Prostate biopsy alternatives?

[Mitch608]

70 n had a biopsy 10+ years ago n not fun...last PSA usually always over 5,seems to me a chronic condition ??Also I thought there was a PSA blood test which is more a accurate(ipo)

[Tall_Allen]

There are a few blood tests. Among the best and least expensive (and insurance-covered) is the Prostate Health Index (PHI). It includes PSA as well as other stuff. A novel non-PSA-based test is SelectMDx, but it may not be covered by insurance (check first). You would qualify for a PCA3 test because you had a first negative biopsy. It's a urine test after a prostate massage.

If you don't have a pattern of rising PSA, or if your PSA is adequately explained by BPH, you probably don't need another biopsy.

[Mitch608 in reply to Tall_Allen]

Thank u

[PCGeorge]

My biopsy experiences were not pleasant either. The first one a few years back was excruciating. But the last one prior to my prostatectomy was almost a breeze. The new doctor did a "Focal Biopsy Test". As best I can describe it, they used an imaging device (to locate specific point(s) of possible cancerous lesions and directed the extraction needle directly at those spots. I had it done at Mt. Sinai in NYC. This second one was truly easier. In the first event they were just jabbing blindly. I suspect my second urologist was better with anesthetizing as well. Of course we continue to follow possible spread with an annual PSA. Good luck to you!

[Mitch608 in reply to PCGeorge]

Thank u very much

[TimCo]

Hello, Are your biopsy and latest psa informing you that surgery or radiation need serious consideration? I trust not. Since your psa is stable/chronic @ 5 hopefully you do not need cancer treatment.

[Svnupsf]

Mitch, I'm now 73 and had an RP in 2016. Prior to that, my PSA had been in the 11-12 range for over ten years. That level had become my normal after rising gradually over years. I had two biopsies years ago with both negative...not fun, I agree. As (I hope) you know, the PSA level is not a definitive indicator of PC. An enlarged prostate is also a source of elevating PSA, along with an infection (prostatitis). My prostate was enlarging over the years, reaching the size of a navel orange when finally removed! As we age, enlarging prostate (and resulting urinary issues) is very common.

The technology available ten years ago was far less than it is today. My third biopsy was in late 2015 after my PSA level rose dramatically. However, before doing that, I had a prostate MRI that identified three small questionable spots buried deep in the gland. As PCGeorge also reported, my third biopsy was an MRI-guided one that allowed my urologist to target those spots, not just poke randomly hoping to find something.

So, based on what you said, a steady PSA level of around 5 may only be a function of prostate size but annual monitoring is a good idea. If it jumps up...time to look more closely. But, if a biopsy is appropriate, then insist on getting an MRI first. Otherwise, the doc is looking for a needle in a haystack. Not all urologists have the technology to do these, so find one who does.

Ken

[G1775 in reply to Svnupsf]

Thanks. Much appreciated. I am right at this point.

[Mitch608 in reply to Svnupsf]

Thanks for the advice😀