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Biopsy after negative MRI

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Posted 11/16/2014 4:15 AM (GMT 0)
I'm 64 years old, in August I had a PSA level of 4.9, and the digital exam was negative. After 6 weeks I was retested and the level was 5.9. I went to a Urologist. He scheduled an MRI which came back negative. I had another PSA test done 6 weeks after the second test and it came back 6.3. Now the doctor wants to do a biopsy.

I have heard of men having an MRI after a negative biopsy, but never the other way around. I thought MRI's were supposed to reduce the need for unnecessary biopsies. Shouldn't my doctor be looking for alternative causes for elevated PSA?

Has anyone here had, or heard of, a biopsy after a negative MRI?

Post Edited (bdbbauden) : 11/15/2014 9:27:25 PM (GMT-7)

Posted 11/16/2014 6:32 AM (GMT 0)
Welcome to HW, sorry you need to be here.

I find it odd they did an MRI. What were they looking for? At you PSA level, it's unlikely any PC would show up on a scan. Were they checking the size of your prostate or something?

PSA rises for a few reasons, enlarged prostate, infection, bad day at the lab and cancer. A rapid rise is more indicative of an infection - yours seems more an infection jump but I am not a doctor so likely don't know what I am talking about. Before a biopsy everything else should be ruled out. I would have expected an DRE, an ultra sound (maybe) and possible a round of cipro to rule out infections (possibly some other blood work).

Still, there are worse things than a biopsy which is merely, annoying and uncomfortable.

Andrew
Posted 11/16/2014 7:16 PM (GMT 0)
Bdbbauden: With the constant PSA rises I would consider the biopsy. Yes, it could be an infection, BPH, sex, biking, etc. PC treatment success is still about early detection! Did you have a mpMRI? As I understand it, MRIs do not always detect smaller tumors.

With the odds of 1 in 7 for contracting the beast the biopsy is just a way of ruling out PC. I wish you well and please keep us posted.
Posted 11/16/2014 8:53 PM (GMT 0)
There are other tests that may help you decide whether you want a biopsy or not, PHI is one of those tests.

Negative biopsy result does not mean that you do not have PCa, the needles could have missed the spot(s). Some people went through several Bxs before PCa was found.

My G6s (3) were from the clean areas of 12 samples , and three samples from the suspicious area came back clean. Apparently the 3T-MRI was not able to detect the G6s.
Posted 11/16/2014 10:21 PM (GMT 0)
bdbbauden,

Sorry to hear about the problem. A MRI and mpMRI (multiparametric MRI) will find tumors and high yield PCA, but Unfortunately you can have a high yield of low grade cancer without being detected.

Hopefully the first thing ruled out was any infection or prostatitis. Did you have a fPSA (free PSA) test? And was your prostate measured to calculate PSA density? Based on the findings of the above tests, I would definitely have a biopsy. And please be aware that a standard 12 core biopsy is a shot in the dark, but can provide you with additional information.
Posted 11/18/2014 4:22 AM (GMT 0)
I would like to thank those who took the time to respond to my question.

I have not been treated for infection or prostatitus, nor am I suffering from any symptoms. I do not know if an fPSA test was run or if my prostate was measured to calculate PSA density.

I am scheduled for a biopsy on Dec. 3rd. There is much that I need to learn between now and then so that I can ask the right questions.

Thanks again.

Bruce
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