11.16 PSA, two negative biopsies, queued up for a third

It is unusual to hear of a small prostate with a rising PSA that didn’t have an issue with prostate cancer. I do know a guy who had a 50 PSA and a large prostate that had multiple biopsies and they never found anything. They do only biopsy of 1% of the prostate when they do one. Could be they missed it, could be there’s nothing there.

The timing of your next biopsy is about right. You don’t want to find out you waited too long and there is something found since your PSA did rise again, even after having an antibiotic.

Besides suspected UTI (for which you’ve been treated), is it possibly prostatitis?

Have you had genomic and genetic tests to help identify the problem?

How old are you?

I am not clear if you are having a "Fusion guided" biopsy using your MRI results.
I believe that it would target identified lesions in addition to sampling of the prostate generally.
My fusion guided biopsy sampled a lesion identified by MRI, as well as as samples from each zone in the prostate.
Best wishes.

Agree with Michael below on is it a MRI guided fusion biopsy? I had 5 cores out of the suspicious area and 12 random cores of my 45cc prostate.

@ma740988
You might want to order a PSE test. It tells you whether you are likely or unlikely to have prostate cancer with 94% accuracy. The company that provides the blood test kit is Oxford Biodynamics and it is a biomarker test.
Here is the link to their product page for the PSE blood test:
https://www.94percent.com/
If it is likely, that you have prostate cancer, then maybe you can use your biopsy material for a Decipher test to give you, and your doctor, additional information regarding aggressiveness given your suspicious nodule and the results of the PSE test.

PSE, Decipher...ARTERRA (AI comparison with thousands of other biopsy slides)

@brianjarvis
Will look into the genomic and genetic tests

53 year old

@michaelcharles

Thanks for the info. Will call and inquire about a fusion guided biopsy for the one being targeted for Feb 26. Will also inquire about the biopsy 1 and 2.

My reports on the past biopsies just reflect the fact that the first one was ‘punch’ biopsy (transracial - I think is the official term). Biopsy 2 was a perineal.

I underwent 6 biopsies since 2014, the first 5 of which did not find cancer. This is a period in which the PSA associated with my enrlarged prostate went up and down wildly , one time reaching 47 due to prostatitis, The sixh biopsy this year found a Gleason 3+4 cancer in one out of 18 cores. So, it is not unususal to have multiple biopsies before actually detecting cancer. While the first 5 biopsies found no cancer, all the genomic tests I took at various times in this period (such as PCA3, GenPath's 4k, SelectMDX, ExoDX ) all indicated I has at least an intermediate risk of cancer, so I knew I was not out of the woods, and continued with my cancer screening. There are also genomic tests like ConfirmMDX conducted on negative biopsy samples which predict the proabaility of finding cancer on repeat biopsy. So, I agree with previous suggestions of getting genomic tests is important in additon to any additional biopsies.

@bens1
The new urologist wants to start off with an isoPSA test before biopsy #3 so will be doing that Wednesday. Never ran across the isoPSA test in all my research so it’ll be interesting how that turns out. I ran across the PSE test a few days ago so it’s up for consideration as well.