Visited a urologist today, because my PSA score has been rising over the past year. Not by very much, from 4.4 to 6.7. I’m 73. The concern is with the possibility of prostate cancer.
My PCP mentioned to me that there is a strong body of opinion in the medical community that men over 70 shouldn’t be tested for PSA because age strongly affects the number, but he did it anyway, and since the number had risen again, he sent me to the specialist.
11 years ago I did have a biopsy, which was painful and caused a very negative permanent effect on my sex life, and was also completely unnecessary, because neither my doctor nor the urologist at the time bothered to explain to me that it is a good idea to refrain from sex for 72 hours before a PSA blood draw, as recent sex can raise the number. So this subject is rather fraught with me.
Because of this history I was prepared to do battle to not have another biopsy. But medicine advances, and now there are MRI scanners that can produce effective MRI images for one’s prostate. This, at least, provides concrete evidence about the likelihood of the presence of cancer before doing something as extreme as a biopsy. So that’s what I’m going to have. Yay for advances in medical science.
I’m glad you’re getting it checked out! PSA is a very uncertain measure, so it’s good that they have a non-invasive tool (and that insurance will cover it).
I had an MRI which showed everything to be normal, and the guy wants to biopsy it anyway.
Was in done in an office, or a hospital. For how long were you laid up afterwards?
The purpose of the MRI is to give the doctor better information about the possibility of cancer, and also where it might be located, so that the biopsy samples can be targeted. It doesn’t mean no-one who has the MRI ever needs a biopsy, but it should mean that a lot more of the biopsies that are done should be actually necessary. If the doctor said everything was normal in the MRI, I think he owes you an explanation of why he wants to do a biopsy. In any case, good luck with your results.
It was done in an office, with no relaxant at all, as if the local anesthetic shots right into my prostate were not themselves going to cause any pain. I was not laid up at all, it was a completely outpatient procedure and I walked out of the office under my own steam. I was warned about possible blood in the urine for a few days, and also possible blood in the semen. I had the former but not the latter. But starting shortly after the procedure (blurred for possible TMI) my ability to have sex and the amount of ejaculate were both greatly reduced, and still are to this day.
The procedure at that time was that some kind of small instrument on a cable connected to a machine outside, was inserted into my backside. Unlike a colonoscopy it doesn’t have to go very far, and I don’t think I had to do much prep – maybe an enema before I left home, but I’m not sure. This was 11 years ago, and things might have changed, and different doctors may have different equipment or procedures. Anyway, this instrument had both the needle with local anesthetic, and the little punch that took small samples of the prostate, in my case 12 samples evenly spaced. The local anesthetic, once it was injected, worked fine and I didn’t feel any pain after that. As of that date, the biopsy was completely clean.
I had a biopsy a year or so ago. They had done an MRI first, so it was targeted. It was kind of like someone sticking a hole puncher up my butt and punching some holes. Everything came back ok, so unless PSA goes up a lot they won’t need to do it again.
i’m 65 and my psa was up to 5.6 from its usual 2.0 and i decided to get the mri before going on to biopsy. it showed a solitary lesion without spread in the prostate. biopsy was thus focused on that spot in addition to bxing other regions. bx came back gleason 9 (ugh!!) from the center of the lesion while other areas were a much nicer gleason 7. had i not had the mri, they might not have bxed the part of the lesion that was g9, and only found the g7 tissue (i’d have done watchful waiting with that result), or might even have failed to hit the cancer.
so i’m happy i went for the mri, even tho it meant rad/hormone rx.
know that having a normal prostate mri does not absolutely rule out prostate cancer, though. deciding to biopsy after a normal mri can be a wise decision based on the specific facts of a particular man’s case. a competent urologist should be expected to explain why to the patient