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Biopsy v non-Biopsy: Can you be diagnosed without a biopsy?
Prostate Cancer | Last Active: Mar 9 9:14am | Replies (70)Comment receiving replies
So funny - I read that about the bones also. I have bone pain that is weird. I asked my Urologist about the “bones first” idea and he blew that off and basically said no. My PSAs are all over the map (high 9.7 - current 8.6). My first Urologist in Jacksonville said “well at least your PSAs are stable so everything should be fine”. I got a new Urologist. There is so much info and so much to misunderstand. My university of Florida urologist (best in the state so they say) never heard of biomarkers in the urine indicating PC - thus my original post. Unfortunately I question everything and argue for my own health. Just because a urologist says X means nothing to me. I will research and attempt to understand it before making any move. I have read every post in this forum and PC is huge - complicated - different for everyone - and the side effects are numerous.
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@csbarry
If you are having bone pain and four MRIs have ALL detected a significant cancer (as you originally indicated); then your current PSA is really of limited value in helping to inform the current status of your situation.
I find it hard to believe that any urologist would "blow off" a patient, having a PSA in the range of 8.6-9.7, who complains of "bone pain" and instead try to ease the mind with "your PSA's are stable". Taking your comment at face value, you did exactly the right thing by getting a new urologist.
As I make clear in my posts on this subject, my concern with repeat biopsies is related to men who have been diagnosed, via biopsy, with "LOW RISK" PCa, have a low Decipher score, and where serial mpMRI's indicate stable or regressive lesion results.
Can you say that your four mpMRI's have indicated stable / regressive results and that the last mpMRI was the best of all four?
The key concern with your comment...an absolute "double red flag"...is your indication of bone pain. The diagnosis of Low Risk PCa, via biopsy, is NEVER accompanied with bone pain. Often times there are zero physical symptoms that can be attributed to low risk PCa.
You are right to question, research and attempt to understand everything that may be pertinent to PCa, before making any move.
However, if it were me, I would not delay to find out what is really going on ASAP. Maybe your bone pain is due to something unrelated (I really hope that is the case for your sake), but IMHO your four MRI's indicating the likelihood of clinically significant PCa would make me want to get to the bottom of what is going ASAP, by the best means possible in 2026. In the US that is biopsy, but maybe you could travel to the UK (I also understand China is also doing this) to go directly to surgery without a biopsy.....of course even in these countries, they all do extensive noninvasive tests to ensure the PCa is clinically significant (see video).
As I try to explain to folks, low risk PCa and high risk, metastatic PCa are virtually two different diseases. True Gleason 3+3 (forgetting, for a moment, the inaccuracies of biopsy and its attempt to characterize the entire gland with only a few cores) is an indolent disease. That is completely different situation than metastasized PCa into the bones and other distant locations in the body.
The good news, as Jeff Marchi has indicated (I fully agree with his comments), even when PCa travels to the distant locations in the body there are treatments available, even after progressing to castration resistant PCa...the worst type.
All the best!