Prostate biopsy without digital examine

I do think that a digital rectal exam would be appropriate; your primary provider should be able to do this as well.
More importantly, it looks like you are not comfortable with your current urologist. Go find another/better one.

Please provide us with some more information. For instance, what were your PSA levels over time?

Thanks guys, my regular doctor usally does a DRE, I too was surprised and already have looked into another Urologist.
Keep it hard guys and enjoy, the best you can.

I'm not taking any medication for enlarged prostate, only herbs and vitamin supplements.
My last score was 3.88. which is acceptable for my age I believe.
My scores fluctuate as most men's do.
In my area, a small town we only have two hospital that have urologist. I am looking for a new one.
If he is not qualified I have to travel over 50 miles to Cleveland. And I am not able to travel without taking antavan.
Thanks

Ohio, first of all welcome. I have a couple of thoughts to share:

1. Of course your uro should have done a DRE. That is standard practice.

2. Knowing that your last PSA was 3.88 doesn't tell us enough to help you with any advice. To help more it would be good to know if you have an enlarged prostate and/or what the trend has been. You said your doc said that this was "down". Down from what? Perhaps you can share with us your PSA trend over time.

3. Also, you stated that you take various herbs and supplements. I hope you also told your urologist. Some of them may actually be masking your true PSA, i.e. it could be much higher than reported if that is the case.

4. It's probably worth taking the Atavan if it means getting to Cleveland and having a urologist who is experienced with prostate cancer take a look at you. You need good medical advice.

Good luck to you.

Jim

Ohio, with an enlarged prostate and your age it's reasonable to think that your PSA score of 3.88 is perfectly normal. Unless a DRE shows that you have any nodules or irregularities or unless your supplements are masking your real PSA results I can see what you might want to avoid a biopsy. There is something called "PSA Density" that you might want to Google, learn about and discuss it with your next urologist. Also, you need to get a record of your previous PSA scores to share with him/her so he/she can look at the trend to make appropriate conclusions. If you have a medical portal you should be able to find the PSA scores or, if not, your GP's office should provide you with the records.

Jim

Ohioprostate, greetings from another native of the buckeye state (even tho I haven't lived there for my entire adult life). If you're taking saw palmetto, you should double your PSA reading, so your 3.88 is more like 7. I get what it is to live in a rural area with one urologist in town. That's what I dealt with when I was diagnosed.

You've shown up here. That's an important step. The next step is to see what your PSA trend is, over at least the last 5 years. As well as what your GP says about your DRE history. The Cleveland clinic IS one of the best in the world--regardless of what your impression of their satellite clinic. With you being in their system already, I'd think you could do a phone/video consult with someone at the main campus, which would help.

With an enlarged prostate, your PSA will be slightly above average for your age--and it is likely to fluctuate some. The good news is that PCa generally shows up as a steady upward trend over time, not fluctuating up and down, so if you're seeing fluctuations, it may NOT be PCa--but--as with all things PC, the first step is finding competent care.

good luck. Give the main Cle Clinic a call. Amazing things might happen.

Welcome. You have received good advice here. Good luck and as always, Go Bucks!