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  • Should we push for a quicker biopsy?

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    Old 07-10-2019, 03:57 PM   #1
    somethingokay
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    Should we push for a quicker biopsy?

    Hi all,

    So my father (68) recently had two PSA tests within 3 weeks of each other. The first measured 15 ng/mL, but he was getting over being sick so they decided to wait to see if it decreased. It got better, and lo and behold the PSA was 18 ng/mL. 3 units in 3 weeks. Also, my dad's further died of prostate cancer and his brother had it, so there's strong family history. DRE was normal though. The earliest they claimed they could do the biopsy was around a month after the test. I know the PSA levels aren't as high as some I've seen, but I'm still concerned, especially due to the apparent rate of increase. Should we try to get an earlier appointment or am I worrying excessively?

     
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    Old 07-12-2019, 04:39 AM   #2
    IADT3since2000
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    Re: Should we push for a quicker biopsy?

    Hi somethingokay and welcome to this Board!

    These days there is an intermediate step that could be available to your father depending on his location and access to care. It is known as a multiparametric MRI (mpMRI), which simply means an MRI where they add usually two extra features to the usual scan of the anatomy. The extra features check the flow of water in the prostate cells and also evidence of blood vessel growth. Both of these help indicate whether prostate cancer is present, and if so, where it is in the prostate, its shape, size and aggressiveness. Results can help the urologist add targets to his usual biopsy sampling.

    You and/or your father could ask his urologist about adding that mpMRI. This is not yet standard practice, but mpMRI use before a biopsy is rapidly becoming popular.

    If that is not going to work, then trying to move up the biopsy is reasonable, though my own layman's feeling is that there won't be much added risk if you have to wait a month. A PSA of 18, especially with that increase of 3 in just 3 weeks, is concerning. However, even if it turns out to be prostate cancer, due to great advances over the past twenty years or so, survival is excellent for the vast majority of us, the best survival of any major cancer. Treatments and ways of managing side-effects have also improved a lot.

    Good luck!

     
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