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Biopsy or not?

Posted by monteshark @monteshark, Jan 29 6:49pm

My PSA went from 2.2 to 2.3 over 5 years, which is nothing. I have chronic prostatitis and BPH. The velocity is very low

I’m 64 and in good health, no
Meds and physically active.

The VA ordered me to have a MRI with contrast. They rated my MRI at Bi-Rad 3. I had an MRI 5 years ago from a different source and they rated me Bi-Rad 2.

I’m arguing with myself to have a biopsy. Thoughts???

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itai | @itai | Nov 30 2:59pm
In reply to @itai "I am also trying to decide whether to get a biopsy. I have a 14.5 psa...." + (show)
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I am also trying to decide whether to get a biopsy. I have a 14.5 psa. And my mri shows a 2.5 cm (1 inch) diameter nodule with possible extra casual extension and it's Pi- rads 5. So rather scary. A bone scan was negative. I already waited several months but I think I will probably have to have a biopsy. I saw a video on the internet that said not to do it. The insurance will not pay for a PSMA scan without a biopsy. Anyone else undecided about a biopsy?

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@itai. "Extra Capsular " not "casual. "

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jeff Marchi | @jeffmarc | Nov 30 4:07pm
In reply to @itai "I am also trying to decide whether to get a biopsy. I have a 14.5 psa...." + (show)
Profile picture for itai @itai

I am also trying to decide whether to get a biopsy. I have a 14.5 psa. And my mri shows a 2.5 cm (1 inch) diameter nodule with possible extra casual extension and it's Pi- rads 5. So rather scary. A bone scan was negative. I already waited several months but I think I will probably have to have a biopsy. I saw a video on the internet that said not to do it. The insurance will not pay for a PSMA scan without a biopsy. Anyone else undecided about a biopsy?

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@itai
Of all the cases I have heard about yours really does call for a biopsy. Between the PSA and a PIRADS 5 You are almost guaranteed to have prostate cancer. I can imagine your urologist is really telling you that you need to do it. While there are tests you can do to find out if you have cancer your MRI really has narrowed down the options.

Speak to your urologist to see if they have any reason you would not need a biopsy. If you can, get a Transperineal Biopsy since they have a lower chance of infection. They use the MRI to guide the biopsy, Make sure yours includes that.

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