Dr. Wants me to take Biopsy

Hi . Your concerns about not wanting to move too quickly to a biopsy and potentially over-treat is understandable. A PSA over four is often the point where a biopsy is considered, but there can be other considerations. This page on prostate cancer detection from the American Cancer Society notes that "If your PSA test result is in the borderline range (between 4 and 10), the percent-free PSA might be used to help decide if you should have a prostate biopsy. A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy:" https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/tests.html#:~:text=A%20lower%20percent%2Dfree%20PSA,between%2010%25%20and%2025%25. The velocity of PSA increases (how fast it is rising) can also be a consideration. If you have concerns about the biopsy you could also ask about urinary biomarker testing. Your doctor should be able to provide further information on all of this. Wishing you the best and please feel free, if you like, to keep us posted on how things are going. Richard (ProstateCancer.net Team)

After my PSA went from 3 to 4 in a year, with something felt on DRE, my primary care doc suggested I see a urologist. Urologist did another PSA, which was 6. We then did a 4K blood test, which is more refined than PSA and looks at 4 specific markers in the blood. Those results showed a high likelihood of aggressive cancer present, and urologist recommended biopsy. He thinks that some docs jump to biopsies, which are not without risks/cost/discomfort. Maybe see if your urologist offers the 4K test?

So from the age of 59 to age 63 my annual PSA trended up from 3.5 to 5.6. The key word here is "trend". When I hit 5.0 they ordered an additional 6 month follow-up PSA - this next one jumped from 5.0 to 5.6 in 6 months (a 5.6 result combined with 4 previous consecutive increases) won me the "Biopsy prize", which I was dreading. Turns out that aside from the embarrassing nature of the test and 5-6 minutes of discomfort it wasn't that bad.

Thank You cuzed for your responce...I have been diligently checking my PSA levels every 6 months since I found out it was an issue...my numbers where generally in the 2-3 range but after my last PSA it went to a 4.75 and Urologist immediately set me up for a biopsy...I have since felt alone of anxiety since he scheduled the test and have researching other options in which the Urologist never discussed or even administer DRE test ...I feel that without even a discussion that the Urologist just went to the common test without discussion which now has me wooried