PSA 9 , age 66 , is there an alternative to biopsy ?

[PBnative]

My friend’s PSA went from 5 to 9 in 8 months . He asked me if there is an alternative to biopsy . I told him that there may be something new since I last had a biopsy in 2009.

[Justfor_]

Multi parametric MRI. If he gets a low PIRADS (1-2) it will be considered good enough, so no follow up biopsy will be needed. But, if he gets a 3 to 5, no doc will provide any further consultation, not to mention treatment, without a biopsy.

[MarkS in reply to Justfor_]

Agreed. My PSA had jumped from 4 to 12 over 2 years (gap due to the pandemic). I had an MRI which found a dodgy area on the front of the prostate and consequently a PI-RADS score of 5. I had a biopsy 2 weeks ago and are still waiting for the results. The biopsy was OK, more uncomfortable than painful and I was back to exercising at the gym in 5 days.

[PBnative in reply to MarkS]

Hope things go well for you

[spw1]

Hope your friend does not try to avoid it. Apart from confirming if there is cancer or not, it can give additional information about the type and potential aggressive nature, etc. My husband's doctor advised him not to do it for a year and that was wrong. Any increase of this nature should be investigated. Good luck to him.

[ron_bucher in reply to spw1]

Biopsy can not confirm absence of cancer. It can only confirm presence of cancer.

[RealtorDude]

There is an alternative, liquid biopsy! cellsearchctc.com/about-cel....

[rsgdmd in reply to RealtorDude]

That test is for metastatic cancer, not initial diagnosis.

[RealtorDude in reply to rsgdmd]

It can tell you what type of cancer it is, if it’s in the prostate what medicines and or naturopathic processes that could be effective against your type of cancer without the invasive destruction of your prostate that could possibly spread it and cause infection. Please read the information on their website. It’s also FDA approved.

[rsgdmd in reply to RealtorDude]

I did read the info. & they are pretty specific about it being for metastatic. Not saying there's no value, but there won't be CTCs if the cancer hasn't breached the capsule.

[RealtorDude in reply to rsgdmd]

I don’t have all the studies at the moment, but there’s tons of studies and evidence that circulating tumor cells are in your body up to six years before it shows up as a tumor.

[RealtorDude in reply to rsgdmd]

Here’s one article that explains how a biopsy breaks open the cancer cells and causes them to metastasis.

pubmed.ncbi.nlm.nih.gov/151...

[j-o-h-n]

NFA: Tell your friend to get a biopsy.......... have the doc knock him out first...... (uncomfortable)... Tell your friend to post here on H.U. If you uses your UserID as reference, he get's a discount. BTW NFA = No Fucking Around...

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 10/14/2023 3:56 PM DST

[petercraig2]

If I was starting over again my first task would be a GA68 PSMA PET/CT scan.

At any PSA over 1.0 it can detect actual locations of PC lesions anywhere in the body.

My starting point was prostate biopsy which on relection is a random shat at finding PC cells.

[cpl901]

Try a genetic test they are different, but it can help you to make a decision, or wait and watch.

[swwags]

There's more to this story and you should share details but the only way you will know a lesion is cancerous, is via biopsy. Everything else is speculative.

[Derf4223]

Your friend has a fairly fast PSA doubling time going. IE likely metastases happening. Biopsies are not done for grins and giggles -- they are justified by PSA DT. Your friends DRE probably signified something odd going on in the prostate. The difference between very likely to be curable and not could be a matter of a few months delay in getting treatment going. After the biopsy, odds are your friend's onco team will require several scans taking maybe 5-6-7 weeks -- bone X-ray, CT scan, MRI, and then PSMA PET/CT.

[groundhogy]

Biopsy might be the only evidence doctors will accept as valid in order for the patient to progress to treatment?

[pe43]

One good reason for getting a biopsy is that the biopsy samples can be used to test for genetic mutations.