Biopsy v non-Biopsy: Can you be diagnosed without a biopsy?

You might consider asking if they’ll go directly to a PSMA PET scan, given the confidence that you have prostate cancer based on your DRE, PSA, MRI, bone, and CT scan results.

Have you had other confirmatory liquid biopsies like FoundationOne®Liquid CDx, Guardant360, and Caris Assure?

Have you exhausted all other blood, urine, and saliva liquid biopsy options such that there’s no question what’s there?

Can you convince your insurance company to pay for treatment without a tissue biopsy?

@csbarry
The PSE test is one alternative. It is 94% accurate in telling you whether or not you have prostate cancer and need a biopsy. In your case, it would just tell you, you have it.

Mark Emberton is an advocate of using MRI and PSMA to avoid biopsy. He doesn't advocate no treatment though. If I was so critical of my caregivers I was refusing to submit to a biopsy, why would I submit to any treatment they were going to proceed with? And if I was going to refuse treatment, what is the point of seeing them, ever again?

Anyway, for what its worth, here is a w year old interview with Emberton: https://www.youtube.com/watch

And a more recent interview: https://www.youtube.com/watch

@climateguy I can see that this approach could work for surgery. But for RT the information in the biopsy, including a subsequent Decipher anslysis, is crucial.

@csbarry

I get it…regarding wanting to avoid biopsies….you can read all about my miserable biopsy experience in this forum:
https://connect.mayoclinic.org/discussion/prostate-biopsy-complication/
I’m currently on AS and my doc said he normally doesn’t go any longer than 5 years between biopsies for men on AS, even if all other markers indicate “no progression” (I was diagnosed with low volume 3+4).

I said “Good, let’s schedule the next one on the 31st day of the 11th month after year 4!”

What I don’t get is what treatment do you want to have without a biopsy.

Do you have symptoms that would indicate you may already have metastasis PCa and want it treated without undergoing a biopsy?

If so, have you expressed those symptoms and concerns to your physician?

@csbarry ‘Quick’, ‘Painless’ and ‘Death from Prostate cancer’ are words that are never found together.
My first urologist, a very happy go lucky female doctor, looked me right in the eye one day and said
“I’ve seen men die from this…and trust me, it’s horrible.”

@csbarry You are receiving the advice you sought. You are free to accept or reject it, but you do not have standing to tell someone to leave the chat.

I asked for alternatives to biopsies not a lecture on my decisions for my body.

Thanks

@csbarry To cut to the chase: Regardless of all the helpful suggestions made on your behalf, there are NO ALTERNATIVES to a prostate biopsy, period.
You either get a biopsy to see IF and to what degree of cancer you have…or you DON’T and you will either die from something else if it’s low grade, or you die a horrible death if it isn’t.
I hope this answers your original question.
Phil

Unfortunately there is no way around getting your tissues under a microscope and actually see if it’s cancer and if so what is the Gleason score………… I fought with my doctor on everything you have done and ended up doing the random biopsy. It came back negative, the Doctor said he doesn’t believe the biopsy and wanted to do a random saturation biopsy 24-30 cores! I said absolutely not. Waiting for the targeted MRI fusion Biopsy……..

I highly disagree with random biopsy’s! Get the targeted biopsy if you decide to do one!

Ray ✅☝️🇺🇸😊