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Posted 10/3/2010 1:56 AM (GMT 0)
Newbie here. 65 years old. 290 lbs. PSA increasing over the years. One year ago 7.3. Now 8.4. Annual DRE all neg. 2 biopsies neg. No history of prostatitis. Now the Dr wants to do another biopsy. I know the biopsy risks.

Question: What is the probability % of cancer in my case?  

Question: Can repeated biopsies cause problems?

Question: How many biopsies can a person reasonably have done? 

Thank you

Posted 10/3/2010 2:14 AM (GMT 0)
I would ask the doctor - WHY? - if no enlargement of the prostate, no prior problems with DRE and previous biopsies - is he just concerned about the level of the PSA?
-when in doubt - ask - and ask again - until you get a satisfactory answer.

all the best
BRONSON
Posted 10/3/2010 2:16 AM (GMT 0)
Read my history, I had 3..I believe the record on this board is 13..

You can ask for a saturation biopsy, 40 cores, usually performed under general anesthetic..You can travel to a center where they are equipped to do a Color Doppler Ultrasound, which is more accurate in scanning your prostate for cancer and can guide the biopsy needles with more precision..

You can wait a few months (not recommended) until the Four Gene Urine test becomes commercially available. This test can determine if you have PC or not without a biopsy..

But with a PSA of 8.4, SOMETHING is going on and I would not rest until you find out what it is.. The 290 pounds is another issue that hopefully you are dealing with..
Posted 10/3/2010 3:14 AM (GMT 0)
In addition to Tatt2's good suggestions to consider a color doppler scan and/or a saturation biopsy, you might consider a PCA-3 test. 8.4 is not a "normal" psa, so I certainly would not "just drop it."
Posted 10/3/2010 11:26 AM (GMT 0)
You may have BPH which is causing the PSA levels to rise.
Posted 10/3/2010 3:00 PM (GMT 0)
took 3 to catch my pc. sounds like a saturation type might be in order next too. good luck
Posted 10/3/2010 8:01 PM (GMT 0)
I would get color doppler if possible........Maybe JohnT will chime in w/some advise! I wouldn't continue to get biopsies without color doppler!!!!!!
Posted 10/3/2010 11:29 PM (GMT 0)
Hi Harry,

You may want to consider getting a free psa test.  Many urologists use the percentage of free psa to assess the risk that you have prostate cancer.  If the percent psa is high, you might lean toward believing the high psa is from bph or other benign causes.  If it is low, urologists tend to get concerned and begin to believe even more stongly that cancer is an issue and it just has not yet been sampled.

Those results might help you decide on a saturation biopsy/12 core biopsy etc.

The odds do go down that the physican will find cancer as the number of negative biopsies go up.  However, biopsies take a very small tissue sample so it is quite easy for false negatives to occur.

Nothing about this disease is straightforward.  There is always a caveat or exception.

This is obviously a layman's opinion based on motivated research.  See what your urologist thinks.

Retire

 

Posted 10/4/2010 9:43 PM (GMT 0)
Harry,
Pleawe read "Invasion of the Prostate Snatchers" by Dr Mark Scholz. There is an entire chapter devoted on when one should get a biopsy and how to eliminate unnessary biopsies. I wish I had known just 25% of what I know now having gone through 13 biopsies.
JohnT
Posted 10/5/2010 1:53 PM (GMT 0)
I agree that Something has to be causing that much PSA so I think you and uro need to work out a plan to detect the cause, which means repeat biopsy at some point.
Have you been given any antibiotics etc at any stage to see if that can do anything about the high PSA?

Alf
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