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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

49 Replies

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  • Tybeeman
    Tybeeman david53732

    Posted

    At your age and a low PSA. I think I would take the wait and see. There is nothing   fun about a biopsy. I had 3 of them the las 12 years
    • david41094
      david41094 Tybeeman

      Posted

      Agree wholeheartedly - at 72 with such a low PSA I would not opt for the joy that is a biopsy. I do not know the country or whether there is a finacial incentive to a biopsy. My recommendations, in order of preference and assuming you are determined do something would be:

      1) MRI

      2) Targetted biopsy

      ​3) Blind biopsy

  • Whiteplume
    Whiteplume david53732

    Posted

    I would say get the biopsy done and make sure you have no cancer, the irony is that if you miss it, the situation could get much worse and require much more treatment.

    Don't worry about the biopsy follow the instructions from your Doc. And don't listen to to much doom & gloom about this test, it's a little uncomfortable but let's be CLEAR,

    (See how all the political class are now using this word!) think they will all follow each other like Blind Mice, May fox Davis & the clown. I digress! So let's be sensible get it done and for me get it OUT HOPEFULLY

    CONTAINED should of course you have a cancerous prostate. Wish you well and lots of luck! I am 2 years on from prostectomy and have a normal life still riding the bike 60km on a good day! Incontinance soon recovers to maybe a small drop under stress from fitness, otherwise it's All Good don't wait to long it's a ticking bomb! The sooner it's defused the safer you will be.

    You think you have problems, I had all mine done in a German Hospital Urologist was and is Brilliant! And follow up second to none. Four door spring technology! Works.

    So my final word to all why be so silly and leave the EU. It's like this forum Better together (the Russians are at the Door)

    Don't listen to May she a wolf in sheeps clothing!!!

    Good luck sorry for the diversion to politics

    You will be fine listen to the doctor and not all the crap that sometimes appears here.

    This page should be better used to discuss the unfolding doom in the Conservative party remember you heard it hear first, it will not work!

    Bye! Good Luck

    Tommy ex Army 38 years!!!!

    Get it done

  • Roger2Dodger
    Roger2Dodger david53732

    Posted

    I cannot reccomend a biopsy, I am not qualfied to do that. However, I can give you my details from my experience. I visited my urologist when my PSA was 4.25 I was 73 years old. My urologist told me not to worry, I did not have prostate cancer. At age 75, I went to my family Doctor and he ordered a PSA test and it went to 5.83. I went back to the Urologist and he told me that the only way I could find out if I had cancer was through a biopsy. I had it performed and prostate cancer was found. 4+3 =7. My advice is, it is your call whether or not to have a biopsy.
    • geoff90305
      geoff90305 Roger2Dodger

      Posted

      And Roger, what did you do about it? as 4+3 usually requires doing something

      Geoff 

    • Roger2Dodger
      Roger2Dodger geoff90305

      Posted

      geoff90305,

      My Urologist sent my biopsy remains to Prolaris  a prognostic test developed by Myriad Genetic Laboratories. My test results came back showing my PCa was within the less aggressive range.16% positive cores (2/12. It also gave a Mortality Risk: 3% 10-year prostate cancer-specfic. Which I understood being a 3% chance of dying in 10 years.

      My score meant my PCa was less aggressive than the average AUA' Intermediate risk.

      I also had a MRI done which showed no PCa out side of the vessel. My Pirad score was 4.

       So, I decidied  to go on Active surveillance. I will make futher decisions on my treatment after I am re evualated in December.

    • geoff90305
      geoff90305 Roger2Dodger

      Posted

      I would get a MRI redone every 12 months or so to compare the findings and ensure the PCa was still inside the capsule with little likelyhood of it escaping.

      I have a friend with PCa T2. Been like this now for 14 years. He gets a MRI every year(he is now 80). The PCa does not seem to change or grow etc, so, proves that doing nothing works for some guys.

