PSA Issue

[oldkraut]

PSA of 12 - Don't want a biopsy

[no5ole]

Then don't get one. When you go to a doctor they take your height, weight, temperature and blood pressure. These are indicators of your bodies condition. A high temperature indicates a problem. Your PSA is higher than the normal value, which indicates an issue. How serious an issue is yet to be determined. Additional information is needed. A look inside your body is the next thing to do. Talk to them about the different scans that are available. If something shows up on the scan, then actually determining what is there becomes much more necessary. Poking holes in your prostate without an idea of where to look is like going to a lake you have never been to and trying to catch a trophy fish. They might get lucky, but I wouldn't want to try it. Good luck.

[gamma909]

It is of course your choice on what you choose to do. Agree with noSole - one option might be to get an mpMRI to better determine what is going on (e.g., is there evidence of a lesion) and then if you then decide to get a biopsy, it will at least be targeted. Another option is to get a DRE with a urologist (if you have not already had) one and see what they find, although these can be somewhat subjective and not at good as a scan.

[EricE]

If it were me, I'd get the Biopsy. 12 is above the level where I'd be comfortable waiting too long. Have you had a digital exam? That would be the place to start. If your PSA were 5 or 6, maybe I'd wait a while and retest, but 12 to my understanding is worrisome. BTW, my starting number was 49 so with me there was no question. I got the biopsy. I'm not sure how many insurance companies will pay for scans before a biopsy but if you can get scans right away go for it. As far as the biopsy itself, it was a 10 minute procedure. It wasn't particularly comfortable but it wasn't torture either. What my Urologist did was numb up the prostate by sticking some kind of rod up there. Then they leave the rod in and the take little bites out of the prostate in different areas. The thing sounds and feels like you have a stapler going "kachunk" up your ass. 12 of those and you put your pants back on and walk out to have a good lunch. No problem. There are differing opinions on all of this of course. I'm not a doctor. I just living the dream. Good luck. 12 could just be an infection.

[ng27868168]

How old are yo???? if you are under 65 not getting a biopsy or any other follow up on a PSA reading of 12 is about the dumbest damn decision you will make in your life. Your body is telling you something that has the potential to kill you! Wake up before it's too late. Just my opinion as a 26 year PCa survivor.

[bitittle]

My PSA was 12 at age 49. I had a biopsy and damn glad I did. I am Gleason 9, T3b/c, EPE, SVI, L0x, M0x. You can look up what the abbreviations mean. I had an RP 4.5 yrs ago. Followed up 2.5 yrs later with SRT due to rising PSA. PSA currently at 0.025 undetectable and in remission for last 2 years. I think you know what I would suggest😀.

[Jeff85705]

Get the biopsy. Mine was easy, virtually painless, with the only side effect being pissing blood one time. You certainly are a candidate. PSA is such a good indicator of POSSIBLE cancer, so biopsy is the logical next step. There are so many cancers that aren't diagnosed until it is too late, like pancreatic cancer. Prostate cancer is not one of those cancers, and the chance to catch any cancer early makes scheduling a biopsy a no-brainer, in my opinion. Best wishes!

[x-rays1]

I agree with Kurt65. Your next step should be to get an MRI of your prostate. The modern MRI T3 scans give a very good idea of whether cancer is present. I would not, repeat not get a biopsy at this stage. Your PSA is obvious cause for some concern but could be something other than cancer, i.e. an enlarged prostate (benign) or a prostate infection known as prostatitis. If the MRI scan show a high possibility of cancer, they usually use a score of 1 to 5 with 5 being highly likely, then you should consider a biopsy. The issue in having a biopsy prior to an MRI is that there is a small chance that the biopsy can cause an infection and damage the gland when it may not be necessary. However I will add that if there is a high chance of cancer reported from the MRI then it is important to follow it up with a biopsy soon after. My biopsy was carried out via the perineum which I believe provides a less chance of infection. I also agree with EricE that you should not leave it too long before taking action as a PSA of 12 should be followed up straight away.

Have a read of this from last year.

nhs.uk/news/cancer/mri-scan...

I am not a doctor nor medically trained. My advice to you above is strictly what I learnt over the past 6 years. I was diagnosed with prostate cancer in 2012.

Good luck to you

[cpcohen]

Repeating what's been said:

a) PSA = 12 is high enough to be worrisome.

b) The next _logical_ step is to get an MRI of your prostate.

If that's not possible, an ultrasound-guided biopsy would probably be a good idea.

If you've already decided that, whatever you have, you won't treat it, you're entitled to do that. But if you're undecided, the results of the biopsy (and MRI) will help you make the decision, one way or the other.

. Charles

[oldkraut]

Thanks for the comments. Here's the additional info:

I'm 76 and my PSA has increased over the last 5 or so years to 8.

I did not want the biopsy since I heard (and believe) there's a high risk of infection.

I would get it if I was convinced it was necessary, but I'm not yet.

I had an MRI with a PI-RADS III score. All was cited as normal with a measurement of 5.4 x 4.6 cm & volume of 42.6 which is enlarged as I knew.

The one finding was "a small focus of mild signal hypointensity on the ADC sequences, measuring 4mm. This legion does not enhance."

I'm not sure what that means but I'm sure my Urologist will continue to push for a biopsy.

[Hidden]

It's a balancing act between length of life and quality of life. It just depends on what your general health is like. Sorry to be blunt, but what's most likely to kill you first? It could well be that you have a small malignant prostate tumour. You currently have no idea how fast it's going to grow or spread.

It's possible that you might die of something else before that happens.

But if that's unlikely then of all the things that you can die from, prostate metastases is one of the most unpleasant. You can read on here what many men have written about their diagnosis, their treatment and it's consequences, but very little from men who are dying.

The real question is, if you did have a biopsy and it was positive then what would you do about it. You could choose one of several forms of treatment or NO treatment. The thing is, if you do nothing, then as time passes you will have less and less choices.

Having a biopsy will enable you to make a calculation of your life chances now. One step at a time, you can make an informed choice about treatment after that.

To be realistic, I believe the chances of infection from biopsy are significantly high. The infection could kill you. from sepsis. I had the highest temperature I've ever had. Another 0.1 degree rise and it would have been an emergency, 38.9.. (That's degrees Celsius, I don't know what that is in Fahrenheit. )

Fortunately, it was uncomfortable, but not mainly from the fever, not pain and with antibiotics I got over it in about 4 days.

I then had to make a choice about treatment - and so on.

Incidentally, PSA comes in 2 forms, free PSA and "bound" PSA. The relative proportion of these to TOTAL PSA is a fair indicator of cancer or something else.

Anyway, you currently have choices, you might want to use them before they disappear.

Good luck.

[wmcrgood]

I am glad I did. It hurt , but it confirmed that I had cancer. Prostrate Cancer varies in aggressiveness..............sometimes can kill you in 3 years, sometimes in 10.

Normal PSA is 4. A reading of 12 shows a serious problem.

[Hidden]

'Random' (no they aren't -- they are ultrasound guided) biopsies are standard treatment. The overwhelming number of people with PC availed themselves of this diagnostic test. Your options weren't offered by my urologist and I took his advice and gritted my teeth and got the biopsy. It's done in a few minutes. No big deal and not something to be avoided.

[Hidden]

You didn't mention the dread DRE test. That's what got me sent for a biopsy. My PSA was a very normal 2.7. Gleason 8 was the biopsy result. Not great news but I'd rather know than not know I have a serious issue to deal with.