Going for Prostate Biopsy Tomorrow ….Looking for Opinions and Thoughts

Had a friend who had a really large prostate and his PSA was 50. Even though he had a few biopsies, they never found anything.

With the size of your prostate, your PSA is quite low. Yeah, a PIRADS 3 Isn’t great, but it isn’t indicative that there’s definitely something wrong.

You may find a very little is found as a result of your biopsy. Hopefully, that is the answer.

As Jeff noted below, your PSA density is very low which is very favorable in terms of explaining why your PSA is somewhat elevated and slowly trending upward.
For what it is worth, I had an MRI that showed a PIRADS 4 lesion and had a follow up MRI-guided biopsy which included four cores sampling that lesion; those all were negative for prostate cancer. So it is very possible that the lesion that showed up on your MRI is caused by BPH or some other factor other than cancer.
The biopsy itself if really nothing to be all that concerned about - it is a quick procedure and generally well tolerated. The pathology report on the biopsy samples will probably be posted in your medical provider's patient portal before you hear from your doctor so you should make sure you have access to the portal and check it frequently after the procedure.
All the best to you.

When I was referred to my urologist because of an elevated PSA reading, he told me the high PSA could be caused by either cancer or BPH (a bigger prostate produces more PSA). A biopsy was the only way to find out which one was the culprit.

Incidentally keep in the back of your mind that AQUABLATION is approved for BPH. It can deal with even larger prostate sizes. At some point some cancers may be approved also. Check out the You-Tube video at the PCRI.org presented by Mark Helfand, MD PhD, [Chicago]

I was/is in a similar situation and can't answer your question on odds, although I totally understand it and the anxiety you are feeling. You look to me like you are utilizing the right tools in the right way to be proactive detecting and now defining this lesion relative to your BPH. You are doing the right thing brother, including connecting with this group, and will pray for good results of your biopsy.

@dgd1953
You didn’t have an MRI first? That eliminates the need for a biopsy if nothing is found. If it finds something that guides the biopsy to the important spots, since a biopsy only targets 1% of the prostate. You should find a center of excellence, your doctor didn’t follow the current standard of care.

@jeffmarc
I did have an MRI first, but it didn’t reveal anything suspicious. The biopsy, on the other hand, revealed cancer. I am very happy with the process my urologist used. If he had decided that the MRI was enough to determine there was no cancer, I could have ended up in a very bad place.

@dgd1953
You did say in your statement that the urologist said the only way to find out what was going on to us to do a biopsy. You didn’t mention the MRI so that did seem suspicious.

You also didn’t state what your PSA was, A big factor in whether or not there’s a problem, What was the Gleason score the biopsy came up with? When there’s nothing found in the MRI one would suspect 3+4 and 3+3. Did they find higher numbers? Just interesting to know when the MRI shows nothing what the biopsy actually comes up with. Something other people besides me would like to hear about.

@jeffmarc
Perhaps it would have been prudent to ask those questions before passing judgment on the care I received. Care that has my cancer in remission.

My PSA was 4.6 and my Gleason score 3+4.

I appreciate all of the replies…thank you.
My biopsy had to be rescheduled that I was supposed to have today, there was a mixup on my appointment. So now I go on 12-11.

I do have another question. Do you think that a fusion guided biopsy is a pretty straightforward and easy procedure for most urologist ?
My urologist is booked up more than a month from now. The office suggested that I can go to another urologist in the office and be seen sooner for the biopsy. He has been there for years…I was hesitant to see someone else but decided to do it so I could get in sooner. The results will be sent to my urologist.
What do you all think about that ?