Biopsy without any bleeding

Ken,

Good for you. I had no blood in my urine but did have the rusty semen. It might be the few cores that your Doctor took. I had 15 cores takes, 3 from a PIRADS 4 lesion that turned out benign. It was good thing my Urologist in my case did the additional grid random as that it where my cancerous cores were.

i did have a MpMRI and nothing else suspicious was seen. My urologist did the biopsy and it was a MRI fusion guided biopsy so he went first to the PIRADS 4 lesion. When I met with him a week later for the results, he even expressed his surprise at what was found. I imagine a interventional radiologist probably just goes for the lesions.
i would watch your PSA . I don’t recall my exact numbers right now but for years it was at 1.9, then went to 3.0. My Doctor then retested in a month, went down to 2.7, quarterly check down to 2.4 (thought I was out of the woods) on my next quarterly I though maybe back to my number, but surprised back up to 3.2. We continued quarterly checks with it bouncing around. Then we did an ExoDx urine marker test and it found cancerous markers that would place my cancer more aggressive. That was thrn off to the MRI. My PSA never went over 4. I would make sure for at least the foreseeable future you get quarterly PSA checks and ask your Doctor about the ExoDx test. You can google it. If your number was high above their threshold low risk, you might want to consider discussing with your Doctor about another biopsy. It is not unusual for cores to show the cancer that were not targeted cores.

The value of prostate biopsies is being questioned but in a light to reduce unnecessary one’s that determine a person’s cancer is low risk or a Gleason 6. The PSA may be heightened or risen but not extremely and too often everyone is rushed into the biopsy even though the result then turns out low risk. That is why they are turning to newer tests all to try and find out if the cancer likely is clinically significant before the decision of the biopsy then if so at that point to get the Gleason grade of the clinically significant cancer. That is the purpose the non invasive ExoDx urine test checking for biomarkers that are associated with aggressive prostate cancer. If it comes back low risk, a biopsy for the time being can be avoided.

Fair point Old Salt, let me be clear. I think the value of “random” biopsies is being reconsidered in the MRI era vs targeted only.