How quickly can cancer emerge after all-clear biopsy?

[ronton2]

My husband had an ultrasound MRI guided biopsy two years ago when his PSA registered 6.9. He was 72 years old at the time. The results showed no cancer and his urologist gave him an all clear but required yearly PSA tests. Last August his PSA was 2.7. His most recent PSA (November 2020) was 30+. We are both very surprised. He will likely need another biopsy. What's up?

[BerkshireBear]

Consider that a biopsy is a random test of about 12 spots in an organ that is the size of a golf ball (or larger) and the needles are only long enough to reach approximately the back half of the gland. It is easy to imagine missing the cancer in a biopsy, especially if it is small and localized. Giving an "all clear" with the PSA = 6.9 was not an appropriate message. It sounds to me like he had cancer and it was missed, but kept growing. OTOH, some variants of PCa are aggressive and do grow rapidly once they start, so it is possible that the high PSA was a fluke and your husband has developed one since. But either way it doesn't matter. It is clear that he has PCa now and it warrants treatment. Forget the speculating, deal with the reality. Considering the "all clear" message I would encourage you to seek a second opinion.

[HopingForTheBest1 in reply to BerkshireBear]

You are describing a standard biopsy, not an MRI fusion guided biopsy. A big difference where the latter is much more accurate since the needles are not blindly nor randomly placed. Also, typically 16 cores are obtained, not 12.

[j-o-h-n]

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Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/06/2020 7:02 PM EST

[billyboy3]

I hate to read posts like this. Someone slipped up, and he lost the chance for a cure if they had caught it earlier. There is no exact number to use, but a psa above 5 almost always signifies pc. Thus, he should had repeated psa over a shorter range. I am confused about it going down, but, and let me advise you, there are several companies providing the medium to obtain a psa test. We did some comparison tests a number of years ago and found up to a 20% disrepancy between different testing firms.

At 30, his cancer has spread so I see no hope for a cure, but that said, he needs to get another biopsy and scans to determine where the cancer is and/or spread to, i.e. lymph nodes first. Depending on stage, you can decide on treatment options, but please HURRY, as time is now his biggest enemy to get a head start on beating the beast off, as the lower the tumour burden, the more you can eradicate etc. so agressive is best-if he can handle it.

Good luck, and keep us up to date.