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Re: Biopsy wisdom

Don, last year I announced that I would not post on a thread that John Bonneville was involved in because of his argumentative, abrasive and insulting style. Unfortunately, in an attempt to add something to this topic, I broke this rule. As one in the "don't trust your doctor brigade", I decided it was time for a biopsy when my GP didn't think I needed one. I went ahead anyhow and 4+5=9 was the result.

After being an avid reader of, and occasional poster on this forum for more than eight years, I am now back in my box. Terry put up with John Bonneville for years, but my skin is not as thick. I will not be posting on the YANA forum again.

Re: Biopsy wisdom

The "don't trust your doctor brigade" have lost another comrade. Gone forever? Unlikely methinks.

Don the previous poster's comments re, "I decided it was time for a biopsy when my GP didn't think I needed one", is of course the expurgated version. You may care to enquire of the previous poster as to how many years passed before they chose to have the biopsy? The 4+5 was the direct result of the previous poster taking charge. Sheer folly in my opinion.

best wishes

p.s. still more to come

Re: Biopsy wisdom

I personally would consider just getting my PSA rechecked in 6 or 12 months. Your velocity is low. My PSA was 3.2 but my velocity was 85 % so I had a biopsy where they found a little low grade ( gleason 6 ) cancer. I was 58. The biopsy was no fun...lots of blood in my urine for about a month.

Re: Biopsy wisdom

You appear to have established a baseline of 3.5 to 3.8 over the past two years. Regarding 3.78 as the top of the baseline range, I find a bump up to 4.7 in five months ambiguous; not an emergency, but not to be ignored either. I would suggest a repeat PSA in three to six months. A urologist would have a better idea of the appropriate time interval.

I had two biopsies, didn't have much trouble with either. The procedure wasn't bad; each needle insertion produced a sensation which was very startling, I couldn't help bu jump, but it was not painful. I had blood in my urine for a few days, but it was expected, and I didn't find it a problem.

Re: Biopsy wisdom

Thanks for all the responses. Seems like there are worse case scenarios - worse then what my friend had. None the less they still seem to be fairly rare.

I am getting a free psa test tomorrow then will get results probably 4 days later. If it is low I will definitely get the biopsies. If it is high - over 25 then I have to decide.

Seems like everything before biopsy is just guessing. Even a low PSA does not really say much I guess. It tells you percentages. Not whether you have something or don't. So biopsy = a much better chance at knowing something solid.

Probability of finding prostate cancer based on % free PSA in men with a total PSA between 4 ng/ml and 10 ng/ml

% free PSA ---- Probability of prostate cancer
0%–10% ----- 56%
10%–15% ---- 28%
15%–20% ---- 20%
20%–25% ---- 16%
More than 25%--- 8%

SOURCE: Journal of the American Medical Association, May 20, 1998.

16% chance still seems pretty high. 8% chance - hmm - is that worth not doing the biopsies? It could come back under 10% - which then means 56% chance of cancer - then it is a no brainer I think. But 20 to 25% free?

Re: Biopsy wisdom

I'm glad to hear that. On second thought, I decided sooner would be better, and returned to the thread to suggest that, but you beat me to it. Good call.

"I am getting a free psa test tomorrow then will get results probably 4 days later. If it is low I will definitely get the biopsies. If it is high - over 25 then I have to decide."

When I researched it back in 2009, I found that a very low free PSA ratio correlated highly with a higher grade tumor. I don't recall anything about the probability of any tumor, but I might have missed that or forgotten it.

"Even a low PSA does not really say much I guess."

One PSA doesn't say much. But a change from an established baseline is significant. If you've been bumping along between 3.5 and 3.8, 4.7 is a spike above an established baseline. I am less concerned with free PSA ratio than if the 4.7 repeats. If PSA repeats at 4.7, I think a biopsy is probably advisable, regardless of free PSA.

Re: Biopsy wisdom

yes - it seems repeated over 4 and it is time to decide for biopsies.

The repeated psa may be helpful before biopsy - seems half of the psa jumps come down again. But if it doesn't go down - it is time for some real information.

Over all my trend is in one direction - which means probably a biopsy for me soon.

Thanks for the info. Not sure if I am making sense right now.

I think this is a really good site too:

Re: Biopsy wisdom

Brooke - do you know if the free psa includes the total figure? So it might come back free over 25% but total psa of 4.7 again?

By the way I went to high school with Dana Jennings - the guy who chronicled his prostate cancer surgery on the NY Times. No relation I am sure - but had to add that.

Re: Biopsy wisdom

Free PSA came back as 13% = 28 percent chance of cancer. Biopsy scheduled for May 7th.

Re: Biopsy wisdom

Finally got the details

Total PSA went down to 4.3 - from 4.7

Free PSA is 13.7%

Biopsies are May 7th, Results May 14th