Concerns prior to scheduled Prostate Cancer Biopsy and I am hoping someone (perferrably a urologist) can?

assist me in making an informed decision. I am scheduled to have Prostate Cancer Biopsy on 05/24/07. Here is a brief history of events up till now:


Vital statistics and hx are as follows: Age: 38; Sex: Male; Ht: 5' 5"; Wt: 162 lbs; Father: recently passed away at the age of 73 2ndry Prostate Cancer which got metastasized and as a result he had bone cancer as well; Mother: has diabetes and previously has had benign tumor removed; Older Brother: Healthy; Race: Asian-Indian.


On 04/23/07 blood test done and the results indicated PSA level of 3.5, subsequent to this FreePSA test done on 05/04/07 and PSA level: 3.68. The normal range is 0-2.5. Based on some some chart scoring had a value of 8 indicative that I probably have a 24% chance of having prostate cancer. Visited Urologist on 05/16/07 and DRE was conducted and was normal. Should I wait 8 weeks and have another PSA test or go for Biopsy as suggested by the Urologist? Don't want to be sliced %26amp; diced but also want peace of mind!

Concerns prior to scheduled Prostate Cancer Biopsy and I am hoping someone (perferrably a urologist) can?
The above answer has the right conclusion, although all the facts are wrong.





While PCa at your age is rare, it's hardly unknown. You have an significantly elevated risk due to the fact that your father had it.





PSA is not an indication of cancerous tissue, it's produced by both normal and diseased prostate tissue. The absolute number turns out to be fairly meaningless, as "normal" could be anywhere from .5 to 8, mostly depending on the size of your prostate and general health. It's best to have regular PSA tests, and to keep a chart of your results. A rapid increase in PSA is more concerning than a high absolute number.





Free PSA is the percent of PSA which isn't attached to protein. If it's very low, there is a higher chance that your PSA reading is caused by cancer.





A DRE can only detect cancer when it's extensive enough to be palpable. In parts of Europe, adoption of PSA testing has been slower than in the US, and DRE is still a preferred detection technique. But DRE will miss cancer in it's earliest, most treatable stage. In the US, the overwhelming majority of men are diagnosed with biopsy following abnormal PSA readings, and never reach the stage of having a positive DRE.





If I were in your place, I would take the biopsy. Although biopsy isn't the most pleasant experience, it's the only way to find peace of mind. If it's negative, I would continue being vigilant, and have PSA tests every six months, charting the results. Given your family history, it pays not to take chances.





What you can expect from the biopsy is a few minutes of discomfort, followed by a month of bleeding. It's not the worst thing that can happen to you.
Reply:I'm a pathologist in Romania and from my experience you have very little chance of having prostate cancer. First of all you are younger than the youngest man ever diagnosed with prostate cancer (he was 39). Second, the PSA level is a little higher than normal, not enough to suspect a cancer. Then, the DRE is normal what means there is a very low probability of cancer. But nothing is impossible and nobody can tell you 100% sure you don't have cancer without a biopsy.


So, my advice is to undergo the biopsy. Its result is the only thing certain so you will get the peace of your mind after it.


Good luck.


More about PSA, on my blog:


http://www.newcancerguide.com/what-is-ps...
Reply:I'm currently being treated for Prostate Cancer after Radical Prostatectomy last year. I agree that you should probably go ahead and get the biopsy tomorrow. Should you decide to wait know that you are not in a life and death situation at this point. Overall Prostate Cancer tends to slow growing so you could wait and have PSA tests done every 3 to 4 months and see what is happening.





You should Probably join the Prostate Problems Mailing List : PROSTATE@LISTSERV.ACOR.ORG





Also get the books "Beating Prostate Cancer, Hormonal Therapy and Diet"by Snuffy Meyers and "A Primer on Prostate Cancer, The Empowered Patient's Guide" by Stephen B. Strum, M.D. and Donna Pogliano. At least the later should be in your library. Do a Yahoo search on either title and you will find places to buy them.