Psa 13, biopsy benign

Posted by lemahb @lemahb, Jun 27 1:01pm

My 68 year old husband has a rising psa score over the last 3 years from 6 to 9 to most recently 13. He has an enlarged prostate. He’s had 2 biopsies and the most recent one, as well as, a year ago, have come back benign.
Should he still be worried?

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perrychristopher | @perrychristopher | Jun 28 8:00am

As other posters said it could be BPH. You may want to ask your Urologist about having an MRI guided biopsy as these are supposedly more accurate than a normal biopsy. Also, they will do this sort of biopsy under anesthesia as it is a more involved procedure.

brianjarvis | @brianjarvis | Jun 28 8:59am

Not to be worried yet. A few questions:
> What were his MRI results prior to each biopsy?
> What is his PSA Density?
> What were his % Free PSA results prior to this recent PSA increase?

crusader76 | @crusader76 | Jun 28 9:17am

Have they treated for Prostatitis? Mine went up to 11 and came down to 5 after treatment with Cypro.

jime51 | @jime51 | Jun 28 2:48pm

I’d say just keep being monitored regularly. I have a friend at church whose PSA has gone as high as more than 50 but has never had a malignancy. Apparently he has a huge prostate. An MRI might be a good next step.

chippydoo | @chippydoo | Jun 29 2:14pm

In reply to @lemahb "What’s a PSE?" + (show)

http://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market

pdcar4756 | @pdcar4756 | Jun 29 2:17pm

Was the biopsy an MRI-Ultrasound fusion biopsy? This is the most accurate. Did your husband have an MRI of his prostate? These two are critical to a proper diagnosis. Both of these procedures yield a prostate volume. How large is his prostate? A PSA of 12 which increased to 12 over a short period of time would be cause for concern. I agree on a PSE test............get one. Get second opinion from a center of excellence on the MRI results to make sure nothing was missed. Do not trust the first set of results. Radiologists make mistakes, especially if they are not expert in reading prostate MRI's. Pursue this until you have high confidence you've got credible analysis of your situation.

trki | @trki | Jun 30 12:21pm

My husband had bacterial prostatitis, managed with long term antibiotics… his PSA continued to rise to 46.6 in 2023.
MRI s, he had one each year, always showed lesions ,PIRADs 3, 4 and 5s
A MRI fusion biopsy in 2022 , with 22 cores taken, was completely benign ( confirmed by John’s Hopkins.) PSA was in 30s
A transperineal fusion biopsy in 2023 , with 20 cores , showed 8 cores were cancerous, a Gleason 9, and Gleason 7’s = 3+4s and 4+ 3s

We regret not pushing harder for more frequent biopsies and scans..
We did at least have second opinions on all his biopsies from John’s Hopkins.

We regret him not getting a Trans perineal biopsy until 2023… I don’t think it was offered at Mayo Phoenix until 2023.
He kept being told his very high and rapidly growing PSA s were due to prostatitis and inflammation…even though antibiotics were managing his infections

lemahb | @lemahb | Jun 30 4:11pm

In reply to @perrychristopher "As other posters said it could be BPH. You may want to ask your Urologist about..." + (show)

Yes,he had a MRI guided biopsy.

lemahb | @lemahb | Jun 30 4:16pm

In reply to @trki "My husband had bacterial prostatitis, managed with long term antibiotics… his PSA continued to rise to..." + (show)

Thank you. That is useful information.
I hope your husband is well and wish him all the best.

MaxC | @cobratk | Jun 30 4:42pm

In reply to @pdcar4756 "Was the biopsy an MRI-Ultrasound fusion biopsy? This is the most accurate. Did your husband have..." + (show)

Two years ago my PSA was 13 had a biopsy with negative results. This year my PSA increased to 27 so I had MRI-Ultrasound fusion biopsy and 6 were negative and 6 were 4+4 and am getting ready to start treatment. My recommendation is ask for the MRI-Ultrasound fusion biopsy it is much more accurate