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Prostrate Biopsy--PSA Testing Results--Family History

To Dr. Tewari

I was diagnosed with an enlarged prostrate about 18 months ago and referred to a Urologist.

I am being checked every six months (PSA and digital exam) by the Urologist, and my PSA has remained constant at 3.6-3.7 range.

Digital exam reveals no nodules (Surface of prostate is smooth).

At this point the thinking is to monitor it on a six month basis vrs doing a biopsy, but do you think I should go ahead and have a biopsy done.

I will be 62 in December this year.


To T1234:

Thank you for your question. Please answer the following in order to help me formulate a proper response.

1) How long have you been getting your PSA tested and what have been the results?

2) Do you have a family history of prostate cancer?



To: Dr. Tewari
PSA results:

10/07/08  3.86 Unknown
04/08/08  3.40 Unknown
12/17/07  3.30 Labcorp
10/09/07  3.87 Unknown
04/10/07  3.30 Unknown
07/26/07  3.00  Prostrate Specific AG 3.4 Free PSA  .80 24% Pathology Lab.
04/02/07          Prostrate Specific AG 3.3 Free PSA  .90 27% Pathology Lab.
03/13/07  3.00 Pathology Lab
01/09/06  2.70 Pathology Lab
10/29/02  2.90 Quest

No family history of prostrate cancer.  Family history of colon, skin, and breast cancer.

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242579 tn?1252114771
Another tool urologists use to determine if a patient needs a biopsy is called PSA velocity which measures the increase in PSA over time in years.  A PSA velocity of over 0.75 ng/ml/year is an indication for biopsy and your PSA values do not fall into this category. Another PSA tests is free PSA which you have already have done. A free PSA <22% is another indication for biopsy and again this is not your case. I recommend having a another DRE and PSA level checked in 6 months.
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