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Thread: QUESTION ABOUT BIOPSY _Got 0 OF !2 NEG

  1. #1
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    QUESTION ABOUT BIOPSY _Got 0 OF !2 NEG

    Hi, my 1st post, hope it is ok. My doctor said my PSA was 6.5 and free psa 14 , so sent me for the biopsy last friday. I was given 3 Levaquin to take for the biopsy. Anyhow took it easy over weekend with some fever,etc. But Sunday night my fever got up to 101.5 , Monday I called the Uroligist and they gave me 4 more Levaquin for Mon. to Thurs. My temp went to 103.3 Mon. after taking the 1st pill at noon. Got fever down after talking with the Uroligist. GOOD NEWS Tues. my biopsy results all negative. Just wondering if this has happened to anyone , Thank you for reading. Edit: i need add I'm 60 years old had no symtoms prior to biopsy, now I wonder what caused the elevated Psa

  2. #2
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    They did not find my PC until the third biopsy...Having multiple biopsies is fairly common.. Using the rectal probe, there are areas of the prostate that can not be reached by the biopsy needles..In "difficult cases" they can do a "saturation biopsy", 40 cores, done differently that finds it if it's there....

    You need to KEEP wondering what is causing the elevated PSA..Take a glance any my signature..
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5. 10/14 PSA 0.6, T-11

  3. #3
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    A positive biopsy is a definitive diagnosis. A negative biopsy means either you do not have or they did not find it this time. The advice from biopsy veterans like Fairwind and I (4 times) are you just have to watch it from now on if your PSA keep increasing.

    What I learned from my 4 times is that preparation is very important to minimize infection. Often, we did not take the antibiotics precisely as prescribed or did not thoroughly clean out our bowel before the procedure. Now you know.

    By the way, we are very happy to reject your membership to our club.

    Take care.
    PCa Dx at 65. PSA 2.5 in 2000, 8.4 in 6/09. Three negative biopsies in between. 6/10 PSA 10.7, biopsy 1 of 12 cores 5% cancer, Gleason 3+3
    CT, bone scans & MRI all negative
    Da Vinci 8/10; nerve sparing, catheter out in 7 days; no incontinence, no ED
    Post Op Pathology pT2N0Mx: organ confined; negative margins; lymph nodes & seminal vesicle not involved but PNI present; cancer extensive within prostate, multifocal G 3+3 and tertiary G 4+
    9/10, 12/10, 12/11, 12/12, 12/13, 12/14 PSA <.1

  4. #4
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    Yeah, I don't want to rain on your parade either, but as stated above a negative biopsy could mean they just missed the tumor. Or when they sliced off a piece for the pathology report they missed it. I only had one positive core but the tumor occupied 20% of the prostate, and they did a 12 core biopsy. Plus, I had two different pathology reports, one reported 40% of one core and the other only 1% because of how they sliced it. Something's causing your numbers, you need to be aggressive until you find out for sure what. Best of luck to you.
    Age 55 at Dx
    PSA 1.34 10/08
    PSA 1.93 04/10
    PSA 4.1 10/11, Free PSA 20%
    Biopsy 12/11 - One core 40%, rest negative, T1c, Gleason 3+3, Some PNI, Prostate 47.4g, PSA Density .086
    RALP City of Hope/Dr. Wilson 2/15/12. Pathology: Prostate 52 grams, 20% total involvement (bilateral), N0MX,
    T2c, Gleason 3+3, margins clear.
    PSA 3/12, 6/12, 10/12, 01/13, 06/13, 11/13: Undetectable

  5. #5
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    Thanks for the replies, I thought I took the antibotics and did the fleet the morning of biopsy as instructed . ? Anyhow, I got a little sleep last night. Hope this 4 pills clears up whatever is causing my fever ,last Leviquin today. I'm self-employed and buy my Insurance.

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    The elevated PSA could be from PCa that the biopsy needles missed, or could be from prostatitis, literally an infection of the prostate, which because it irritates the prostate, kicks up the PSA.

    So excuse us for hoping that you're sick, and therefore not eligible for club membership.

    Prostatitis, BTW, is reported by all to be a bear to cure, so don't be surprised is 7 days of antibiotics doesn't get it done.
    age 60
    PSA 7.5
    Gleason 3+4
    HIFU June 10 Bermuda Dr Scionti
    Salvage HIFU April 11 Bermuda

  7. #7
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    flody1 - my temp spiked to 103.5 the night after the biopsy and I could not control body temp. I was shivering uncontrollably, even in a warm bed then bath tub. Ended up spending 3 days in the hospital with sepsus (blood infection) from e.coli in the blood. A gift of the biopsy. I'm guessing you may have an infection, but hopefully just a UTI and they can deal with it with oral antibiotics. I'm surprised the Uro only had you do a few days. If they suspect an infection, which they obviously do given they gave you antibiotics, it is usually a couple week course of meds to kill it. Watch your temp carefully after you finish the meds. If it comes back up, talk with them immediately.

    Hope all is doing better for you now and it all goes away. It's nice to have that negative biopsy, and hopefully you don't have PCa. However as others have said, that elevated PSA is an indicator of something going wrong. Make sure your Uro gets to the bottom of it. You may only have a small volume of cancer and the needle biopsy did not hit the spot. At least if that is the case, it is very early and easily treatable should it show up in a biopsy in the future.

