I scheduled a Prostate Biopsy in 2 weeks
Posted , 15 users are following.
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
rogcal Motto
Posted
In this order:
PSA test
DRE
If abnormal:
Check for presence of UTI and if found, treat and PSA test after treatment ends. If PSA lowered consider regime of "watchful waiting"/AS
If PSA unchanged, request multidimensional MRI.
If lesions found undergo template biopsy and consider treatment options when pathology of samples have been confirmed. If Gleason 6, consider AS with 6 monthly PSA tests, If Gleason 7 or higher, seek opinions on level of treatment required, i.e. radiation, HIFU, Cryotherapy, Brachytherapy, HT, prostate removal.
If no lesions found consider AS and follow up PSA every 6 months.
Good luck.
p.s. if you are clear of PCa and symptoms of BPH cannot be relieved with medication and are offered a TURP please consider the HoLEP procedure instead. The TURP is so barbaric and should be consigned to the history books.
Motto
Posted
Hi everyone. Thanks for the incredibly informative responses. Question I read the there's a pca3 test? Does anyone know anything about that? Supposedly it will tell you if the elevated allegedly PSA result is due to cancer or something else.
I think I'm going to stop bicycling for a while and not have an orgasm for a while and then get a retake the PSA aunt and ask for a PC 3 result.
lastly if I have just prostatitis how do they diagnose that? Nobody is seem to ever mention the word between the two urologist and two PAs that I have seen
Thanks again you guys are terrific.
dcooperxyz Motto
Posted
My prostatitis was diagnosed by a prostate biopsy . My URO was very honest with me and said URO’s don’t like prostatitis as there is nothing they can do for it and it’s difficult to diagnose .
It’s sctually quite common but the non bacterial version ( CPPS) is almost impossible to treat . It’s characterised by urinary problems and pelvic pain . Some men are helped by pelvic exercises or yoga etc . For me it comes on strong and may last 3 months then goes on its own .
There may be an underlying cause in my case , a bladder blockage.
Motto dcooperxyz
Posted
oh I see. That's very typical of medicine. They don't want to talk about medical conditions they don't have an expensive way to treat.
rogcal Motto
Posted
All the PCa 3 test will tell you is if you carry the PCa 3 gene or not. It will not tell you have PCa.
If you carry the gene then you are going to be more susceptible to developing PCa. Just another money spinning test IMHO and like the PSA test will leave you with lots of unanswered questions and nagging doubts which will worry you needlessly.
One day a definitive test will become available, it's only time but in the meantime all we can do is question everything the professionals say and if they get uppity, dump them. It's our lives they are messing with and until they learn to respect our wishes and desire to know the answers to our questions, they should steer clear of practicing medicine.
bill02607 Motto
Posted
My first prostate biopsy was terrible, with about 30 to 40 needle pokes. It wasn't that painful, but I bled especially in my ejaculate for 3.5 months. Seven years later my Uro wanted to do another biopsy to rule out cancer and I refused. He then scheduled me for an MRI which was a piece of cake. However, he found a small area where he suspected CA and then wanted to do another biopsy, which didn't make me happy. Since my prostate is about 127 CC and my PSA is pushing 8 (I am 71 years old), I was now in a position where I couldn't get a referral for any kind of BPH remedy without a biopsy and I have made it very clear with the last three urologists that I am really having trouble in the leaking and peeing and getting up at night areas. All the Uros want to do is find cancer! I wanted a PAE but all the Uros say that is experimental. I think they don't like it because they can't do a PAE or get paid for it! Medicare pays for it and that is good enough for me! I like that it doesn't reduce my sexual potency and also that it significantly reduces the size of my prostate. I have been married to my present wife for only a year. The last Uro made it sound like it would be a single needle that would be fused with the MRI image by ultrasound to go right through the suspicious area so I consented. I ended up with 16 needles instead. That was over a month ago and I am just beginning to slow my bleeding. The result was a Gleason 6, watch and wait diagnosis. I called an interventional radiologist that does PAE and he said a Gleason 6 diagnosis is not incompatible with PAE and I can self-refer. Since the embolism destroys a portion of the prostate, I am hoping that they will kill the area with the cancer! My take is that a spectral MRI or "multi factorial MRI" I believe they call it, will find cancer far more effectively and with far less pain and trauma than any biopsy. But it costs a lot more. Be sure your insurance will pay for it, then go for it. If you simply refuse a needle biopsy, they should schedule you for an MRI. An ultrasound-guided biopsy would use less needles, and less bleeding. I would do anything to avoid another prostate biopsy or to reduce the needles.
Bill
dcooperxyz bill02607
Posted