PSA Jumped from 5 to 10.5 in 12 months

Hi Taylor. I would have thought, after an initial negative biopsy, a continued rise, even if fluctuating, would have led to repeat biopsies and/or mpMRI's. I had nine (negative) biopsies over a 20+ year period for a slowly rising PSA in the presence of significant BPH.

Since you don't have the benefit of pre-identified targets from an MRI, your uro will rely on the ultrasound screen to direct the needle in each prostate zone to any areas that look suspicious (abnormal tissue, whether benign or malignant, reflects ultrasound less than healthy tissue and appears darker, I believe). In other words a "random" systematic biopsy isn't quite random.

My only suggestion is that you consider requesting more than the standard 12 cores. If you agree, your uro may be more inclined to go along with this if you call today with the request, so that he/she can have the additional specimen cups prepared beforehand (rather than having to change the setup tomorrow at the last minute, taking up more of his/her time). I'm not suggesting you need a saturation biopsy -- about 24 or more cores -- unless your uro thinks you need it. You'll be on the table, one your side, with the biopsy wand you know where, with no train to catch. If you are unlucky enough to current harbor prostate cancer, the increased cores might improve you luck in finding it. If I had to pick a number, I would suggest 16 cores. It should make the procedure just a few minutes longer. In for a penny ...

Hope that helps,

Djin

Often this will indicate cancer in the transitional zone, which the TR biopsy can not reach. I would look to other methods to determine what is going on. Use Avodart to shrink the prostate and then watch the PSA trend. If it goes up, it is likely cancer. You could have the complete TP biopsy that gets to all parts and takes dozens of cores. Since you have had one TR biopsy, your insurance may pay for the TP method. Get an MRI to see if there are suspicious areas and a PIRAD score. More to do than just repeat the standard biopsy, in my opinion.

If you do not do a target or MRI guided biopsy then it is a waste of time.

I had a psa increase from 5 to 7.5 four years after a couple of negative biopsies and a mri, also negative. Then, I had another mri test showing a pirads 5 lesion, without apparent extension. The mri informed biopsy only found a small amount of G6 but, based in the mri and psa increase, I decided to be treated. The report after surgery was in better agreement with the mri result, G8, though localized. Then, in my particular case, mri gave a more precise information than biopsy. Therefore, my biased advice is that you should insist to have a good mpmri test more than in extracting many cores in next biopsy.

Thank you. Dr ended up doing 12 samples. All went good. Just extremely fatigued since got home from procedure yesterday. Small amount of blood in urine and some burning in penis when just laying and relaxing.

Awaiting pathology results. Hope to hear something by Tuesday or Wednesday.

What will be will be.

Thanks so much!!

Should I read anything into the fact that pathology results is taking longer than I was told after my procedure last week?

Remember Tom Petty singing that " the waiting" ... is the hardest part?

His lyrics fit your situation ... and we have all been in your situation, waiting for test results.

Meanwhile, don't cross the bridge, until you get to it ...

We're here for you, rest assured!
CYCLONE - # Iowa State University

Been thinking of you, Taylor ---- I know it's a restless time, leaving you with uneasiness.

Nothing better than an evening walk right now ---- take a walk for a little while, and it will help settle the anxious thoughts.

Above all else, I am sending my encouragement and support ---
CYCLONE

Taylor - It is possible that a positive result takes a little longer to process if the pathologist is looking for verification from another pathologist but this does not takes days. Most have a review process in place where another pathologist reviews and concurs with the pathology. I don’t think there are any special tests that are done with prostate pathology that take much time compared to some other cancers.

I think a week for getting the “call” might be typical in the private setting, maybe a little faster in the university or cancer center system. One constraint is the doctor has to get the results, review them, then give you a call (if positive) or call/leave message (if negative). If you don’t hear anything at a week, a call might be in order.