Increased PSA level

Like you, I've had some high numbers. I had as high at 17 in one instance, and went through with a biopsy. In fact, over the course of about 5 years where my PSA's were as high as 17 and as low as 12, I underwent 4 biopsies. After my first,which went well, a very good friend of mine in another city who was a prostate cancer doc himself advised me the following after my first all biopsy was all clear:

"Get a new doctor and a new lab and have it done again" (which I did). Not kidding. Each time my PSA "spiked" another biopsy. Some guys simply have high PSA's. Finally, my new urologist put me on Avodart which he claimed would stabilize my numbers, and "half" my PSA (which it did). One they had a baseline on me, which was about 6, and four biopsies later we figured out I simply had an enlrged prostate and a higher PSA. Cancer nothing you want to fool with, and I'd suggest getting one biopsy to be sure. Does it hurt a bit? It does. Kind of like snapping a rubber band against your wrist about a dozen times, you'll be ok. I finally had a TURP 6 weeks ago when my urination symptoms got the better of me. Recovery has been slower than I thought, but progress none the less.

get the biopsy and be sure, you'll sleep better once it's behind you. Best of luck,

So latest blood sample shows PSA back up to 6.5. Going for MRI tomorrow then another PSA check, but the doctor said that MRI misses between 20 and 30% of cancer growths so unless my PSA goes back down i will be having a biopsy anyway. He said standard is now 14 - 16 biopsy sampling. Keeping my fingers crossed.

Andy, I think a lot depends on the type of MRI being carried out and the ability of the radiologist and their interpretation of the imaging.  The latest 3T multi-parametric MRI equipment is, when combined with an very experienced radiologist, capable of providing grading and staging of any tumours showing in the imaging. If a contrast dye is added to the equation then the imaging is even better. The day will come when biopsies will be a thing of the past and the sooner the better.

It would be great to hear a follow-up from andyr0.

I live in California, so consideration of prostate anomalies may be different.  I concluded that random, ultrasound-guided biopsies are obsolete.  When my PSA zoomed up to 14 from 8, I had a multi-parametric MRI performed on a 3-T machine, in California in Jan 2015.  There are not many such facilities in the U.S.—maybe more, now.   The p-MRI can determine a location where if there is a very high likelihood of aggressive cancer (it won’t identify indolent cancer); but, it is not diagnostic, as far as I know.  If suspicious spots are found, a biopsy can be performed at that spot. 

Ideally, the biopsy should be performed in the bore of the same MRI machine in which the multi-parametric imaging was done.  There is ever-evolving software available now that provides an alternative to the in-bore biopsy, and that’s to superimpose the multi-parametric MRI with the suspicious spots identified, over the ultrasound image on the traditional machine used by urologists to aide in guiding the biopsy needle.  This is less accurate in locating the precise spot that was identified on the multi-parametric MRI because the prostate changes shape, and the overlay cannot be perfect.  The biopsy needle, itself, when inserted into the prostate also changes the shape of the prostate slightly.

In any case, my result was negative for identifying any aggressive cancer, and shortly afterwards, my PSA zoomed back down to the 8 it was beforehand, and that has moved from 6 to 8 in a period of 17 years.