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Psa, mri, prostate biopsy what next to be sure
Hope this is in the right place. I am 67 yo
With a psa of 5.0 in 1-26’. Had a prostate mri w/ and wo contrast w/ 3d reformat. Prostate vol. 87.1, pi-rad 3 lesion, size 21x15 mm left posterior mid gland. Biopsy 13 cores all benign prostatic tissue. Free psa of 16, I know i have BPH not sure now what to do. Second opinion? Any thoughts would be appreciated.
Thank you
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Speaking to the BPH only:
https://aquablation.com/
On PCRI.ORG has some great information videos.
One in particular on PCRI.ORG:
Hope these are good information for you.
Ray
Your somewhat high PSA can be completely caused by BPH. Your free PSA doesn’t imply much of anything.
You could get a PSE test to see if you do have prostate cancer and the biopsy missed it. When you have a biopsy they only get about one percent of your tissue so it could be you still have prostate cancer.
Get treatment for your BPH and see if your PSA drops a lot. You do have a large prostate so as a result, you do have a higher PSA than normal. I know somebody had a really large one. His PSA was 50, but they never found anything doing biopsies..
@jeffmarc
Thank you Jeff,
I was thinking a biomarker test. This is so new to me. I have been followed for years with a psa by my pcp. I will ask my urologist about that pse test.
Thank you
@ray092271
Thank you Ray, i will watch the video.
I have been searching Aquablation for sometime, then found out I had PC Gleason 3+4 Stage 2, decipher .46, PSA 2.9, prostate 69cc, My urologist is also great with Aquablation, but said its not quit there for PC. Then I found this, video and thought I would further check it out by reaching out to Dr. Helfand Md.
@ray092271
Thank you I did see Dr.Helfand video on the aquablation.
What was your prior PSA test? With PCa it tends to go up by a significant percentage. A PIRADs of 3 can go either way (mine was benign). Even if PCa very good chance it will be 3+3 Gleason and recommended active surveillance. I agree that the next steps should be getting PSE and seeing you what treatment is available for BPH. If you cannot get the PSE make sure you follow up with another PSA test in 3-6 months (useful even with PSE). If PSA is still rising (like a 7+) then a biopsy is warranted. PCa tends to be slow growing.