PSA high

[Pokerplayer]

friend has psa 8 had bladder cancer year ago should he get biopsy first or pet scan or whatever? 67 yr old thanks for your replies

[Tall_Allen]

mpMRI and biopsy.

[Pokerplayer in reply to Tall_Allen]

thank you

[MarkS]

I had a PSA of 12.7. First I had an MRI which gave me a PI-RADS score of 5 (highly probable PC), then a biopsy with Gleason 4+5 (high risk) and then a bone and CT scan to check if any spread (very fortunately no spread identified in my case). That all took about 5 months on the UK NHS. I then went private and got treated properly with a more accurate PSMA PET scan (still no spread identified) followed by ADT and RT.

[Pokerplayer in reply to MarkS]

Thank you

[AnthonyStark]

Imaging first. Start with an MRI to see if there is even something there. Based on the results and if it identifies lesions and if they have a high PIRADS score, then have a targeted MRI/Ultrasound guided biopsy. If biopsy confirms active prostate cancer and there are signs of possible activity outside the prostate capsule, get a PSMA PET/CT scan. Never go straight into a biopsy off of a PSA score. A good urologist should always having imaging first so they can do targeted, guided biopsies so there are not just randomly poking the prostate, but getting tissue from the suspect areas. MRIs cost less than a biopsy, so it is the best place to start. A picture is worth a 1000 words. Blind biopsies is just poking a needle in the dark and have been known to miss cancerous tissue.

[Pokerplayer in reply to AnthonyStark]

Thank you

[despurato]

I would ask for a decipher test when the biopsy is done. Mine was in the 90’s and my treatment plan has been very aggressive.

[Pokerplayer in reply to despurato]

Thank you

[FastingLife]

I'm 67. I had a prostate biopsy 2 months ago. The urologists downplay the potential side effects...if they even mention them at all. My urologist didn't mention side effects until 15 minutes before the procedure! It is an invasive procedure with risk of infection AND PAIN! They gave me a powerful antibiotic... 3 pills: took one the day before biopsy, the day of biopsy and the day after biopsy AND I STILL GOT AN INFECTION. It was torturous and I had to get a new prescription for a 2 week antibiotic regimen. So, my advice would be to avoid the invasive biopsy and potential side effects. Get a PSMA Pet-Scan and/or the new urine test: MyProstateScore2.0, (also referred to as MPS2)