The beginning of this journey. First step is.....

[Climbing]

New to this blog with a question. Info to date is an elevated PSA (6.5) and this has been between 4.7 and 5.5 for three years with 6.5 last year and 6.6 this year. Most recent PHI test shows 8.64. Question is next recommended step is a biopsy. Would the group recommend the biopsy and an ultrasound/MRI. Just one of the two? The biopsy procedure seems driven by the urologist vs. what might be the best test. Thank you all.

[cpcohen]

FWIW (I am not a medical professional):

I think that "best practice" would be:

. . . Get the MRI (not an ultrasound, it's not good enough);

. . . If the MRI shows troublesome areas, get the biopsy.

There has been some research comparing the effectiveness of MRI-only screening, vs. MRI + biopsy screening. I believe that the results showed that, if nothing suspicious appeared on the MRI, the biopsy was very unlikely to find any PCa.

"Normal" PSA varies with age:

. . . How old are you ?

. Charles

[Roger2Dodger]

My PSA readings were similar to yours. My opinion if you are concerned as I was if cancer was present. Get a biopsy. My urologist told me that was the only way to find out if I had cancer, is to get a biopsy. I got a biopsy and cancer was present.

[Jimraz]

I'm not a doctor but I would suggest a biopsy. The results are more conclusive. My psa was 4 Gleason 6 , then had Proton beam. Nine years later, psa .00061, no incontinence, no pain, no ed, no burnt rectum, no side effects. Not bragging just straight talk and inforMing.

[MelbourneDavid]

An multiparametric prostate MRI plus a biopsy if something is found is substantially more reliable than an ultrasound-only guided trans-rectal biopsy. 90% detection of significant prostate cancers vs 70%. MRI also reduces the number of unnecessary negative biopsies or ones that find insignificant non-growing low risk "cancers" (small Gleason 6 lesions almost never igrow or spread)

I don't know where you live. Unfortunately in the USA it is rare for an insurance company to pay for an MRI until after a positive biopsy and the MRI is usually expensive in the USA.

[amsoil in reply to MelbourneDavid]

Hi just to let you know here in usa if you have medicare and a suppelmental like i do it takes care of everything mri,catscans,all pills and whatever it takes with the right plan it takes care of everything no money out of pocket,i have had 45 radiation treatments,i am on lupron,also i am getting 6 cancer treatments, one every 3 weeks,paid from medicare.i do not see any thing about a hematoligest oncologest for cancer on thease pages,you can keep your uroligist whitch knows more about your prostate,you should be seeing the other hemotoligest for cancer.i have stage 4 ,psa 25, if i had numbers in you guys bracket under 10 i would be tickled.have a great day, amsoil

[Hidden]

I didn't hear anything about a DRE. An abnormality there got me sent to a urologist for a biopsy. My PSA was only 2.7, so don't let a low score there sway you. I think you are well overdue for a biopsy. There's certainly no harm in catching this disease early in the progression.

[Paulo1968]

Hi,

My experience with PC diagnosys' path was similar to what cpcohen said: 1st MRI as ultrasound said everything was clean; 2nd biopsy.

I think biopsy is an operation with certain invasion degree, so in my case it was done later.

I am not a doctor though, so this was the path teh doctor decided in my case.

All the best to you, Paulo

[LVRob129]

I'm all in favor of MRI guided biopsy. That way at least some of the samples can be targeted at potential tumors instead of a random sample.