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PSA of 8, age 53. Should I have a biopsy?

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User
Posted 14 Aug 2018 at 08:15

So I recently asked for a prostate check your because of my age (53), no other symptoms. I was given a DRE then a blood test, in that order by the GP. PSA 8.  A week later saw a consultant who gave me another DRE and blood test, again in that order.  Plus I had been mountain biking the day before.  Again PSA was 8. ive now had an MRI and am being referred for a biopsy, which of course carries risks, e.g. Infection etc

so my question is, should I go ahead with the biopsy yet?  Both my blood tests to date were preceded by a DRE which from what ive read will increase the PSA count

Or should I have more blood tests to see if my PSA count is correct?

am I right to be concerned about he biopsy?

 

 

 

User
Posted 14 Aug 2018 at 09:35
Is the referral for Biopsy as a result of something that showed up on the MRI or is it just the next test on the list?

Richard

User
Posted 14 Aug 2018 at 10:21
Geoff, a biopsy is the only certain way to know whether or not you have prostate cancer. It's a minor discomfort and a tiny risk weighed against something which could be life-threatening. If I were you, I wouldn't hesitate to have a biopsy.

Chris

User
Posted 14 Aug 2018 at 10:31

Hi Geoff,

What did they find on the MRI scan? Definitely go for a biopsy if that’s what urology are suggesting.

And no, the risks of biopsy are infinitesimal compared to what one might uncover.

Cheers, John

Edited by member 14 Aug 2018 at 10:35  | Reason: Not specified

User
Posted 14 Aug 2018 at 10:32

Hi Geoff,

I think you need to take the advise of the Doctors and if you need a biopsy.Just because you are young at 53 with a PSA of 8 does not tell you you don't have PC.

I was referred with a PSA of 2.19 and was diagnosed with PC in 12 of the 20 samples aged 70.

Infection is the last thing you should worry about just get it checked out for the sake of you and the family, you may feel very well and fit in your self but that does not mean you are clear.

My PC was detected by a blood test in a private medical that i had to take to renew my 7.5 ton driving license and my doctor wanted to investigate more so we caught it early and i am doing very well 23 months after brachytherapy.

John.

User
Posted 14 Aug 2018 at 11:22

I was 46 with a PSA of less than 8 and was diagnosed with PCa.  Now that you’ve started on the diagnostic journey, I think the only way to have peace of mind is to complete it, otherwise you’ll always wonder.  It’s best to get a complete picture of what is going on.

Ulsterman

User
Posted 14 Aug 2018 at 12:00
I think you should continue with the biopsy but be aware you may be getting on a rollercoaster that you can’t get off. 50% of men in their 50’s will have some cancer in their prostate that would maybe never affect their lives. But once it’s found you enter a treatment plan and it’s all pretty life changing and unpleasant.

You should never have a psa test after rigorous cycling, ejaculation , anal sex or DRE. This is not explained to many men. Make sure you ask questions about what is going on and what the scan has seen if anything. And if you have a biopsy you shouldn’t have a psa for ages afterwards. Good luck whatever

If life gives you lemons , then make lemonade

User
Posted 14 Aug 2018 at 12:09
At 53 your upper threshold for a 'normal' PSA is 3.0 so at almost 3 times the threshold for referral you should be a little concerned. Cycling and DRE can both raise the PSA temporarily but not by that much.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Aug 2018 at 13:31
I think I had a blood test almost immediately after an ejaculation (I get turned on by nurses’ uniforms...not) and my PSA was raised by only around 1 whatever, from 16 odd to 17 odd.

So yes, get that biopsy organised.

Cheers, John

User
Posted 14 Aug 2018 at 20:43

There is only one answer having a biopsy is Yes. 

 

Yes I know there are a risk of sepsis (i got sepsis) but they also discovered cancer and I have had 4 years clear. 

 

My PSA is rising again I am going to have Radiotherapy but that biopsy has allowed me to see my second grandchild and do lots of things and hopefully, the radiotherapy will help me have more.

