Prostate Biopsy

[RW744]

It seems to me that the PSA test is not conclusive (low number can be cancerous and high number can be normal)and leads to a dangerous biopsy procedure (possibility of damage to nerve bundle, incontinence, ED, infection) that is also inconclusive (with PSA over 4, even if no cancer in the biopsy, more biopsies are needed in the future), I understand that other bio-markers are being sought through research. Shouldn't we wait until those bio-markers are available? I am scheduled for a biopsy tomorrow but am seriously considering cancelling because of the aforementioned. My PSA is 5.4, free PSA is 17%, my father had pc, and I am 67. I am in good health and feel great. What do you advise?  

[countryjoe770]

A related discussion, Repeat biopsy was started.

[RW744]

A related discussion, CyberKnife or robotic sugery was started.

[Rajiv Goel, MD]

Dear RW744,

Based on my clinical experience you have all the reasons - raised total and free PSA with family history, to be subjected to prostate biopsy. It is absolutely indicated to rule out the possibility of prostate tumour

I agree with you that better markers are not available at this point of time, but I do not suggest you to wait till then. I think you need to go ahead with the procedure. Though this is not something that is needed immediately, you would need to consider it at the earliest.

Complications do exist with prostate biopsy, but when performed by an experienced and competent doctor, the procedure is successful without any major complications.

Few other tests such as ultrasound abdomen and pelvis, CT scan might help in the diagnosis; however they are less conclusive diagnostically when compared to biopsy and pathological studies. I encourage you to go ahead with the biopsy without a second thought.

Hope that this information helps and hope that you will get better soon.

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Best Regards
Dr. Rajiv Goel