Should I get an biopsy?
Hi, I was on therapy for low testosterone for several years until my annual exam with my urologist showed my PSA had risen to a 2.91 from 1.75 within a year. So we stopped the testosterone therapy to see if my numbers would go down. My PSA went down to 1.93 in September of 2022. I caught a bad uti in October of 2022 and sought treatment. When it was time for my yearly checkup with my family doctor she ordered my bloodwork including a PSA. It came back at 3.61 which is very concerning. So I just had bloodwork done for my yearly exam with my urologist and it came back at 2.61. They are recommending a biopsy since I’m an African American male who tend to be higher risk. They told me insurances don’t like to pay for MRI first they prefer the biopsy. Is this true? Could I have BPH? What do you guys suggest I should do because now I’m very nervous? Also, I’m going tomorrow to seek a second opinion.
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I was told same thing about insurance and MRI but, had them submit paperwork and insurance did cover it before biopsy. My MRI showed nothing while psa continued upward, 6 months later biopsy confirmed my pca. Cancer may not be cause of PSA rise. Get second opinion. If PSA continues to increase biopsy is only way to confirm PCa.
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If memory serves me right, I had a 3T MRI to support a guided fusion biopsy. Pretty sure this guided biopsy took samples from suspicious areas (from the MRI) and actually samples from the entire gland. Obviously, the MRI had to come before the biopsy in order to do this. I did not have to fill out any paperwork to get my insurance to pay. I am on Medicare and have a supplemental. As Rob.Ski says a biopsy "is the only way to confirm PCa." Best of luck on your journey.
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Your up-and-down PSA may be due to the reasons already pointed out, such as BPH. But I second the proposed biopsy to rule out (for the time being) prostate cancer.
An MRI guided biopsy is 'state of the art', but if you can't get that procedure, a transperineal biopsy is preferable over the conventional (transrectal) one.
Wishing you the best and feel free to ask further questions or clarifications.
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