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Is it time for a 4th Biopsy?
Obviously will discuss this with the doctor when he calls on Friday but my wife and I are wondering if I am in for my 4th biopsy.
59 YO who has had a high PSA for 15 years, enlarged prostate at 55cc, the last biopsy was in 2019 with 24 cores and was negative. I had another jump in PSA 13 months ago and then again in July 2022, then moved to 3 months VS 6 month testing interval and it continued to rise. In November the DR ordered a Prostate MRI that due to travel and the holidays was performed on 1/3/2023, the results again suggested possible PCa or prostatitis similar to my 2019 MRI. Dr ordered a FreePSA test and I received the results today, my PSA is 6.5 FreePSA is 0.75 or 11.719% which is still above 10% but low for my age, and depending on the chart I look at has a 25-35 % chance of cancer. My PSA density is in the normal range at 0.118 so that is a good sign. I have a family history of PCa with my dad, 2 uncles, and a grandfather on my mother's side.
I have been reading the forum for a while but thought it was time to join for support and a place to have a conversation and ask questions.
Thanks in advance.
Paul
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Honest Q: Why the concern over a repeat biopsy?
And why track PSA if adverse? Biopsy only way to confirm. And with personal history of prostate concerns, and family history of confirmed cancer???
What would be better: 5 more negative biopsies or 1 positive biopsy 3 years late?
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Hug
1 ReactionIf you get another biopsy, which kind of makes sense, you might want to get the Decipher test as well which uses the biopsy material to test aggressiveness and treatment modality.
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1 ReactionNot adverse to another biopsy though they only confirm PCa and have no guarantee against a false negative result, was hoping that the MRI would have shown some targets for the DR to go after and not just have the random cores again. I do think the PSAFree is a better indicator than the PSA density, it is interesting that the growth in the volume of my prostate correlates with a percent PSA increase from 01/18 to 01/23 at 35.1% and 35.4% respectively. It is the low %PSAFree number that has me agreeing it is time for the 4th.
Clearly you are obtaining, thinking about and analyzing a lot of relevant information, and that is great.
Sounds like you are inclined to have another biopsy, and I can only hope that you are and continue to be cancer free.
I'd go with Radiation Oncologist suggestions. My Biopsy was performed by a traditional urologist. A Device with a bunch of needles, thankfully that procedure is being replaced by MRI biopsies. Your vigilance is commendable.