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Brother's PSA is 8

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Posted 3/11/2023 10:13 PM (GMT 0)
My brother told me yesterday his PSA went up to 8 on his recent check up. He has not had cancer and most recently had a UTI and multiple peeing at night and a lot of frequency. It sounds like enlarged prostate, but he's going to see a urologist.

I've seen good advice so many times over the years here, but I seem to remember that many people said not to rush into a biopsy. If his doctor wants to do a biopsy, what would you recommend in that case other than biopsy?
Posted 3/11/2023 10:37 PM (GMT 0)
i'd recommend getting a doctor you trust and take it from there. my initial PSA was 6.8 and biopsy showed all 12 cores positive with G7 cancer and at least one at 70 percent
Posted 3/12/2023 4:01 AM (GMT 0)
Sparky - Depends on what your brother’s PSA history is. Any infection could spike his PSA but if his normal was 5 then a biopsy is a good idea regardless of infection. Another PSA should show a massive drop after a treated infection. As F8 indicated, find a urologist that he trusts and take it from there

Rushing into a biopsy is a good idea some times. Urologist has to do DRE and review PSA history, etc before suggesting biopsy. Your history should make your brother respectful of the need to follow up with a good urologist.
Posted 3/12/2023 5:24 AM (GMT 0)

Sparky9 said...
...most recently had a UTI and multiple peeing at night and a lot of frequency. It sounds like enlarged prostate...

if your brother had cancer based off the symptoms you presented to us, the cancer would be highly advanced. i would agree with your thinking that it sounds more like your brother may have BPH, prostatitis or a UTI. at least two of those i know of can have an impact on a mans PSA. i think a history of PSA could help, but a PSA of 8 is a good indicator that a biopsy may be needed vs. a PSA of between 4 and 6.

as the others have noted i would ask that you find a good urologist you trust and DON'T be afraid to ask questions.
Posted 3/12/2023 2:41 PM (GMT 0)
Start with a MP-MRI first, before a biopsy.
Posted 3/12/2023 3:42 PM (GMT 0)
Even if an mpMRI is negative, most uros (rightly, IMO) will want a biopsy in a biopsy-naive man once any infection is ruled out/cured: an elevated PSA warrants investigation, and BPH and PCa can coexist. If imaging and the biopsy are negative, they still serve as a baseline going forward for any future rise in the PSA. As we know, both imaging and a biopsy can miss existing cancer; however, repeat investigations with a rising PSA will reveal cancer.

Djin
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