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PSA of 27.2, retest PSA? or biopsy?

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Posted 4/10/2013 2:37 AM (GMT 0)
hi everyone,
just discovered this helpful board.

i am 47 year old with no urinary/no sexual dysfunction symptoms who had PSA test result of 27.2 from labs done 1 week ago in conjunction with annual physical. primary doc did not perform DRE.

only prior PSA was 6 years ago and was 2.7.

once my primary doc saw the 27.2 PSA he urged me to see uro.

saw uro today and did DRE exam, uro immediately suggested biopsy.

the week prior to the high PSA test i was sick with sinus issues, stomach bug, and pink eye.

i'm not sure if i should have PSA retested or proceed to biopsy? my concern is should i consider antibiotics and retest to rule out infection causing the high PSA or does the high PSA score and DRE by the uro warrant going to biopsy sooner rather than later?

thanks.
Posted 4/10/2013 2:48 AM (GMT 0)
Did your urologist comment on the result of the DRE? The way you said it -- saw uro today and did DRE exam, uro immediately suggested biopsy -- makes it sound like he might have felt something. That would make a difference.

If the DRE was normal it might be sensible to try antibiotics and a re-test, abstaining from sex, bycycle riding and DREs for 48 hours before the blood is drawn. You should also lay off decongestants during that 48 hours since they can make your PSA go up too. (You mentioned sinus issues.)

Welcome to the forum, by the way. Let's hope you don't need to be here long but you are welcome to stay as long as we can be helpful.
Posted 4/10/2013 2:48 AM (GMT 0)
Evening,
Did uro say anything specific about DRE?
Posted 4/10/2013 2:56 AM (GMT 0)
the urologist mentioned a "focal" something re the prostate check. he then said i should consider a biopsy within 7 to 10 days. i scheduled it for later next week. he also said that he suspected a retest would yield a similar PSA level. thanks for your input.
Posted 4/10/2013 3:45 AM (GMT 0)
"Focal" is urologist speak for "small". But a small something is still something. With your PSA and anything but a normal DRE I'd go ahead with the biopsy if I were you.
Posted 4/10/2013 3:50 AM (GMT 0)
The biopsy is (or at least was for me) a brief indignity. The information it gives you is very valuable.

My (non-professional) advice - do it, and go from there.

Posted 4/10/2013 5:53 AM (GMT 0)
First, welcome to our corner of the world. Sorry you need to be here but it's a good place to be.

I vote for biopsy. Something isn't right and you need to get it to pathologist to take a look. You could ask for PSA retest but in your case I'd be more concerned about the DRE than the PSA. PSA is just an indicator but feeling something during the DRE is something worth getting test for right away.

The biopsy isn't that big of a deal - annoying and undignified but generally not painful.

keep us update and let us know if you have other questions.
All the best,
Andrew
Posted 4/10/2013 6:03 AM (GMT 0)
Welcome Tom
I too had a high PSA as a result of routine exam (aged 48).
DRE was not done till after high PSA found.
Given my DRE was okay, but a biopsy was still done, I think that in your case with a "focal" being felt during your DRE you do need a biopsy to give you more info.

Alf
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