    • david53732
      david53732 Roger2Dodger

      Posted

      Roger, thank you for yur response.  Thanks to you and others I am getting an education about prostate issues.  It is all very helpful.
  • terryw
    terryw david53732

    Posted

    Hi David

    I put up a thread here about 18 months ago on whether I should have a prostate biopsy and there is a lot of excellent feedback on that thread from people with all sorts of experiences.

    I'm in the UK and the same age as you, and had a psa steady between 6 and 7 for 18 months or more. I knew nothing about pc before a keen GP put me in for a battery of test and flagged up the psa as risen. She found that my prostate was enlarged (BPH?) which would explain why my psa was slightly up, and I found that other GPs in the practice would not have referred me, but this doctor was keen to and I had two hospital appointments.  By then I had done a lot of reading, and found that I was only told a good deal because they realised I already knew about it.

    In the end I decided not to have a biopsy and cancelled a further hospital appointment.  My decision was based on all my personal circumstances, plus the fact that even after 6 years my psa was nowhere near doubling, which suggests that if I have a tumour, which 70% of guys in their 70s are supposed to have, it is likely to be slow growing and unlikely ever to cause me any problems.

    I know there are people who would not want to make that decision and would rather just follow what the medical profession tell them, but I'm satisfied that I have made the right decision for me and I'm happy with it.

    I hope you can arrive at the right decision for you.  All the best.

    • geoff90305
      geoff90305 terryw

      Posted

      Hi Terry, Yes, we all have to make our decisions for our circumstances. Is it possible for you to get a MRI done. It is not invasive at all, but will give you a clearer picture what if anything is growing and a better opportunity to remedy it. 

      I agree, as we get into out 70's PCa is one of those things, and as long as it is the slow variety, then will not be a problem..for most of us.

      I saw a paper from the UK last month talking about a guy in his 80's with PCa, that had spread, and he had the prostate removed and commenced other treatments. This basis was to remove the source of the PCa, and fight the escaped bits to give him a longer life.

      Geoff 

    • david53732
      david53732 terryw

      Posted

      Thank you for your response.  It is very helpful.
    • david53732
      david53732 terryw

      Posted

      Thank you for your thoughtful response.  All the best to you, too.
  • miss_sue
    miss_sue david53732

    Posted

    You know already that the hard spot on your prostate is not normal . A biopsy would be able to a sign Gleason score to what is in the prostate . It will help you make decisions of what you should have done. You don't want to miss being able to put a halt to problem you could end up with. Can you ask to have the Mri done ?

    • miss_sue
      miss_sue

      Posted

      The only thing wrong with basing things soul on Psa can be detrimental. Very good Freinds of mine live in Florida PSA in Darrell was never a factor. But the cancer was stage 4 and ended up going metastatic. His Psa hovered around 8 and has only now started to climb after 67 chemo therapy treatments. I totally agree that treatment should be based on quality of life and quantity. I also know how sneaky PC is and just how horrible and devastating it was to see Dave die from it at 64. There is no way we could go back in time to get a early diagnosis and that diagnosis if done early very well could have saved his life. A stage 2 PC diagnosis offers many treatment options but really stage 4 gives nothing .It gave us 27 months and even as I write this I shed tears because you just have no idea how wretched this was .I think if you are in your 70s you could still have over 20 yrs of living to be done . If you are in the 80 to 90 range of life you make think you have had and done what you wanted in your life time and proceed to just ignore PC .
    • geoff90305
      geoff90305 miss_sue

      Posted

      There is no doubt sue, you need to be informed. Work out what grade/stage the PCa is and work out YOUR plan. Stage 1 and 2, you have lots of options, including time. Stage 3, you need to do some thing now. Stage 4...it is like a lottery. It is some where in your body. If it latches onto something important, difficult to treat. My father in law had PCa, said it was slow? so not to worry about it!! 18 months years later, it went to his brain.
    • david53732
      david53732 miss_sue

      Posted

      I will ask about having an MRI. The urologist did not mention that possibility at my appointment.  thank you for your help.
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