 

So do not hesitate get it done asap

 

 

User
Posted 15 Aug 2018 at 06:47
I think you're making the right decision, Geoff. It's a worrying time, but please remember that you're not alone in this - there are always people here who can offer support. Another wonderful resource is the PCUK nurses who are very knowledgeable and understand exactly what a stressful time this is for you. Do ring them if you have any questions either before or after your biopsy.

Very best wishes,

Chris

User
Posted 13 Sep 2018 at 18:47

Hi Geoff

Similar journey to you.  completely fit, well and 100% symptom free prior to first psa check (see my profile)

For me, surgery was always my preferred option and absolutely no regrets whatsoever. Choose your surgeon wisely. I also think (and was advised) that it’s important to give your decision 100% backing once you’ve made it and not to dwell on the ’what ifs’ However,  I was really tempted with brachytherapy but ultimately for me it came down to personal choice and side effect goals/expectations. Only had my catheter removed today so still have an awful long way to go and I’m taking nothing for granted and each day by day, but if a friend or family member asked me for an opinion (and surgery is an option for them) then that’s what I would advise.

Good luck with the road ahead. Everything seems to become a little easier once you have a plan.

 

 

Edited by member 13 Sep 2018 at 19:06  | Reason: Not specified

User
Posted 19 Sep 2018 at 18:59
Hi Geoff,

I decided to have surgery for my cancer and I'm glad I did as, so far, my outcomes have been very good. I had my operation at UCLH in London and received fantastic care both before and after. If you can try to get a referral there as they have a great reputation and deservedly so. They also run a patient surgery school prior to your op which is very informative and can alleviate a lot of your fears regarding robotic surgery.

Wishing you all the best

Ants

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User
Posted 14 Aug 2018 at 09:35
Is the referral for Biopsy as a result of something that showed up on the MRI or is it just the next test on the list?

Richard

User
Posted 14 Aug 2018 at 10:21
Geoff, a biopsy is the only certain way to know whether or not you have prostate cancer. It's a minor discomfort and a tiny risk weighed against something which could be life-threatening. If I were you, I wouldn't hesitate to have a biopsy.

Chris

User
Posted 14 Aug 2018 at 10:31

Hi Geoff,

What did they find on the MRI scan? Definitely go for a biopsy if that’s what urology are suggesting.

And no, the risks of biopsy are infinitesimal compared to what one might uncover.

Cheers, John

Edited by member 14 Aug 2018 at 10:35  | Reason: Not specified

User
Posted 14 Aug 2018 at 10:32

Hi Geoff,

I think you need to take the advise of the Doctors and if you need a biopsy.Just because you are young at 53 with a PSA of 8 does not tell you you don't have PC.

I was referred with a PSA of 2.19 and was diagnosed with PC in 12 of the 20 samples aged 70.

Infection is the last thing you should worry about just get it checked out for the sake of you and the family, you may feel very well and fit in your self but that does not mean you are clear.

My PC was detected by a blood test in a private medical that i had to take to renew my 7.5 ton driving license and my doctor wanted to investigate more so we caught it early and i am doing very well 23 months after brachytherapy.

John.

User
Posted 14 Aug 2018 at 11:22

I was 46 with a PSA of less than 8 and was diagnosed with PCa.  Now that you’ve started on the diagnostic journey, I think the only way to have peace of mind is to complete it, otherwise you’ll always wonder.  It’s best to get a complete picture of what is going on.

Ulsterman

User
Posted 14 Aug 2018 at 12:00
I think you should continue with the biopsy but be aware you may be getting on a rollercoaster that you can’t get off. 50% of men in their 50’s will have some cancer in their prostate that would maybe never affect their lives. But once it’s found you enter a treatment plan and it’s all pretty life changing and unpleasant.

You should never have a psa test after rigorous cycling, ejaculation , anal sex or DRE. This is not explained to many men. Make sure you ask questions about what is going on and what the scan has seen if anything. And if you have a biopsy you shouldn’t have a psa for ages afterwards. Good luck whatever

If life gives you lemons , then make lemonade

User
Posted 14 Aug 2018 at 12:09
At 53 your upper threshold for a 'normal' PSA is 3.0 so at almost 3 times the threshold for referral you should be a little concerned. Cycling and DRE can both raise the PSA temporarily but not by that much.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Aug 2018 at 13:31
I think I had a blood test almost immediately after an ejaculation (I get turned on by nurses’ uniforms...not) and my PSA was raised by only around 1 whatever, from 16 odd to 17 odd.

