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

@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 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

@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.

@jeffmarc HI Jeff: I wondered what the PSE is? (the one with 94% accuracy)

@drcopp
The PSE test is a blood test that analyzes your blood for material that shows whether or not you have prostate cancer. It can be used when you have a higher PSA, but the MRI showed nothing. It can tell whether or not there really is prostate cancer in your system and that you need a biopsy.

Episwitch Is the company that makes the product and does the testing?

Here is a table that shows you the PSE test at the top compared to all the other others that were available a year ago. There are some newer tests.

@drcopp
The PSE test is a blood test that analyzes your blood for material that shows whether or not you have prostate cancer. It can be used when you have a higher PSA, but the MRI showed nothing. It can tell whether or not there really is prostate cancer in your system and that you need a biopsy.

Episwitch Is the company that makes the product and does the testing?

Here is a table that shows you the PSE test at the top compared to all the other others that were available a year ago. There are some newer tests.

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

Just watched this February 28, 2026 ASPI webinar with Prof. Mark Emberton (University College London) entitled "Prostate Biopsy: The Beginning of the End?"

Shockingly, only 35% of men receive a mpMRI before a biopsy in the US and in some rural locations the percentage is much lower.

Prof. Emberton goes into detail regarding the latest findings and concerns with prostate biopsies.

The UK is way beyond what is unfortunately being practiced in the US. As research and observations being learned in the latest studies become more well known by men in the US, our medical urological establishment will be forced to change.

Interestingly, Professor Emberton uses NO biomarkers (other than PSA) but relies on advancements in MRI scanning, to monitor MRI visible lesions. Most US urologists, unfortunately, jump to the biopsy, when it is now known to have many inherent inaccuracies. Professor Emberton does a great job describing a few of problems with biopsies in this video, based on the latest research. It will be interesting to see where this will all lead in another 5 years....for folks on AS....stay tuned...

Meanwhile, every man needs to be doing his own research and taking action, if they are concerned with the status quo regarding standard prostate biopsy practice in the US.

@climateguy "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?"

I just found this thread & your statement, which I totally agree with. In the past couple months, this forum has exploded with the number of people looking for "alternate cures", as I would describe them. Everyone has to make their own decisions, but it's part of a trend in current society of mistrusting established science, & I find that especially troubling for us in the long term if it is not reversed. That's probably all I should say.