Prostate

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I am 61 with a family history of prostate cancer. My psa has been between 0.7 an 1.2 since 2017. My psa jumped to 1.9 in June of 2022 but my DRE is normal and I have no symptoms. I had another psa done in September and it was 3.9. What I have found out is many biopsies are not necessary and many urologist have mixed feelings on whether not they will order a biopsy. My urologist ordered an MRI which was normal with one pirads 2 and a pirads 3. I just had another PSA and it went down to 3.1 and the free psa is 11.9 %. My urologists thinks there is a very low chance of there being any cancer and wants to keep a close eye on it(active surveillance) and I am pushing for a biopsy.

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2 Replies

  • Posted

    The prostatitis/UTI and sexual activities have an impact on the PSA level change. An urologist does not know a patient's sexual activities. The patient should know when is the best time to perform the PSA.

  • Posted

    Usually PSA below 4 is not a problem. You had a little bit of a fast rise between June 22 (1.6) to Sept 22 (3.9), but was still under 4, and went down to 3.1 after. You Urologist is probably right to do watchful waiting. If your MRI did not show anything I would not push for a biopsy. The biopsy itself can cause problems. If you get an MRI looking for prostate cancer it should be a 3 Tesla MRI with and without contrast. It is important to have the MRI looked at by an expert in looking at MRIs for prostate cancer, not just a general MRI examiner. If a nodule is seen on the MRI a targeted MRI can be done with a single needle rather than the random 12 or 16 needle biopsy. The random biopsy can miss a nodule.

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