Psa 13, biopsy benign

I am 60 and my first biopsy came back benign my PSA was 6. Prior to my second biopsy my PSA had doubled to 12, they did a PSE and my results came back as high likely hood of cancer. I had my second biopsy and they found the cancer on the second biopsy. Talk to your Urologist about a PSE and a Decipher test, ASAP.

You are in a good position. You can continue active surveillance and get MRIs to see if a biopsy is still necessary,

Have they mentioned BPH to you? That enlarged prostate is Due to BPH normally and that can cause the higher PSA. They normally start on antibiotics to resolve it. Are they doing that?

That PSA sounds like it’s all due to that large prostate.

If you’d like to see a video on active surveillance and who qualifies, ask in a follow up post to this.

What’s a PSE?

The PSE is a much more accurate test for Prostate Cancer. You can read about here it's a simple blood test.
https://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market

@lemahb
Another poster answered your question on PSE. I got a PSMA which looks for prostate cancer cells throughout body.

Question: Did you have a MRI with contrast? This would have shown suspicious areas.

Remember biopsies are only good for diagnosis of where they were taken from. It is why I asked did you have a MRI with contrast done prior to biopsies.

Even with mulitple biopsies you could miss an area that has cancer cells. It is why most R/Os when doing radiation will radiate all of prostate and margins not just the biopsy areas.

The only individual who can give you a diagnosis is your medical professionals. BPH is quite common and affects PSA. What (according to my Mayo PCP, urologist, R/O and UFHPTI R/O) it is the continuing rise of PSA numbers that is a concerned. Could it be BPH yes could it be from prostate cancer yes.

How serious is his side affects from BPH? When you say his biopsies came back negative were you given a Gleason score or just a negative diagnosis? Again did he have a MRI with contrast to see if any suspicous areas.

Now your question. Since you are asking it and worry about diagnosis you can like most of us get a second opinion. But most urologist start of with DRE, then MRI with contrast, then biopsies. Did he have he DRE and MRI with contrast? That is something you could discuss with second opinion urologist. If I was worried I would get a second opinion and most likely if he has not had one a MRI with contrast. If second opinion comes back same most likey but can't gurantee is BPH needs to be treated as well as PSA numbers are rising.

Which biopsy type? I had transrectal, which was benign. Transperineal found cancer with Gleason 9.

20 years ago my first PSA was 5.6, over the 20 years it went up into the 20s. I had 3 biopsies and 2 color Doplars. (remember those)LOL All negative. Finally my prostate got so big it shut down my urethra completely and urine backed up into my kidneys and they shut down so I went to the hospital. Took 3 days to drain the urine out. I had a foley catheter for 13 months looking for the right urologist. Last January (2025) I had a HoLEP and my prostate was 201. they removed 3/4 of my prostate. Sent pieces to lab and came back negative for cancer. So I had PSA in the 20s and no cancer. So size matters.

@vernscw
Wow you went through a lot.

Every doctor I have talked to and all my urologist, R/Os, and PCPs and everything I read about prostate cancer that a high PSA does not mean you have cancer. Nor does it mean you don't have cancer with a low PSA.

My PSA was 3.75 which is under the normal number of 4.0 for normal level of PSA. However my PSA was rising every 3 months for a couple of years so my PCP referred me to urologist and then the journey to diagnosis of prostate cancer 4+3=7.

I think the most important think with PSA rising is to have it check. My PCP about a year ago said to me that Mayo (that is where I have care) was about 10 years ago not recommending PSA tests as too many false readings and clear evidence a parameter to determine cancer.

Then he said their statistic were showing a very high rise of stage 4 prostate cancers coming in. Their research showed this started right about the time they said PSA test would no longer be recommended on on going basis but if asked. They went back to recommending PSA test for me as the PSA will show issues within prostate which need to be treated regardless of being cancer or BPH.

Your experience shows a high and rising prostate level does not mean cancer but the cause of your high PSA needed to be treated.

@lemahb
you can also email Steve Arrivo at Oxford biodynamics. He is a VP at Oxford Biodynamics and they make the test. He has been helpful in answering questions. So has Joe Abdo who is a VP on the clinical side. His email is
Joe.Abdo@oxfordbiodynamics.com.

They are happy to answer questions about the PSE test.

Sorry steve.arrivo@oxfordbiodynamics.com