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hybrid biopsy

About a year ago I had a regular, transrectal biopsy which found nothing. My PSA at the time was 4.3. After six months, my PSA was 6.2 and it is now 7.1. The urologist suggested doing a hybrid MRI biopsy. My question is, is this second biosy necessary given the first found nothing and I have no symptoms (as I told the urologist, "if you hadn't said anything, I'd never know anything was wrong!"😉?

The MRI is being done a month before the biopsy; if the MRI shows nothing, should they continue with the biopsy?

Thanks for your input!

  1. You may want to consider the possibility that the original 12 or so biopsy samples taken a year ago may have missed the exact location of a potential cancer site.


    It is my understanding that the hybrid MRI biopsy is better able to identify, verify or eliminate possibilities.


    Currently the most often used approach to verify the presence of and aggressiveness of prostate cancer is a biopsy which ranks the cancer on a Gleason Score. A Gleason Score of 6 for example is low and often considered as marginal. After that the risk goes up. I also understand that liquid biopsies (urine test) are out there if that is something available to you.




    None of us look forward to undergoing a biopsy. Yet at the same time if cancer is present you most likely will want to know and understand how aggressive it may or may not be. If the potential discomfort of a biopsy is of concern ---ask your MD to use of a numbing agent prior to taking any samples. I had a 12 core biopsy and really did not feel much. One guy in my support group had the MD put him in a twilight sleep for the process.


    In the end you are the one making the final decision. In closing I will say identifying PCa early greatly increases your chances of success vs letting it gain a firmer hold over time - making it harder to treat ....Dennis(ProstateCancer.net TEAM)

    1. Thanks! The biopsy I had last year wasn't too awful - pretty rude, but not painful. Just wondering how many times I can let him use my prostate for target practice and not have it turn into mashed potatoes!

      1. Hi . This really is exciting. I wonder about combining it with some of the more advanced urinary biomarker tests which prognosticate cancer severity. This could really pair down on over diagnosing in a non-invasive way and really upend the reasoning behind not testing younger men or for that matter the eliminating of testing for older men. Best, Richard (ProstateCancer.net Team)

      2. Good it was not a painful experience and if you are concerned why not bring that up with your urologist? I have found it better for me if I express my concerns and see where the conversation leads

    2. Hi bhpbhp! Your situation sounds very similar to mine. I had a traditional biopsy which found nothing. So, we did more monitoring for another six months or so. My PSA kept trending up (it would go up and down), so my urologist asked for an MRI. The MRI found something suspicious, and they used the MRI data for a second biopsy that targeted the specific area. They found the cancer and I was diagnosed. I had the robotic surgery to remove the prostate early this past March (2022) and am doing well now.

      Both biopsies hurt, but they weren't unbearable. But, the second one only took maybe 5 samples, as opposed to the 12 or 14 they did the first time. I'm no doctor, but I'm guessing that if the MRI doesn't find anything, they probably won't do the second biopsy.

      Also, Hi everyone! This is my first post! I wanted to connect with other men who had, or still have, prostate cancer.

      1. I forgot to mention something: I also didn't really have any symptoms. The reason this whole thing got started is because I told my primary doctor that after I urinated, by the time I got to the sink to wash my hands, I felt like I needed to urinate again. That's why we started doing the PSA tests, which lead to the biopsy and the MRI and ultimately the surgery. Even though I thought it was a dumb question, I asked my surgeon, "So, the cancer is what was causing the feeling of needing to pee again, right?", and he said "No, the cancer wouldn't do that. That's just because you're 46 years old". So, while I thought that was a symptom, I actually didn't have any symptoms of cancer, just of getting older lol. I would stay on it, just to be safe. Finding it early is always best. Mine was found super early and I am still healing, but I can do most of the things I used to and I'm only five months out from my surgery.

        1. Thank you for the advice. So far my two PSA results have both come back as <.013. I am scheduled for another one in November, The mental stress every couple months is something I have to get used to.

        2. Hi . You definitely are not alone is getting stressed with the PSA tests. There is even a term for it - scanxiety. That said, everyone has their own way of coping and do what works for you and know this community is here for you. best, Richard (ProstateCancer.net Team)

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