Is a biopsy only way to diagnose prostate cancer?

If I'd had a biopsy at a PSA of4+ at age 40 I wouldn't be in the fix I am now.

I was told in 2018 to do actives sevalance I now have stage 4 metatasic cancer in my ribs sternum scapula in July they found a new spot on my L2 lumbar biopsy found aggressive cancer in 2018 dr told my it was low grade I was good for 10 years he was wrong find out what’s in there I’ve had radiation hormone therapy 5 chemo treatments now on xovigo radiation injections once a month for 6 months who knows what Is next good luck

Doc did biopsy - radical prostatectomy stated he got it all contained..90 days later PSA .1 again Doc I got it all no worries 30 days Nurse Practitioner PSA .331 referral new Urologist and Radiation Oncologist Eligard (2years) Radiation 39treatments..

I had a psa of 10.2 and a level 4. Low to intermediate risk. Get the MRI biopsy or fusion guided (combo) biopsy with propanol so you are asleep. It will give you peace of mind. These doctors do the best they can but they are human and don’t have all the answers. Be your own advocate. Use your biopsy material and have them order a Decipher test to measure the aggressive nature (it’s like having a second biopsy/pathologist opinion).

Sounds too familiar. Undetectable cancer cells can escape the prostate (apparently).
My surgeon was very encouraging after RP.
Postop pathology all clean: surgical margins, lymph nodes and seminal vesicules. Best surgeon can do.
Pathology also reported Gleason 9 (& 8s) and extra prostatic extension (EPE). 90 day PSA 0.19. Started Orgovyx 4 days ago and whole pelvic radiation this coming Friday. PSMA PET scan prior to RP suggested possible pelvic lymph node involvement. So we are chasing cancer cells with radiation and hormone therapy.
Best wishes to you (and all).

Gleason 7+9 post surgery results clean without extra prostatic extension. With bio recurrence PSMA Pet CLEAN..treatments started..

Treatment options are a personal decision, but it is hard for me to understand why a doctor would recommend active surveillance for Gleason Score of 6 and higher when a patient is healthy/active. If there is cancer within the body, my choice is always to address it immediately to minimize the likelihood of it spreading further into my body. When I was told of my increasing PSA and after MRI/biopsy, I did a significant amount of research. Doctors discussed all the options, but my decision was clear - Immediately fight the cancer to prevent it from spreading further. I had a radical prostatectomy on November 3, 2022. Margins were clear and now waiting on my 3-month post-surgery PSA. God willing, PSA will be zero or negligible, but as others have pointed out, there is no guarantee.

Thanks to all of you for the updates on Mayo-Connect. These have been so valuable in my journey.

Jim

I am 69 and had a PSA of 4.5. I had an MRI done and it showed a PIRADS of 5. I had the mri ultrasound biopsy done taking extra samples where the mri showed a lesion. My biopsy had Gleason 3+4 cancer on the right side. The biopsy was very straight forward and was not bad at all. My robotic removal was Sept 6 2022. The biopsy had 2 locations with no margin, at the bladder sphincter and right per. Rated stage 3a. Nothing showing in lymph nodes but found extra prostatic extension. I had a good first PSA at 6 week and have a 6 month PSA coming up in February. I still have the urinary incontinence and erectile dysfunction but these are not an issue to me. The cancer is my biggest issue and hopefully it will stay gone

Jerry, did you ever get an answer to this. I have the same question? 1 lesion with a PI RAD 4/5.

Do a trans-perineal MRI guided biopsy - NOT RECTAL!! Painful, dangerous and inadequate.
I too had a 4K test and it was a 9. Not too bad, right? My biopsy revealed Gleason 4+3 unfavorable in the entire LEFT HALF of the gland with peri neural invasion.
After I picked myself off the floor I had robotic surgery. Go to the best doctor/center you can find. Get the biopsy and know for sure!