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Thread: Husband Needs Biopsy for Prostate

  1. #1
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    Post Husband Needs Biopsy for Prostate

    Hello! My husband is 52 (family history: his dad had prostate cancer when was in his 50's and is still kicking at 87, he had seed radiation, his mother died of lung cancer in her 60s). My husband has had his PSA checked for the last 2 years. Readings were always 2.1. This month, his reading was 3.9 (an almost double jump). Primary sent him to Urologist, who did a DRE, he found nothing remarkable except slight enlargement of prostate. Husband has no urinary symptoms at all except he pees often. Urologist took another PSA test after the exam (does this make any difference, I read that this should be done before the exam?). His reading was 3.44. Urologist still recommended a biopsy next, even though he is not outside of the normal 4.0 range. We're in the process of scheduling it now. Does this sound typical to biopsy with his readings? I'm so worried, my husband doesn't have a spleen so I worry about infection or worse. Glad I found this forum, lots of great info on here!

  2. #2
    Hi and welcome.

    I'm 48 and my PSA was rising consistently for nearly a decade and my pcp ignored it. I was biopsy high since 2013.

    I would say have the biopsy. It is really the only thing that can say either way. There are high grade cancers that spit out small amounts of PSA that would be my worry.

    I also have bph so it could just be that your husband's psa is driven by the size of the prostate.

    I'm a play it safe type so I would have the biopsy.

  3. #3
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    There is no normal PSA, imo. 3.0 to 4.0 is the range for testing with studies indicating testing sooner produces better outcomes. Your husband is young for this. His PSA is expected to be less than 3.0 by some.

  4. #4
    Hi and Welcome jjbean66! It is always best to follow the advice of an expert URO MD. Having a PSA drawn following a DRE may result in a PSA elevation due to the DRE.

    You should ask your MD if your husband is a candidate for an MP 3T MRI that can later be "fused" with a TRUS Biopsy, if the MRI determines that biopsy is needed.

    At this current time point, Biopsy remains the only way to diagnose prostate cancer (PCa). Biopsies are small samples of prostate tissue. Existing PCa can be missed by biopsy. Also, biopsies are not free from potential complications. For most, biopsies are not a painful experience. The anticipation leading up to the biopsy is worse than the actual procedure!

    Keep in mind that IF he is harboring PCa, you want to find out now. As with nearly all Cancer, early detection offers the best opportunity for complete cure.

    Hoping that he does not qualify for membership to "The PCa Club!"

    Keep us updated!

    MF
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Referred to URO MD
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = G7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left: PM + EPE. MD waited in surgery for preliminary Path Report then excised substantial left adjacent tissue(s) down to negative margins and placed 2 Ti clips for SR guidance, if needed in future.
    Pathology: Gleason (3+4) pT3a pNO pMX pRO c tertiary pattern 5 / Prostate Size = 32 grams / Tumor = Bilateral: 20% / PNI: present
    3 month Post Op standard PSA = <0.1 ng/ml
    1st uPSA at 7 months Post Op = 0.018 ng/ml
    uPSA remains "stable" at 91 Months Post Op: Mean = 0.022 (22x uPSAs: Range 0.017 - 0.032) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  5. #5
    @jjbean66.... I won't tell you to worry because its a natural and human reaction. I can tell you I was in the same situation you are about 7 mths ago. I was terrified, nervous and any other emotion you can think of..

    However, there is light at the end of the tunnel. I would recommend you doing the biopsy.. But I would do a MRI/Tru biopsy.. Better Than Them just poking a needle around in areas where they may be no Pca and missing the areas that does. The biopsy wasn't that bad for my husband. More of his male ego being hurt than the actual procedure itself.

    My husband was 42 at time of diagnosis. Mri showed leisons and biopsy confirmed G6 pca. We opted to act swiftly and not prolong this. Just seemed to be the right thing as with anything in life. Early Detection is key. My husband had Ralp on 6/5. Has regained full continence and had no ED issues. Recently he started to take ED meds to make sure the blood flow continues, due to we noticed it was taking a little longer to get stimulated than we would like. Since taking ED meds, no issues.

