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Being pushed to have a biopsy

Hi all, a little background here. I am 56. Prior to 50 PSA was less than 4. Starting at 50 it started creeping up to 4 and at 52 it spiked to over 10. My regular doc thought it was prostatitis. I went on a course of antibiotics and it went down to 6. Around the same time is when I started experiencing urination issues. Like going frequently and not emptying well.

To be on the safe side I went to see a urologist. Ended up doing a bunch of tests including a SelectMDX which came out with a very small chance of having anything aggressive (less than 10%) and he ok'ed to basically go about my life. Fast forward to 2022, just had my physical, PSA was still around 6.2 and the new urologist (the prior one left the area) is pushing me to get a biopsy.
I agreed to gradually do some tests. Just had the 4K Score, it came out at 21% chance of having something aggressive, that is significantly worse than I expected. I am planning to do an MRI on the prostate next.

Some family history, my dad had the same exact issues that started when he was around my age and he ended up having some laser prostate procedure and he's been happy ever since.

I am not worried too much about it. I find the invasiveness of a biopsy disagreeable so I am looking for some experiences from people who may have had a similar experience.

Thanks

  1. I have heard all kinds of reports on the biopsy procedure. One friend told me it was the worst experience in his life. I had a 12 core biopsy 9/28 due to a PSA of 4.26. Doing a routine cysto and ultrasound, the urologist saw "hotspots" suggestive of cancer. The biopsy was done 2 weeks later and 4 cores were positive for cancer with a Gleason of 7 (4+3). An MRI was also done finding neurovascular and seminal vesicle involvement placing me in stage T3a, b which is high risk category. I had the biopsy with local anesthetic. I felt the gun each time the trigger was pulled and felt the discomfort but the discomfort was not unbearable for me. I have been on Lupron since 12/22 and will start 45 IMRT treatments in a couple of weeks. Best of luck on your journey!

    1. Thank you, my doc said they would do 'twilight' anesthesia for the biopsy. I am more worried about pain after the procedure and the possibility of infection which I was told is around 4%.

  2. I am also 56. In early 2020 my PSA was 3.5. A year later it had gone to 7.5 and I had the biopsy done. Reading through some of these forums and talking to my brother I realize there were options, like a MRI, that I wasn't even informed of. The biopsy wasn't all that uncomfortable and I was surprised how quick the procedure was. Biopsy was scored 3+4 and scored grade group 2. I consulted with the Seattle Cancer Alliance and was given all the options for treatment. By November 2021 the PSA had climbed to 9.5 and I made the decision for surgery which was done January of this year.

    1. I am a current patient at SCCA, stage 4 cancer that has spread to 5 locations in my bones in the torso.
      I am curious about your surgery.. was it a complete removal?
      I am four months into chemo, and expect to be doing it at least six months, when I might have to start radiation.
      My frustration is with my Urologist at UW, that did not immediately test me for cancer, despite complete blockage of my urinary track: instead, he surgically removed two kidney stones.. which put my in the hospital, for an infection I got from the stent. Anyway, three months before confirmation of advance cancer, and treatment started.
      I must say, the staff at SCCA are exceptional.. hope you had the same experience!


    2. yes, complete removal of the prostate and seminal vesicles. They found some "extra" tissue attached to part of the prostate that also had cancer in it.


      I had already been diagnosed with the cancer before I consulted with SCCA so it was a different experience than you for sure. For me it was a decision on a course of treatment.

  3. Interesting, thank you

    1. My surgery was done in 2013 - Gleason 9 in 2 of 12 biopsy sites - rest were clear as were the margins. I did opt for surgery to totally remove gland and seminal vesicles. I needed radiation 5 years later for a slowly rising PSA post surgery . So far the follow-up combination of hormone therapy and radiation has worked. Initially I was very concerned about the idea of radiation but it proved to be rather routine with very few issues.


      Chemo can be challenging and have been through that as well for NHL. Hope you are also doing ok with it. Having a great medical team is so important and it looks like you found one. Hang in there

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