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Is this too long to wait for a biopsy?

Posted by yarddogman @yarddogman, Nov 22, 2025

My doc can’t do my MRI fusion guided transrectal biopsy til 1/27/26. MRI found two lesions of concern. Prostate 82cc. PSA 4.8. PSA density .06. I wish this could be done sooner. But maybe I will take this opportunity to change my diet some and basically get healthier. And mid January take another PSA. If it’s lowered substantially (2-3 range) maybe skip the biopsy and keep monitoring PSA. Do you think this is “fools gold”

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jeff Marchi | @jeffmarc | Nov 23, 2025
In reply to @overage "@jeffmarc Jeff Marchi, You commented, “If you live outside the United States, it may be a..." + (show)
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@jeffmarc
Jeff Marchi, You commented, “If you live outside the United States, it may be a problem” to get a transperineal biopsy. My urologist here in Panama offered me a transrectal or transperineal fusion biopsy. With my little knowledge of biopsies, I knew the transperennial fusion biopsy was safer and more precise. Told him to go with that, he then said we need to get prior approval from the insurance plan. My reply, my insurance does not require prior approvals on services or medications received outside of the United States, let us go. Within two weeks I had the procedure and 2 weeks later my report of Gleason 4+4 = 8, in 2 of 6 cores, and Cribriform glands in one core. Total cost, a few pennies short of $2,000.
No serious side effects after the procedure.
Panama may be considered third world by some, but it has some good services, but you do need to be selective. Medical appointments can usually be made within 3 weeks, and the appointment lasts as long as necessary without a rush to get you out.

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@overage
That’s great to hear you could get the biopsy. Sorry to hear it was not as minimal a case as you might have hoped for. What treatment have you decided on?

When you mentioned $2,000, you didn’t have to pay that right, Insurance paid it.

I know that people have reported that in some other countries they’re unable to get tests or treatments we get here. He did state he couldn’t get it so that was one consideration.

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overage | @overage | Nov 23, 2025
In reply to @jeffmarc "@overage That’s great to hear you could get the biopsy. Sorry to hear it was not..." + (show)
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@overage
That’s great to hear you could get the biopsy. Sorry to hear it was not as minimal a case as you might have hoped for. What treatment have you decided on?

When you mentioned $2,000, you didn’t have to pay that right, Insurance paid it.

I know that people have reported that in some other countries they’re unable to get tests or treatments we get here. He did state he couldn’t get it so that was one consideration.

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@jeffmarc
I had 28 fractions of IMRT, totaling 70 gray, which was completed about 5 months ago. The PSA before radiation, but on ADT for about 20 months, was 0.944. At 4 months after radiation, PSA was 0.051. Tuesday, I will have another PSA test.
I paid up front for the biopsy, and then after submitting my claim, insurance reimbursed me 85%. Net cost $299.57.
I recognize there are times when you have to search far for medical expertise. I did so 36 years ago when a Pulmonary Sequestration was found below my left lung. I had the procedure with a doctor at Thomas Jefferson Hospital in Philadelphia who did hundreds of lung surgeries.

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jeff Marchi | @jeffmarc | Nov 23, 2025
In reply to @overage "@jeffmarc I had 28 fractions of IMRT, totaling 70 gray, which was completed about 5 months..." + (show)
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@jeffmarc
I had 28 fractions of IMRT, totaling 70 gray, which was completed about 5 months ago. The PSA before radiation, but on ADT for about 20 months, was 0.944. At 4 months after radiation, PSA was 0.051. Tuesday, I will have another PSA test.
I paid up front for the biopsy, and then after submitting my claim, insurance reimbursed me 85%. Net cost $299.57.
I recognize there are times when you have to search far for medical expertise. I did so 36 years ago when a Pulmonary Sequestration was found below my left lung. I had the procedure with a doctor at Thomas Jefferson Hospital in Philadelphia who did hundreds of lung surgeries.

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@overage
The radiation results sound real good. As you probably know, the PSA could continue to go down, since the cells die off when they try to divide. The PSA can bounce around a little bit, but it usually keeps going down for a while.

Wish you the best on the next PSA.

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jc76 | @jc76 | Nov 24, 2025
In reply to @yarddogman "@jc76 May I ask what treatment did you chose." + (show)
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@jc76 May I ask what treatment did you chose.

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@yarddogman
Of course. I am not known for my brevity of posts so trying to limit my words.

My Mayo R/O originally had my treatment plan for 20 rounds of SBRT photon radiation with hormone treatments. However R/O ordered Decipher and it came back low risk. So they removed the recommendation for hormone treatment.

My Mayo PCP was big on second opinions and referred me to UFHPTI. The R/O there (after have me do a PSMA that was negative) recommended 30 rounds of proton pencil beam radiation no hormone treatments.

Met with my Mayo PCP and we went over all the pros and cons of each and decided as a team to go with 30 rounds of proton radiation at UFHPTI no hormone treatments.

I am 2.5 years after radiation treatments ended and PSA is .12 It originally was at 3.75 but had been steadily rising ever time PSA was tested. I have my PSA done at Mayo and they do not give PSA numbers below .10 as considered undetectable at that point by Mayo Jacksonville

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