Upcoming biopsy / psa levels

Obviously creeping up. Husband was 4.88 in February/march,5.17 in August with Gleason 7, and now 7.44. Will make treatment decision shortly even though he’s 86. Do your homework. Lots of treatments available.

"a good urologist will use this MRI(with sonogram) to specifically target this suspicious area and know for certain that he is getting the samples he needs; you can puncture the prostate repeatedly and still miss the cancer, "

IMHO ->This is the best argument for getting an MRI before the biopsy.....

@heavyphil
Absolutely true !
Even with MRI AND ultrasound guidance thing can get missed since biopsy samples about 1% of the whole gland - imagine a "blind" one O_O !?

Just one more thing - biopsy should be transperineal if at all possible since it is more precise and there is less chance of getting an infection.

And thirdly - @mpersonne , you can order your own PSA in Quest or WalkInLab and not depend on the your PC's mercy . It is about $50 and sometimes they have coupons and such .

It is Ok start off with a basic biopsy (poke and hope) as the cost is a lot less and most if not all insurance companies cover that cost. MRI fusion biopsies is a procedure called URONAV. You get an MRI, the MRI images are overlaid on 3D imaging software magnified at least 10 times. When biopsy is performed the Urologist can see exactly where he/she is taking core samples. Not all insurance companies cover that cost except the cost of the MRI minus deductible . Your out of pocket cost can be from $600 -$1000 averaging about $750 for the procedure. Essentially peanuts when your life is on the line. All based on PSA levels, if the PSA levels are climbing then a URONAV is extremely recommended.

@surftohealth88
One other reason for the transperinial biopsy Is that it can reach more parts of the prostate.

Somebody posted a couple of days ago that that their biopsy didn’t show problems, but they were unable to reach the spot where the cancer actually was detectable.

More specifically

The anterior and apical regions of the prostate gland, particularly areas furthest from the rectum, are difficult to reach with a transrectal biopsy but can be accessed with a transperineal biopsy. The transperineal approach allows for a more complete and accurate sampling of these anterior portions of the prostate.

Well i went on Monday for another blood test, so im now just waiting for my results. Im curious if it has dropped substantially. When I was there, I also saw my family doctor, and he thinks it will come down, but still wont prescribe TRT until the urologist results.

MRI comes before a biopsy. The results of the MRI guide the docs as to where they should remove the samples.

You only need a PSA test. No other test found in the Basic Metabolic Panel (BMP), Comprehensive Metabolic Panel (CMP), Lipid Panel, Hepatic Panel, etc. would reflect that you have an issue with your prostate. The initial diagnostic criteria are Digital Rectal Exam (DRE) and PSA test. You don't necessarily have to have a lump, ridge, nodule, or other anatomic anomaly with your prostate to have prostate cancer, but...there is "usually" something palpable during the DRE that gives your urologist a clue that something may be going on.

@jeffmarc

Yes, that is what I meant when I said "more precise" ; ), can reach more parts of a gland, probably should have said "more extensive" (?), my English is not perfect on good days lol, and on days like today (when outside barometric pressure changes rapidly up or down ), I am hardly managing to have comprehensible conversation " in vitro" or "in vivo" XP.

@rlpostrp True, but i still have issues with high hemoglobin, so i still needed that to get check, so since they were doing a blood panel, i asked to check psa again, for im curious if it came down from being off testosterone.