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Should I do biopsy?

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Posted 5/28/2014 2:18 PM (GMT 0)
I am a young man at age 33. I did my physical back in March and found that my PSA is 4.1. (Family dr check that just because my uncle was diagnosed at age 47). Urologist had me recheck in a week, same at 4.1. Did a DRE and feel nothing. Had me on antibiotics for 3 weeks , hoping to see a drop. In May , PSA went up to 4.6. He suggested to do a biopsy.
Is that too early to do one? My uncle said he didn't do biopsy until higher than 8. If I do one now, is there a big chance the cancer cell not yet spread to the tissue he picked and tested negative? But I actually have them?
What other things will cause high PSA at age 33?

Yes. I sit a lot in front of PC all day. I'm a little over weight.
Posted 5/28/2014 2:29 PM (GMT 0)
I would follow your doctors lead. The biopsy will either put your mind at ease or may alert you to do something.

All the best.

Posted 5/28/2014 2:36 PM (GMT 0)
I seriously doubt you have PCa at 33. Although not unheard of, the chances are really miniscule. The US has a better chance of winning the World Cup!

There can be other causes for elevated PSA but your urologist should ahve discussed these with you.

The biopsy was a non-event in my case. Didn't even have any bleeding afterwards. Was literally back to normal as soon as those lovely drugs wore off.

What some folks/activists fear is that the biopsy will reveal something you don't need to know of yet and that it will potentially induce you into a state of chaos that will lead to potential bad personal choices. I personally dismiss that notion but might explore alternatives to a biopsy that are available to some and/or escalate the issue with my urologist asking about other potential causes for the elevated PSA and potential remedies.
Posted 5/28/2014 2:46 PM (GMT 0)
welcome to HW.

My question is, what would you do if they found PC?

I can't see a reason to ignore your doctor's advice - even though you're very young for this kind of thing.

and, In you're place I'd do something about that last sentence of yours. An improvement in your general health could help avoid nasty problems later.

Andrew
Posted 5/28/2014 3:31 PM (GMT 0)
Get a Free PSA test and a PCA-3 test. That will give you a LOT more information

Mel

Posted 5/28/2014 3:33 PM (GMT 0)
33 is very young to have prostate cancer but then again your PSA indicates something abnormal is going on. My own opinion, for what its worth, would be to have a biopsy to get some more information on what is going on. Maybe a biopsy would show there is nothing of concern going on right now but that rising PSA number does need monitoring. And yes, it is possible to miss an area of cancer in a biopsy. It happened to me but my prostate was badly enlarged. One area of cancer was found with a biopsy and a second area of cancer was found in the post surgery exam of the prostate.
Posted 5/28/2014 3:37 PM (GMT 0)
Runs in your family best case you have a baseline for the future. Good luck
Posted 5/28/2014 4:15 PM (GMT 0)
Ditto what davidg said.
I'd do the biopsy due to family history and to get solid facts to inform how to understand the elevated PSA.

-Gedman
Posted 5/28/2014 4:26 PM (GMT 0)
There are a few doctors and facilities that use a Color Doppler Ultrasound machine to examine and then biopsy the prostate if needed..These advanced machines give the urologist a much better picture of what he is dealing with
Posted 5/28/2014 9:44 PM (GMT 0)
Unfortunately, prostatitis will often not respond to many antibiotics.If antibiotics don't get it, they usually just treat any symptoms. It can relapse and remit periodically. Other causes of elevated PSA are BPH/enlarged prostate (unlikely at your age), prostate cancer (unlikely at your age), acute urinary retention (any problems peeing?), and temporary blips from sex, bike riding, etc.

There is a new test called PHI that is much better than PSA at separating the increase in PSA from prostate cancer from the PSA caused by all those other things. Your doctor may not be aware of it because it just became available in the US (it's been used in Europe for many years). Here's a link to the site from which you can order the test. Unlike some other tests, insurance covers it or it's free. You can email the link to your urologist and ask him to order it for you.

- Allen
Posted 5/28/2014 10:55 PM (GMT 0)
My son just turned 33. I would suggest to him to have a 3t MRI with and w/o contrast prior to biopsy. I would make sure he had it done by a facility that does a lot of these and I would make sure the Radiolologist who reads it knows what he is looking at. The disc from the MRI can be evaluated by other doctors if requested. Depending on the result of the MRI, go forward with an MR guided biopsy. In my opinion, there is just too much risk in having a random needle 12 core biopsy and having significant tumor(s) undetected. In my case, several doctors told me my 4+4 tumor would not have been sampled by the TRUS biopsy due to the location.
Posted 5/29/2014 12:08 AM (GMT 0)
Gordonp, I concur, MRIs and MRI guided biopsys are the future norm!
The normal random biopsy is just too hit or miss and may lead to delayed diagnosis of PC.
Posted 5/29/2014 1:29 AM (GMT 0)
I'm sorry you're going through this "stuff" at such a young age. Given your family history, be proactive with your health. Do what the doc's suggest. And we all hope for the best..
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