Psa

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Had a psa test with my physical and it was 8.3. Sent me to urologist About three weeks later and they did another psa test. It came back 9.2. They’re wanting to do a biopsy but I’m not sure if I should. Any advice?

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  • Posted

    Yes. Insist on an MRI scan so any "lesions" i.e. suspicious areas, are the target of any biopsy.

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    • Posted

      I didn't know anything about any of this when I went to my appointment, so I didn't know to ask for the MRI scan.  I am scheduled for a regular ultrasound guided biopsy.  I think it's too late to change it, I'm scheduled to undergo the procedure in six days.  Thanks for your input. 

       

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    • Posted

      Don't do it without the MRI. Otherwise, they're shooting in the dark. They may miss an aggressive cancer, find a less aggressive one and recommend watchful waiting, which will kill you. Also, don't let them do a rectal biopsy. Punching a needle many times through your non sterile rectum is the best way there is to get you a very bad prostatitis which will be very difficult or impossible to cure. A few antibiotics taken before the procedure will not prevent the infection.

      It's your money and your life. You can cancel the scheduled procedure and get it done right. It's important, and no skin off your doctor's nose. If necessary, get a different doctor who will listen to you.

      Neal Pros

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  • Posted

    was it the same lab that did the test? If not, results cannot be compared. Also, activity before the test can influence the result, like biking or sex, even constipation.  It is much easier to repeat the PSA test. As far as biopsy, as suggested, 3T MRI can tell more if you have any traces of cancer and then if they discover anything,  targeted  biopsy would be appropriate.  Doing "blind" biopsy is shot in a dark and carries the risk of infection.

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    • Posted

      Thanks. The MRI definitely makes sense.  I never really thought about the fact that they are just hoping to hit the right mark.  I think it's too late to change to the from the ultrasound guided to the MRI now though. My biopsy is in six days.  Thanks for the info.

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  • Posted

    Insist on an MRI followed by a biopsy targeted to any suspicious areas - but get them both done. Doing a blind biopsy (vs targeted) is like throwing darts at a dartboard in a pitch black room.  
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  • Posted

    If there is something unusual with your urination and you are younger than 80 it pays to get more tests.
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  • Posted

    PSA  in some countries is rejected other countries rely on it so much that they automatically have a knee jerk reaction to to biopsy if around 5 or more, the traditional ultra sound guided 12 needle biopsy is these days considered a  blind approach however it can find cancer that an mri might miss and vice versa, some would have both done depending on the need, then there is the view not considered fact by the general medical world that if you have cancer in the prostate the 12 needle biopsy which will cause bleeding may release cancer cells into your body where it may spread and kill where as if it was kept inside the prostate you may eventually die of something else depending on how aggressive the cancer may be.

    the medical world will likely say the cancer cells will die off before they can spread but as we know doctors believe what they are told and they conclude a biopsy may save life.

    My option would be have another psa test and if still high have an mp MRI which is a 3 tessla mri which will be more successful at finding cancer than other mri  though not 100% guaranteed but very good. PSA can be high if the prostate has grown and an mp mri will accurately show whats happening, if any suspicious areas are found the diagnosis may say a suspicious area has been found with a high risk of cancer but the ones that make the diagnosis are in fact not as highly trained as you may think and they have to cry wolf rather than not, if so you may choose to have a 3 needle biopsy in the suspicious area or you may choose to have more needles, some urologists using ultra sound are experienced enough to hit the suspicious area others may miss it.

     

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