc. 

      I was advised on my MRI that they could not determine if a cancer was Gleason 3 or less.

      Geoff

    • Supertractorman
      Supertractorman geoff90305

      Posted

      Even although I had 3xMRI they were done blind and I was advised 16 needle all done Rectal.  Each result was only 1 needle in 16 showing Cancer. Gleason said as 3+4.  I was advised by the surgeon that it is awkward to cover the whole of the Prostate as one side is virtually blind and the effect of pushing the needle in can also push the Prostate to the side.   I personally will never want another biopsy due to my Sepsis experience, but think it may be a necessary evil, but please before having it done check you are getting or have had Antibiotics before going home.
    • geoff90305
      geoff90305 Supertractorman

      Posted

      Yes, agree...maybe a necessary evil to get an accurate score. What PIRAD score did you get with the MRI?
    • Supertractorman
      Supertractorman geoff90305

      Posted

      No PIRAD score given or talked about, just told results were not conclusive and biopsy needed.  I think too many believe the new MRI scanner can produce all the answers, but it seems in not every case as mine was done on a brand new machine 2 years ago.
    • barney34567
      barney34567 Supertractorman

      Posted

      Why did you have the biopsy when you hd hemmheroids? Why did you not wait until they were healed before having the biopsy?

      I was disgnosed with hemmheroids and was treated with banding. I then waited 2 months before the biopsy.

      And the biopsy went smoothly.

    • Supertractorman
      Supertractorman barney34567

      Posted

      Had Haemmoroids for 10 years and banding did not work they kept recurring and Drs did not want to wait for my Haemmoroidectomy as they needed the biopsy result.
    • geoff90305
      geoff90305 Supertractorman

      Posted

      Yeah, agree about the MRI is only a tool with its own limitations. My urologist said while the 3T MRI are very good at Gleason 4 and 5, they tend to be not so flash at lower Gleason levels due to lower Gleason level tissue looking similar to normal tissue on MRI images. The PIRAD score is supposed to be the summary of the radiologists findings of all the tissue and the liklyhood of finding PCa. PIRAD 1 being teenager to PIRAD 5 you got issues....

      Did you get the actual report, or just the urologists comments from him reading the report. 

    • david53732
      david53732 Supertractorman

      Posted

      Thank you for your response.  sorry to hear about the Sepsis...hope all is better now.
    • Supertractorman
      Supertractorman david53732

      Posted

      Unfortunately Sepsis left me with continued urine infections which lead to Prostatitis which the medical profession seem to want to avoid as there is no clear path to getting rid of it, other than pain medication. But I am lucky as others have lost out.  You have done the right thing asking questions and being aware of what can happen can help you avoid the situation. Hope all goes well and keep taking the tablets !!.
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