    We were blessed to get our final path back and it was confirmed a gleason 6(many times an upgrade to the gleason can happen) All margins and adverse findings were negative. I truly believe had we opted to not have surgery since his pca was only 3.04 that over time, we would have not gotten the results we did.. This forum is full of knowledge, I'm limited but I don't mind sharing my experience - woman to woman if you have questions. Feel free to DM me

    I've learned a lot from my. FBs and FSs

  6. #6
    The 4.0 is just a suggested range. An increase from your previous base can indeed be a sign that a biopsy is warranted.

    When I was your husband's age, my PCP sent me to the urologist after I scored a 3.5 after the previous year I scored a deuce.

    The urologist told me to get a PSA in 6 month, I did it and scored a 2.5 and didn't go back to the urologist until i went over 4.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3, PSA test 7/2019 2.0


    DOB 1956, in Pittsburgh, USA

  7. #7
    My Psa increased at a steady rate until it went from 3.2 to 4.1. I was about 54 at the time. My PCP sent me to a Uro, but the next Psa came back at 3.4. Uro said it was under 3.5 so nothing to worry about. At that time there was (and probably still is) a great amount of negative opinions and literature on Psa testing. My Uro said I was probably fine and didn't push for the biopsy, so neither did I. My Psa leveled around 3.5 for another 2 years or so before it jumped up to 4.6 and finally 5.9. Ultimately, my biopsy showed 7 positive out of twelve. My pathology after surgery (different Uro!) indicated 50% involvement with multiple positive margins. I sure wish I would've pushed for the biopsy two years earlier.
    If you decide to pass on the biopsy I would understand, but I wouldn't wait a year to test your Psa again. Test every 6 months or less.
    YOB 1957, Age at Dx 57. Pre-surgery psa 5.9, 5-27-2014 RP, T2c, 3 G7 (3+4), 4 G6 (3+3). 50% involved. Prostate 28g. +2 margins (lateral, apical). Post surgery psa <.006, 19 month psa 0.023 on 12-16-15.
    70gy/35 SRT finished 2-16. No ADT. 3 mo Post SRT Psa on 4-16-16 0.02 (no change), 6 mo 0.009, 9 mo .006, 12 mo .008, 15 mo and currently <.006

  8. #8
    Moderator Top User HighlanderCFH's Avatar
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    Welcome to the forum, jj,

    I agree with the others that a biopsy is probably wise at this point. But I also suspect that the biopsy will be negative. But, with his family history of PC, it is best to check it out.

    Having too pee more often is a prime sign of BPH (enlarged process). This is a benign condition, but could also account for his rise in PSA.

    And, yes, your husband should never have a DRE just before a PSA test. In the 48-72 hours before the blood draw, do NOT: have a DRE, have sex (sorry!), ride a bike or perform any strenuous exercise.

    Please keep us in the loop on how things develop.

    Take care,
    Chuck
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  9. #9
    Regular User
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    Thanks everyone for your replies!! So great to find this forum, it does help! Oh yes, he is definitely getting the biopsy!! No question, especially with his dad having PC in the past. We are in the process of scheduling it now. I've been a wreak because 3 years ago THIS month I was diagnosed with Uterine cancer and had a radical hysterectomy with DaVinci robotic (no complications, had a wonderful surgeon), followed by 5 rounds of brachytherapy radiation. Happy to report as of today, I remain cancer free. As tough as this is to possibly go through again with the person you love as your whole world, well I tend to stay ahead of the horse and my husband does too after seeing what I went through you just become a realist, no waiting around!

    I'll report back with his results thanks again!!


    Quote Originally Posted by HighlanderCFH View Post
    Welcome to the forum, jj,

    I agree with the others that a biopsy is probably wise at this point. But I also suspect that the biopsy will be negative. But, with his family history of PC, it is best to check it out.

    Having too pee more often is a prime sign of BPH (enlarged process). This is a benign condition, but could also account for his rise in PSA.

    And, yes, your husband should never have a DRE just before a PSA test. In the 48-72 hours before the blood draw, do NOT: have a DRE, have sex (sorry!), ride a bike or perform any strenuous exercise.

    Please keep us in the loop on how things develop.

    Take care,
    Chuck

  10. #10
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
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    7,296
    We'll be waiting to hear his results.

    He is as lucky to have YOU for his support as you were in having HIM when you were going through your own ordeal.

    That's a winning combination -- and I'm sure you'll both continue on as winners in the war against cancer.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

 

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