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

@heavyphil
Also - get this! People who work for and contract with the VA do so for less than minimum wage.
I had a great urologist in Palm Springs - Dr Alexander! His bill for one visit was 800 American dollars. The VA paid him 34.00. That’s insulting - it didn’t cover the cost of a ream of paper. So beware of the government cheese - lol. You have to take it slow.

@csbarry My non-VA doctors also bill for hundreds - sometimes thousands of dollars - and get less than 10%. It’s not insulting, it’s what they contracted for in their agreement.
Ins. Co’s INSIST that doctors bill for a certain ‘ usual and customary fee’ which is nothing but a pipedream.
When you Get your EOB, you’re seeing the negotiated fee - done WELL before your claim was submitted. Nobody negotiated anything on your behalf.
But your reaction is supposed to be something like: WOW, my insurance company really took that crook to the woodshed! Thank you so much for protecting me from greedy MD’s!
It’s just a game, there’s no cheese, no bait, just business…
The only person who cares about you - is YOU; all these mind games are just obstacles you are erecting to avoid a biopsy.
Phil

@csbarry IF LOW GRADE…are you kidding me? What IF NOT LOW GRADE??
How can anyone ever know without a biopsy?? There isn’t a test in your best wet dream that can determine the grade or aggressiveness of PCa….only a biopsy can do that.
Well, I’ve said all I can in defense of proper diagnostic procedure; what you choose to do has been and always will be your decision. Best of luck to you,
Phil

Whoa! That was a lively discussion! Im not an expert, but do have an opinion...lol. But first: Aug 25, 3 days in the ICU with huge blood clot in left arm, left with Eliquis and PSA of 66. Yikes! DRE, hard lump, Dr bypassed MRI went right to biopsy...Gleason 8,4+4 Yikes! Posluma petscan, stage4 met pc. Double yikes! So for the last few months Ive been reading and thinking and wondering...what to do. In the end I decided that watching the granddaughter grow up was more important than the championship sex I have been having all my life. Laughing again, but at myself, I was really good at it! So Im on the ADT, FEb 23, 2026. So far so good...but without the biopsy I would not have been able to make an informed decision....I didnt like it, it was not a very dignified experience and I would not want to do it again. But that biopsy had to happen, cant have too much information I am already preparing for the next step....radiation or chemo....I dont want to do either but will make that choice when I get there..... that pesky granddaughter again! lol....which is why I was quite taken with the essays written on Phoenix5....it is in no way a pc handbook, it was not research, just one persons experience in coming to grips with his illness. I like the way he wrote and that he felt compelled to write. I like the way he died. I hope I can be as graceful and positive when my time comes. I find the mental aspects of this black spider growing inside me interesting...rather than a time of procrastination I like to think of my several months of doing "nothing" as a time of reflection, introspection and contemplation. I guess we all come to terms with our diagnosis differently. Im waiting for a book to arrive...Intoxicated by My Illness.....The title struck a chord in me, I am for sure a little bit in love with my cancer, its the new me! Sitting in the Dr office with 6 other cancer patients, a man opened the door and asked the room: "is this Ear nose and throat"? and right away I said: "we wish"! Every one except the guy in the doorway laughed, I felt like a rock star! We all started talking to each other, it was a good moment. Im going to find the humor in this, and I hope it will see me thru the hard times that are coming my way....good thoughts to everyone here....and thanks for letting me have a place to come to read and relax, write and laugh at myself. Oh yeah, almost forgot the medical insurance comments you two were getting into....but maybe thats a bulletpoint for another time....who has an opinion on that? I do!

Double whoa! Sorry didn’t read it all. It’s a lot. I don’t have a granddaughter guiding all my decisions - and dont want one. It is funny to me that people who had biopsies defend them to the “death”! “If you don’t you will die a horrible death and your grandbabies will suffer”. Hi, Phil!
PC is huge and complicated - everyone is different. PC is diverse. My experience is different from yours. I am not afraid to die - I am a 100% disabled vet and have more pressing issues than PC. Some have claimed it is suicide by PC - ok maybe that’s a definite option. I see two sides to this issue - I had a biopsy so you have to also.
I don’t! My death is my choice - Phil! Not yours! I am seeking clarification on options! And an understanding if I don’t get a biopsy what can I expect once my cancer starts to spread - what can I do? Is there a doctor who can help with pain management. I suffer extreme pain from a poorly done lumbar fusion - in the Pentagon on 9/11. PTSD - MDD - alcoholism - panic attacks - OMG panic attacks! Spiraling, catastrophizing, reliving events! Sleep and night terrors! So the horrors of a PC is more than welcome. Not your way to go cuz you have grands! Trust this - you will go! We all do. They will undoubtedly miss their P pa! In the meantime - thanks I guess for your comical response and insightful thoughts.

Another Whoa!...Im not saying because I had a biopsy you should, Im just telling my story. Like you, Im not afraid to die. Im looking forward to it, but am going to enjoy the journey getting there. My cancer has already spread so Ill be asking for morphine when the time comes. You probably will too. Sorry I didnt read all of your post either, it was alot. Thanks for your response, I guess, I wish you the best with your personal demons, we all have them, in one form or another......now Im going to pour a double of Makers Mark and get rid of mine...lol...hang in there, its all good if you keep laughing.... PS: dont read all of this post, its all BS.
Omg. Im laughing so hard Im cryin....thanks! Cancer IS funny!

@csbarry
Not all prostate cancer cases need a biopsy. When they do a PSMA pet scan and find that the cancer is all over the body there’s no need to do a biopsy. This is the type of thing where they immediately go to triplet therapy, ADT and ARPI and chemo.

In this situation, they might not ever need to remove the prostate, It’s been found that in a very serious cases it doesn’t make sense and doesn’t help.

@stage4lovolmetpc
Final whoa!
The Makers Mark is what is going to kill ya.
Infinity I quit - I win!

@csbarry Giddyup!
Thats what Im hoping, and the sooner the better!
And yes, you win, lol.
BTW, I wrote my first cancer joke last night, its about getting a prostate biopsy.
Im wondering how it will land with those hammerheads at the Friday night poker game.
I guess you CAN make this stuff up. lmao! Nice talking with you csbarry, I had a good time writing and reading the posts here.

Yeehaw:

After my recent Prostate Exam - one of the most thorough examinations I've ever had –
the Doctor left the room and the nurse came in.
After she shut the door, she asked me a question I didn't want to hear....

She said...."Who was that guy?"