Awaiting Biopsy Results

Is there a way to predict or give a % of the possibility of cancer as I await my Biopsy results?  In one yet I went from a 2.4PSA to a 4.2 PSA and my FreePSA was 8% and DRE was normal to small. I went in for yearly routine physical when this was discovered.. I was not so concerned about cancer at the 4.2 (doubling in one year) because I feel perfectly healthy. So I had another PSA as well as Free PSA test done 6 weeks later because I was traveling. Now my PSA was 4.4 was and my Free PSA was reported at 8%. At first I though great only 8% until my DR explained the lower number was not good.
Guess my question is 2 fold, 1. Can a person feel pretty healthy and have cancer? And 2.if the 12 needle Biopsy is negative what causes a false positive FPSA of 8%???
I run a lot of my business life on statistics and I don't like the numbers but I also trust in the medical community.
  I would also appreciate your comment considering I am only 52 with a great wife and 9 y/o daughter and I am active businessman and outdoor sports enthusiast - if caner were present in the prostate gland only it seems to be coin flip on Brachytherapy (Seeds) or Radical Prostectomy (Surgery?  It seems Brachytherapy accomplishes the same goal with less side effects? Any comments?

[Kevin Pho, MD]

It is difficult to predict the chance that cancer is present.  

To answer your questions:
1) Yes, it is possible to feel healthy and have cancer.

2) If the biopsy is negative, there is always a chance the biopsy did not sample the cancerous tissue.  Repeating the biopsy can always be considered.

With a free-to-total PSA ratio of 8 percent, this increases the probability of cancer.  Studies have shown the prostate detection rate for a free PSA ratio below 10 percent to be about 56 percent.  

It is important to note that a normal ratio does not preclude the chance of cancer, as those with normal ratios have an 8 percent probability of prostate cancer.  

As for the treatment - that would depend on the stage and spread of the cancer.  Diagnosis should be done first.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b