I scheduled a Prostate Biopsy in 2 weeks

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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. 

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  • Posted

    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   

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  • Posted

    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.

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    • Posted

      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.) 

       

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  • Posted

    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!

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    • Posted

      Thank you Lee. Unfortunately these strangers on the internet are far more informative and helpful than these effing urologists. Question how does one get a prostatitis diagnosis? what test is required for that?

      I've never been given antibiotics for prostatitis and never given a diagnosis that I have prostatitis. regular old prostatitis would account for my symptoms but nobody screaming for that.

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  • Posted

    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.

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  • Posted

    Good points re a jump in the PSA.  I believe any significant change is what they are after. 
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  • Posted

    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!

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    • Posted

      Just want to make sure your statement is correct.  A urologist does not do PAE.  It is done by an interventional radiologist. Maybe it was another procedure?
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  • Posted

    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 . 

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    • Posted

      thank you I appreciate your comment. My anxiety level is low. I think they're using cancer to scare me into doing a procedure that I don't think is warranted. I mean I'll get a needle stuck in my but if I have to it's not that big a deal but I want a better reason than my PSA is 4.

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    • Posted

      Motto.  Do not let them bully you into having any test.  Tell them no for now  Do another PSA in 3 month's and see what is is and go from there.  You do have that right  Ken  

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