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How long to get a new PSA test after a biopsy

Shaker1521
Posts: 1
Joined: Jun 2018

I was recenlty diagnosed with prostate cancer.

I had a PSA done in September 2017 with a score of 4.5

Again tested in February and score rose to 8.5

 

Got the MRI and then a biopsy on 5/7/2018.  Geason is a 3+4

 

Went to a nationally recognized cancer hospital.

They drew blood for a new PSA test.  It was 15

 

CAT and Bone scans show no spread beyond the prostate as of 6/8/2018.

 

The urologhist at this hospital was very alarmed at the sudden rise since Februay.

The radiologist said the PSA is irrevelant because the biopsy was so recent.

I started complaining to the patient advocate asking why two highly trained and experienced doctors can look at the same results and have such widely opposing opinions.

The PA got someone from Urology in on the conversation and after some back and forth where I kept calling BS, finally admitted the Urologist was wrong.

 

So, my queston is:  How much time needs to pass between a biopsy and a new PSA test to ensure an accurate PSA score?

SantaZia
Posts: 64
Joined: Apr 2018

I was told that my PSA will go up after a biopsy. Your increase also could be caused by an infection related to the biopsy or it is going up because of the cancer.  I was also told that 3 months is a good rule. Also to limit my running or other similar activities and sex 3 days prior to test. Good luck!

Old Salt
Posts: 720
Joined: Aug 2014

Is the sudden rise in PSA, if true, due to prostatitis (infection) or to the biopsy (I gather that the blood for the PSA test was drawn shortly after the biopsy).

You should ask your urologist how long one should wait after a biopsy for a PSA test; the 'wounds' need to heal.

PS: I see that SantaZia gave a similar answer.

 

Regulator
Posts: 42
Joined: May 2018

I'm shooting strictly from the hip here, because I'm no doctor and I have no legitimate evidence other than my own data, but I had a biopsy in February and the urologist that performed the biopsy called for another PSA within 45-days or so, and he readily acknowledged that the trauma of biopsy does in-fact 'spike' the PSA. However, he also said his experience had shown that the temporary 'spiking' phenomenon was minimal (i.e., not capable of doubling an existing or pre-biopsy PSA value), and that it typically returned to its 'unmolested' (??) state within 30-days.

As for me and my own thoughts? I'm not so sure that I agree with him. My PSA had climbed significantly at that 45-day re-draw period, and a very recent high-rez 3T-MRI scan (done almost 100-days post biopsy), showed some tissue characteristics that the radiologist called "consistent with biopsy hemmorhaging". So, for my money, I wouldn't be surprised if research showed that the true recovery timeframe for the PSA value (post biopsy) was every bit of 90-days or potentially much more. But then again, I am admittedly, not a trained doctor.   

hopeful and opt...
Posts: 2218
Joined: Apr 2009

Shaker,

I am sorry for your diagnosis. Welcome to the board.

The CAT scan and bone scan can give false negatives, that is does not dectect the cancers that have escaped the prostate.

The T3 MRI uses the most powerful magnet in clinical use, and is preferred over the 1.5 magnet...and provides the greatest definition, that may show signs of extracapsular extension, that is if the cancer has escaped the capsule, where the cancer(s) may exist in the prostate, and ranks these tumors with likihood of cancer.

You mention that your Gleason is 3+4, however you did not mention how many cores, or the involvement, percent that was cancerous  of each core that was positive

There are various PET scans that are available that determine where cancer may exist outside the prostate, which I beleive can be appropriate in your case, since your PSA is very high. There is an axium one that is medicare approved, which is good, however there are better ones, for example a PSMA that are considered investigational however more accurate results....they are available by cash for about 3K or part of a clincial trial.

The biopsy is the critical information, however the very high PSA is of concern, and is an indicator...please be aware that many factor can cause a rise in PSA; infection, large prostate( the size of the prostate is in the MRI report), sex before, bike riding and other exercise before......you may ask for another test called a  FREE psa test

 

 

 

Lola52's picture
Lola52
Posts: 7
Joined: Jun 2018

The machine mentioned above found out there was something in my hub's prostate that was very likely to be a PC. (PI RADS 5) Given that the image was so clear, in this third biopsy (had had two negative  previous to this one) the doctor could easily get to the suspiciois area and take the right samples. Then he had Da Vici surgery and the tumor turned to be very similar to that described by T3 TESLAS. 

I wish the best to you, Shake.

Lola.

 

Old Salt
Posts: 720
Joined: Aug 2014

That's how it's supposed to work. The high-definition MRI identifies suspicious areas which allows the biopsy to be targeted. 

I have read that there is a relatively novel instrument where the two are combined into one (at considerable cost, of course).

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