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Multiple negative biopsies and rising PSA

I have been reading this forum for a while and have to say that y'all give me hope no matter how my personal situation turns out in the end. I'll give a brief synopsis of where I am at as a 64-year old patient.

So far I've had 6 (yes, I said six) negative prostate biopsies over the past 20 years. My PSA was 10 for years and just went up to 14 late last year. My last 2 biopsies (last year and this year) were mpMRI targeting a lesion and including transitional zones with 14 cores taken each time and all were negative showing typical BPH cells. My prostate size is > 2x the norm which could account for some of the elevated PSA numbers.

Next steps from the docs are monitor the PSA and if it continues to rise do a saturation biopsy next. At some point they will either find a PCa or just chalk it up to BPH. The waiting and uncertainty is the worst part of the whole thing. Still, I have what are considered the best urologists in Atlanta, so feel good about their expertise.

Bottom line is I'm not overly stressing, but hope that others in a similar position can share their experiences. It is a strange place to be.

  1. Glad you have joined us and agree --- It is a strange place to be in and --- we have all been where you are to some degree at some point . And it is no fun waiting. Best advice is to focus on the future and enjoy life every day. It is really g reat that you are meeting with urologists vs relying on a GP
    Yes ... a large prostate can produce a larger PSA reading. At the same time you may want to ask about a new and different type of scan that can detect prostate cancer at its earlier stages in remote locations in the body.
    Some men can show no cancer in the prostate while having cancer elsewhere. None of this is fun and agree ... the worst part is not knowing what is up.-Check out....

    The PSMA PET is a new imaging technology that allows doctors to "see" PSMA using a PET scanner. Compared to the scans currently used for prostate cancer detection, such as CT, bone scans, and MRI. The PSMA PET is more sensitive and can detect much smaller prostate cancer metastases.
    Hang in there and please keep us up to date on your journey.- Dennis(prostate TEAM)

    1. Hi, - We posted this forum conversation to our Facebook page. We had a couple of people weigh in with their experience, and I wanted to share the comments back with you:

      Robert M.: "I had two biopsies within a 5 year period. The first was negative, the second showed half of the samples were positive. Had a radical prostatectomy by Da Vinci robot. That was 14 years ago this month, follow up every 6 months. Still cancer free."

      Doug G.: "I had a PSA reading of 4.2 back in 2009! Had a biopsi 4 samples came back postive and surgery they the whole prostate and lymphs too! My age was 50 years old! Turned my whole life upside down but glad to be alive!"

      Laureano A.: "I had about 8 biopsies over a period of 15 years, all negative. When my PSA reached 16 and yet another negative biopsy, I had a prostate MRI. The MRI detected cancer in an area missed by all of the biopsies. The cancer had started to penetrate the tissues surrounding the prostate. I had radiation and 3 yrs later my PSA has so far been stable at 0.1."

      Here is the link to the post if you wanted to check out the conversations for yourself:

      We are glad you're part of this community. Sending all my best!

      Amylyn (Community Manager)

      1. Thanks for doing that

        I should have mentioned that my last 2 biopsies each with 14-18 cores were MP-MRI guided biopsies targeting all zones and a few small lesions. I see the top urologists at Emory in Atlanta, but they admit they are stymied. Going for a PSA test in a few weeks and the results will determine next steps. If it has gone up they want to do a saturation biopsy in a few months, if down back to normal routines of yearly checks.

        1. If you are not getting the answers you need, and are seeking other options the top rated hospitals in US for prostate and urology are The Mayo Clinic... Memorial Sloan Kettering... and Johns Hopkins. If you are ok where you are - then no need - My own hospital is connected to Memorial Sloan Kettering -- Never any easy answers at times so just know you are not alone in trying to find answers

      2. I'm comfy with my Uro's. Top guys at Emory in Atlanta. Last 3 years of PSA remain hovering around 15 with PSA ratio around 20. After both the MP-MRI targeted biopsies (done in last 2 years) were negative not even showing any issues, they are going to do more blood and urine tests. Next PSA is in 6 months and will decide next steps depending on how all the new tests come out. Possibly a saturation biopsy is in the future.

        It's a bit mentally tiring, but carrying on as normal. Thanks everyone for listening and for the advice!

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