    If it were me, I'd be watching that PSA closely. Do another one 3 months or at most 6 months and see if it keeps rising. No sense doing one shortly after a biopsy, it will be falsely high. I had a Medical Oncologist do one 2 weeks after biopsy and it was 8.0. All other doctors said it was a silly thing to do because it would be known to be high and of no value.

    Good luck.
    Age 49, healthy, physically very active
    PSA 6.9
    DRE felt nodule on right side
    Free PSA 13%
    Biopsy 10/24/11, Gleason 3+4, all cores positive
    Surgery 1/26/12
    Pathology: T2c, Gleason 3+4, 1 mm positive margin at apex
    PSA 3/9/12 - 0.01

  8. #8
    Moderator Top User HighlanderCFH's Avatar
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    Hi,

    Has your urologist mentioned anything about having an enlarged prostate? Before my PC developed, I had BPH for years, which had initially been the reason for my elevated PSA. The general rule is "the larger the prostate the higher the PSA." This is simply because the prostate creates the PSA in our bloodstreams and larger ones will naturally produce more PSA.

    And, as others have suggested, a negative biopsy could simply mean that any tumors did not happen to be in the path of the biopsy needle. When I had a biopsy last August, the doctor took 20 cores (instead of the more customary 12) because my prostate was so much larger than normal. He took a cross section of cores guided by an ultrasound probe. After he finished, I asked if he saw any suspicious areas through the ultrasound images -- and he said no. I felt pretty confident after that.

    But yet, my results came back malignant as 3 of the 20 cores were cancerous (all three were about 20% malignant). After surgery, I learned that my prostate was 98 grams and the tumor (only that one tumor was found in the post-op pathology) was only 2 grams. A small tumor within a very large prostate. So I guess I was lucky that my urologist was so thorough because a smaller number of cores may well have missed the tumor.

    But it is still very possible that your PSA reading could be from an enlarged prostate if your doctor may have mentioned BPH to you.

    In any event, future biopsies may be the best way for you to play it safe. I hate saying this, though, because I did not really enjoy the one biopsy that I had.

    Good luck!


    July 2011 Local PSA lab reading 6.4 (from 4.6 in 2009). Sept. 2011 Mayo Clinic PSA lab reading 5.7
    DRE revealed no lumps, just severe BPH.
    Biopsy early Aug. 2011, 3 of 20 cores cancerous (about 20% of each core).
    Gleason 3+3, pT2c, NO, MX, R1 adenocarcinoma.
    DaVinci prostatectomy Nov. 1, 2011.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left mid posterior prostate.
    right posterior margin involved by 0.2 cm.
    first post-op PSA less than 0.10 on Feb. 13, 2012.
    Last edited by HighlanderCFH; 03-21-2012 at 08:12 AM. Reason: slight revision

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    Update: 9-2012 , PSA 7.7 and Free PSA 7.9 at my family doctor . Watching & waiting . Uro's next step prostate massage test 9-11-12. Thanks for all the advise.
    Last edited by flody1; 09-06-2012 at 08:46 PM.

  10. #10
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    You need to be in the driver's seat when it comes to your healthcare. And if I were you, I'd be insisting on another biopsy. Now.
    Age 55 at Dx
    PSA 1.34 10/08
    PSA 1.93 04/10
    PSA 4.1 10/11, Free PSA 20%
    Biopsy 12/11 - One core 40%, rest negative, T1c, Gleason 3+3, Some PNI, Prostate 47.4g, PSA Density .086
    RALP City of Hope/Dr. Wilson 2/15/12. Pathology: Prostate 52 grams, 20% total involvement (bilateral), N0MX,
    T2c, Gleason 3+3, margins clear.
    PSA 3/12, 6/12, 10/12, 01/13, 06/13, 11/13: Undetectable

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    Newbie13, when I go for the PCA3 test, I,m going to ask about the tenderness below my testiicles ( in the tube bundles)and Prostatitis tests. I have not had test for that yet . Wishful thinking maybe????
    Quote Originally Posted by newbie13 View Post
    The elevated PSA could be from PCa that the biopsy needles missed, or could be from prostatitis, literally an infection of the prostate, which because it irritates the prostate, kicks up the PSA.

    So excuse us for hoping that you're sick, and therefore not eligible for club membership.

    Prostatitis, BTW, is reported by all to be a bear to cure, so don't be surprised is 7 days of antibiotics doesn't get it done.

  12. #12
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    You need to consider a second biopsy unless the Urologist can explain your PSA levels satisfactorily..If it's the same Uro that did the first one, he knows (has a map) of where he placed the first biopsy needles. This time, he should try for slightly different areas than he sampled the first time....JMHO....

  13. #13
    75% of the 1 million biopsies done each year in the US are negative. So your result is the norm and not the exception. After two negative biopsies and continued rise in psa a saturation biopsy or a color doppler guided biopsy are highly recommended. I had 13 biopsies before cancer was found by a color doppler.
    psa at diagnosis 40 in nov-08
    gleason 6 and 7
    Treatment choice seeds and IMRT

  14. #14
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    Quote Originally Posted by flody1 View Post
    Update: 9-2012 , PSA 7.7 and Free PSA 7.9 at my family doctor . Watching & waiting . Uro's next step prostate massage test 9-11-12. Thanks for all the advise.
    Pca3 test came back 35 , Dre normal, Uro will retest in 3 months. Thanks for the input.

 
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