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I scheduled a Prostate Biopsy in 2 weeks

Posted , 15 users are following.

Motto
Motto

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. 

0 likes, 40 replies

40 Replies

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  • timothy81571
    timothy81571 Motto

    Posted

    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. 
    • dcooperxyz
      dcooperxyz timothy81571

      Posted

      Timothy did you find out why your PSA was high ? Or was it a false result ? 
    • bob31550
      bob31550 timothy81571

      Posted

      If you had MRI (or even the newest high-res ultrasound imaging)  first, then the biopsy would not have been necessary?
    • timothy81571
      timothy81571 bob31550

      Posted

      That’s what I thought too, bit according to my Dr, insurance doesn’t work that way. I don’t know, this is all new to me. 
  • barrie62598
    barrie62598 Motto

    Posted

    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

  • kenneth1955
    kenneth1955 Motto

    Posted

    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
    • bob31550
      bob31550 kenneth1955

      Posted

      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?

       

    • kenneth1955
      kenneth1955 bob31550

      Posted

      Bob that was 15 years ago.  I think I was on 3 weeks of Ciprofloxacin   Ken  
  • dl0808
    dl0808 Motto

    Posted

    What are ur symptoms and history ?
  • bob31550
    bob31550 Motto

    Posted

    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.

     

    • Motto
      Motto bob31550

      Posted

      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

    • bob31550
      bob31550 Motto

      Posted

      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!

  • rdemyan
    rdemyan Motto

    Posted

    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.

    • bob31550
      bob31550 rdemyan

      Posted

      My uro said mine was 50g.  Ultrasound yesterday showed 96.6g.

      Please share your reducing meds experience -- which one(s) worked the best, and how much reduction did you get, in what time frame?

      Thank you in advance.

    • rdemyan
      rdemyan bob31550

      Posted

      Hi Bob:

      The tests I mentioned including PSA work best, imo, if you can establish a baseline to refer back to.  I've had PSA measurements done for over ten years, so seeing it go up or down is of some use.  Free PSA is supposed to be able to differentiate better between possible cancer and prostatitis.  I got the test done so I could have a baseline to refer back to in the coming years.  PCA-3 test was discussed below by rogcal.  I'm the kind of person who wants as much information as possible, especially because there is no clear cut procedure for dealing with BPH.  Many uros don't know about the new procedures and still recommend TURP.  My own uro never prescribed alfuzosin before, but after researching it I had him prescribe it for me as a replacement for flomax (i have a post on alfuzosin in this forum).  I got a message back from him saying that his department is now considering prescribing it more (instead of flowmax).  At least he has an open mind.

      The medications for reducing prostate size are the typical ones: finasteride (Proscar) and dutasteride (Avodart).  I started Avodart 6 weeks ago and don't really have anything to report.  It typically takes 6 to 12 months to see a reduction (nominally a 25% reduction is quoted).  There are a number of side effects so be sure to check them out.  I have lost some sexual drive (although it picked up last week) and have had some retrograde ejaculation (but never completely dry).  I'm really hoping that fexapotide triflutate will be approved soon.  However, I'm a bit concerned that the glowing reports only come from the company that produces it.  That company is a startup and if the drug fails, they likely will go belly up.

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