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My husband is going for a consult to see if he has cancer or an enlarged prostateJ Just wanted to know is a biopsy the only way to diagnose? Are PET scans able to detect it?
I believe it's an insurance issue, the biopsy being this least expensive alternative. Do your husband a huge favor and schedule the biopsy to include conscious sedation. If he has it performed without, it will be comparable to an episode in the shower room at any maximum-security prison. It was the most barbaric event I have ever endured. The downside is, you'll need to allow extra time in your day in order for him to recover from the anesthesia, and he can not drive afterward.
I did not have the conscious sedation for my biopsy. It is no day at the beach. Out of the 12 cores that were taken – 2-3 hurt. I was not prepared for the noise that goes along with the biopsy device. It really makes things worse hearing the noise created by the spring.
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Did you have an MRI in addition to the biopsy?
I did have an MRI as well after the biopsy. You have to wait a period of time after the biopsy to have the MRI. I believe it was 4 weeks. Maybe 6 weeks. Gives you time to heal up after biopsy and get more accurate MRI. I also had a bone density scan, ultrasound and CAT scan before I started treatment.
The doctor offered the MRI before the biopsy as an extra measure towards accuracy and specificity. If insurance doesn’t cover the MRI, which is $10k, it won’t be done, just the biopsy.
My impressions of reading “Dr. Google” are that:  PSA, DRE, PHI, and PCA3 are not accurate.  %freePSA is better,  4K & 3TMRI are very accurate.  blind 12-core biopsy is not accurate.  3TMRI guided fusion biopsy is better than blind 12-core.  3TMRI in-bore, real-time, biopsy is most accurate. Are those impressions wrong? I am 78, with family history, PSA=9.7, PHI=100, %freePSA=10, 4K=83, and 3TMRI found 2 lesions PI-RADS=4. Should I skip the biopsies and just schedule 3TMRI in-bore, real-time robot assisted partial prostatectomy to remove the 2 lesions? Jerry
Hi @chesstutorjerry and welcome to Connect. You may have noticed I moved your post to this existing discussion so that you and connect with others who have faced similar questions.
I'd like to tag @wizard59, @dmadi61 and @stoney as they have experience with deciding how to diagnose prostate cancer and may be able to offer you support.
Back to you @chesstutorjerry what was your doctor's suggestion?
To Ethan McConkey, Thank you. My urologist wants to do BOTH a random blind 12-core biopsy AND a fusion (not in-bore, not real-time) 3TMRI guided biopsy. From what I have read on the internet: [A] the inaccurate random blind 12-core biopsy was rated a grade of "D", [B] the fusion 3TMRI guided biopsy is more accurate than the random blind 12-core biopsy, and [C] the real-time in-bore (not fusion) 3TMRI guided biopsy is more accurate than both [A] and [B]. My current question is: "Should I skip all biopsies and just schedule 3TMRI in-bore, real-time robot assisted partial prostatectomy to remove the 2 lesions?" Jerry
My impressions of reading “Dr. Google” are that:  PSA, DRE, PHI, and PCA3 are not accurate.  %freePSA is better,  4K & 3TMRI are very accurate. Jerry
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