So yes, get that biopsy organised.

Cheers, John

User
Posted 14 Aug 2018 at 20:26

It was explained that the result of the MRI suggested I should have the biopsy.  Having read all the other replies, and a msny thanks for those, I feel the sensible option is to go ahead

 

User
Posted 14 Aug 2018 at 20:43

There is only one answer having a biopsy is Yes. 

 

Yes I know there are a risk of sepsis (i got sepsis) but they also discovered cancer and I have had 4 years clear. 

 

My PSA is rising again I am going to have Radiotherapy but that biopsy has allowed me to see my second grandchild and do lots of things and hopefully, the radiotherapy will help me have more.

 

So do not hesitate get it done asap

 

 

User
Posted 14 Aug 2018 at 21:33

Same age as me. Diagnosed four months ago, my PSA was 7.5 so get it done. The doctors are very adept at watchful waiting so you won’t be rushed. On the other hand if it’s urgent it could give you a better life span with a better treatment path. 

Fresh

Base jumping without a parachute should be frowned at, never criticised. Fresh

User
Posted 15 Aug 2018 at 06:41

So to all of you who have taken the time to reply, many thanks.  Clearly many of you are further along the journey than I, and I wish you all the best.  The overwhelimg advic is to have he biopsy so i shall. 

Thanks once again for your valuable advice

geoff x

User
Posted 15 Aug 2018 at 06:47
I think you're making the right decision, Geoff. It's a worrying time, but please remember that you're not alone in this - there are always people here who can offer support. Another wonderful resource is the PCUK nurses who are very knowledgeable and understand exactly what a stressful time this is for you. Do ring them if you have any questions either before or after your biopsy.

Very best wishes,

Chris

User
Posted 16 Aug 2018 at 08:19

If it has shown up on MRI you MUST have a biopsy OR be happy to take the consequences.

Can't belive GP and Urologist were doing PSA after a DRE? Ask the urologist why he did it that way, if you don't like the answer I would get a different urologist if the biopsy takes you down the surgery route!!

Otherwise MRI then biopsy is the current gold standard for screening.

User
Posted 16 Aug 2018 at 08:50

Geoff - did you have a mpMRI scan - a multi parametric scan?

If so, it gives a PIRAD score.  I had a PIRAD score of 5, meaning that clinically significant cancer was likely to be found on biopsy.  When I went for my biopsy, the urologist conducting it told me he had no doubt he would find cancer based on my PIRAD score.

Ulsterman

User
Posted 18 Aug 2018 at 11:38

Had my biopsy done on the 08/08/18 and all is fine - take the antibiotic as stated and don't strain yourself for a couple of days. My result showed I have cancer in & outside of the prostrate and lymph nodes are enlarged - it has enabled the medical team to pursue treatment - already on hormone treatment and feeling a lot better knowing the score than I did prior to the biopsy managing to flow easier too! Which is a plus. Only mu experience but I hope it helps.

User
Posted 18 Aug 2018 at 21:08
46 year old friend had PSA of 4.7. After biopsy 17/29 samples cancerous and 4/3 Gleason. Says it all I think
User
Posted 23 Aug 2018 at 19:48

Just to add some balance, read my thread. Just had the result of template fusion biopsy  after an mp MRI scan showed significant areas of concern and my PSA has gone from around 9.6 down to more recently 4.65 due to medication and biopsy results were all negative. Nobody is the same so don't get too downhearted! I was convinced it was a positive biopsy result.

User
Posted 24 Aug 2018 at 06:23
A point I didn't see mentioned...

Be aware that if your biopsy is TRUS (rather than template), the chance of a misleading result is significant (25%+ I've read), and it's relatively common for a subsequent template-biopsy to yield a different (often cancer-positive) result. The prior MRI should help reduce this.

 
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