Elevated PSA - level of concern?

[jk1021]

I'm 55. New to the forum. Father had prostate cancer in his 60's with full but uncomfortable recovery. I've had 5 PSA's:

Nov 2014 2.4

Sep 2016 2.6

Jun 2019 3.3

Feb 2020 4.0 (DRE one hour before)

May 2020 3.6

I saw primary care doctor in Feb because I was waking up 5x a night to urinate and was suffering with kidney stones. Now taking Tamsulosin and night time urination is near normal. Spoke to urologist in Feb and he recommended biopsy due to elevated PSA. I decided to wait a few weeks. Delayed due to Covid and got the 3.6 result last month. Both urologist and PC urged me to get biopsy.

I have one scheduled in 3 weeks.

Now I'm freaked out and anxious full time. Anyone have any words of wisdom on how concerned I should be from the elevated PSA?

[LowT]

I’d vote for a prostate MRI before considering Bx

[Tall_Allen]

Ask for a periprostatic nerve block or a pelvic plexus nerve block. I had that on my last biopsy, and it was a breeze - no pain, no grogginess. This involves a urologist who is able to locate those nerves on an ultrasound, rather than randomly injecting lidocaine.

Also discuss a transperineal biopsy. There is less risk of infection. Not every urologist can do this. If transrectal, ask for a rectal culture beforehand to make sure you don't have resistant bacteria.

Sometimes insurance will cover a multiparametric MRI-targeted biopsy on a first biopsy, but often not.

[Magnus1964]

The biopsy may be advisable. Catching this beast early has the best chance for a permanent remission.

[Hidden]

As LowT suggested mpMRI first.

[Leeaussie5]

You have cause for concern but your still in the normal range - chill. An MRI will show you whether you should really worry. It gives you a very accurate picture of your prostate and will give you a PIRADS number. That is an indication of whether any thing in the prostate is a worry. It makes the biopsy more accurate by providing a map to the urologist about where to look when doing the biopsy. It happens that a biopsy misses a cancer giving a false negative. This is less likely with an mri guided biopsy.

Good luck

[RonnyBaby]

You are guessing / speculating about a possible PCa situation.

Of course, that would be a concern to anyone who has an awareness of what might be.

Panic, should be the last thing to do.

Maybe there is something 'wrong' but this is very early in the PCa world, in terms of making an accurate Dx and providing appropriate care.

A biopsy is in order, which type, I'll leave to the professionals.

Keep us posted - wishing you the best on your journey ....

[j-o-h-n]

Greetings jk1021.... Can you give us more info about yourself? Location, Treatment Location, Doctor's name(s)? All info is voluntary but it helps us help you and helps us too. Thank you!!!

If you're going for standard prostate biopsy... INSIST they knock you out.... Insist, insist, Insist.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 06/06/20202 5:49 PM DST