Biopsy decision.

I am 57 years old, no family history of Prostate Cancer.

I have elevated PSA over the last year it was 6.5, six months later 6.8 and the recent level of 5.8.

My doctor did a DRE and he feet nothing wrong the three times I got them done.

I have a good flow, do not get up at light to urinate, and no symptoms at all.

I am worried about a biopsy, as I have read it alone can give me more problems, I am an active adult, likes to snorkel, swim, ride bikes , etc.

I figured the knowledge here might give me a good direction, I'm not sure if I should wait, take another blood test and see, or get the biopsy.

I'm scared as I have a lot to do in this life.

Any sound advise is welcomed.

Worried.

TonyPal, do you have Psa's scores from prior years?  If you've recently jumped from the 3's or 4's my advice to you is to have the biopsy.  Chances are it's not PC, but it's causing you to worry, so why not eliminate the uncertainty.  I know friends and family that have had 5's, 6's and even 8's that have come back negative but they're glad they had it done.  The biopsy isn't really all that bad.  It just makes your discharge pretty yucky for a month or so.  I just wish I had done so sooner.

Were you put on antibiotics in the event of an infection? That's typically the first step to see if that's the case. Another possibility would be a PHI test, which is supposed to be better at predicting cancer than PSA. I'm no expert on that, but if you search here you should find more information.

Also, try not to worry to the extent you can. No matter what happens you'll have plenty of time to do everything you've planned on doing in life.

It’s been written that the prostate biopsy for men in the PSA grey-area (between 4ng/mL and 10ng/mL) is “the ticket to ride the Over-Treatment Express .”   Here’s my suggestion to help keep you from becoming the next statistic among the legions of the over-treated, including many here at HealingWell.   First, now that you have already repeated the PSA test, consider further testing with PCA-3, color Doppler ultrasound and/or multi-parametric MRI.   If these tests fail to reveal anything worrisome, frequent monitoring may be preferable to an immediate biopsy.   Second, before you agree to a biopsy, be sure you have done your research and are up to speed on prostate cancer, the treatment options and the potential negative side effects.     Start by ordering the book, “The Invasion of the Prostate Snatchers.”  If you are 57 years old, you need to start learning about this part of your body.   The prostate cancer world is run by urologists.   Urologists—and remember, a urologist is a surgeon—are the specialists to whom primary care physicians refer their patients to when the PSA rises.   It’s no exaggeration to say that to most urologists an elevated PSA calls for a biopsy.   And that a modest number of “weird cells” in a few biopsy cores will be sufficient reason to reserve time for you in the operating room.   Move cautiously, and be your own best advocate.

thanks for all the advise, I will do some studying now.

Tonypal,

Since they ruled out prostate infection and/or inflammation I would go ahead and get a standard 12 core biopsy.
I had a multiparametric MRI and it didn't show anything, even though my biopsy showed GS 6 & 7. For what its worth, mpMRI usually isn't very sensitive when PSA is below 10, and your urologist doesn't feel any nodules or lumps. And it is rather expensive if you don't have insurance.

I guess this is why it gets very confusing to me sometimes.

Hi TonyPal,
I too, was anxious about side effects from a biopsy, however I am soooo glad to have had them. First biopsy negative, second biopsy, bingo! I think it is the nature of the beast to be concerned ( or it is for me) about what we, who are not part of the medical fraternity, having medical procedures where we read about things that could "possibly" go wrong.
Being a wimp, I had both my biopsies under a light general anaesthetic and woke up both times with no pain or any discomfort whatsoever. I had blood in my urine for a while and blood in my semen for a little over a month. Not pleasant but not painful either.
Although it is your decision I reckon you should have the Biopsy and then you can make more informed decisions if it is positive. If it's negative, of course that entails a different lot of decisions still to be made.
Good luck with whatever you decide.
Cheers
Greg

Thanks for that, yes I am scared but you guys are making me feel better about this.

Tonypal,
I had two biopsies, diagnosed on the second one. Its no big deal. I'll give you my opinion in one short sentence...

Overtreatment, Shmovertreatment. Better safe now than sorry later. Do the biopsy

I had a PCA3 test and my score was 39. My uro said they don't like to see a score greater than 24. He scheduled a biopsy and I only had mild discomfort after the procedure.

-------------------------------------------------------
Age 54 as of 2015

PSA 2012=3.1, Feb 2013=2.76, Mar 2014=3.12, Jul 2014 3.5, Jan 2015=3.46
Bx and Dx Feb 2015 = 4 of 12 cores all G6 (5-25%)
RALP at USC on 6/8/15
Post-op path: G6 in 5% of organ. Organ Confined. Margins, Seminal Vesicles, Lymph Nodes - Negative

Pratoman said... Overtreatment, Shmovertreatment.          That’s troubling.   I realize that you are still very much a newcomer to PC (diagnosis late Nov-2014, surgery less than two months later in early Jan-2015), but take a pause for a moment…   Be aware that a fairly recent poll of members at HW/PC resulted in an overwhelming (>90%) majority who felt newly diagnosed men with low-risk PC who are just starting their “patient education” should be informed about the PC overtreatment controversy .   See the poll HERE .   In case you haven’t noticed, prostate cancer has a “ bad name .”   It is not PSA mass screening that is the cause; rather, PC overtreatment has given the world of prostate cancer a “ bad name .”      PSA mass screening has been widely rejected by every single professional medical society because of today’s reality on PC overtreatment .   If smarter, more discriminating, treatment decisions were being made, nobody would have a problem supporting mass screening—overtreatment IS the root cause of the PC world’s bad name.   The pages of HW/PC (and elsewhere) are filled men who rushed (“get it out now ”), or were rushed by their urologist, into an aggressive treatment out of fear for the word “cancer” even when their cases were low-risk or benign.   The professional medical societies today (and since 2013) are all strongly encouraging men with low-risk cases to “educate themselves” about the disease before agreeing to an aggressive treatment.   Scientific evidence shows that with proper modern care most of those cases do not need immediate treatment and many of those cases will never need treatment.   Sadly, many men make an emotionally-based decision rather than a scientific-based decision, and many suffer unnecessary consequences as a result—most typically incontinence and impotence, but a whole litany of other problems also accompanies aggressive PC treatments.     We should collectively recognize and acknowledge that it is difficult to engage in conversations with low-risk men who have already had an RP because I don't want to hurt anyone's feelings.   A RP can't be undone.   The men that are post-RP, that geared up for their major surgery, and are gung ho—you can't tell them that they might have done the wrong thing, not after what it has cost them financially, emotionally, and physically.   FOR THIS VERY REASON, sites like HW/PC should be communicating very early with newcomers about the reality of the PC overtreatment controversy , and that education is the key to the least-regretful decision about prostate cancer.   “ Overtreatment, Shmovertreatment. ”    That’s a step backwards for better men’s health.   TonyPal, the overwhelming percentage of the men and women here at HW/PC want you to be aware there is a PC overtreatment controversy.  Be aware of, and carefully navigate, the "slipery slope."    

Right on, PDA.

I didn't invent this phrase, but I recognize the sage wisdom in the saying that "the prostate biopsy for men in the PSA grey-area (between 4ng/mL and 10ng/mL) is 'the ticket to ride the Over-Treatment Express.'”

TonyPal's PSA is high. But he will benefit from this site's wisdom to tread carefully on the PC biopsy slippery slope.