Truck Driver, With your PSA and free PSA numbers you have to get a biopsy, the other alternative will be much less pleasent in the long run.
I've had a total of 13 biopsies, so I know a little about them.There are several possible ways you can go.
You can go to a doctor that will sedate you. In this case get as many samples as you can, at least 24.
You can find a doctor that gives a lidocane shot, this decreases the pain a lot. Also take a vicodine, this helps with immediate and post pain and won't cause bleeding. (Docs won't tell you this).
You can get a color doppler targeted biopsy. This is by far the best method as it is the most accurate; if there is no suspicious area no biopsies are taken. If a suspicious area is seen only that is biopsied. Rarely are more than 6 cores are taken. If nothing is found then a base line picture is established to compare changes. If cancer is found it can be accurately staged as to exact location and tumor size. A normal biopsy can't do this.
The only problem is there are only a few doctors that are skilled in it's use. Dr Fred Lee in Mich, and Dr Duke Bahn in Ventura Ca are two that I know of; there may be a couple more around. If anone knows of other good doctors that use this please let this forum know.
After 13 biopsies I would only get another color doppler biopsy, even if it meant flying across the country. It's that much surperior to a normal biopsy.
I had a psa of 4.4 in 1999 and steadily increasing psa every 3-6 months before reaching 40 in 5-08.Free psa ranged from 16 to 10%
I had biopsies every year, 13 total in all. I saw 5 different doctors, all urologists or urological oncologists at Long Beach, UCLA, UCSF and UCI and had an MRIS at UCSF in 2007. All tests were negative and I was told that because of all the biopsies I most likely didn't have PC, but to keep getting biopsies every year.
in Oct 08 my 13th biopsy of 25 cores indicated 2 positive cores, gleason 3+3 less that 5% in 2 cores. Doc recommended surgery.
2nd opinion from a prostate oncologist, referred by my wife's oncologists said cancer found wis indolant and statistacally insignificant, but PSA histor was a major concern and ordered a few more tests.
Color Doppler ultrasound with targeted biopsy found a transition zone tumor 18mmX16mm, gleason 3+4 and 4+3. CT and bone scans clear, but Doc thinks that there may be lymph node involvement (30% chance) because of my high PSA, and referred me for a Combidex MRI in Holland, currently scheduled for Feb 14.
Changed diet and takiing supplements while I wait. The location of the tumor plus the high psa make surgery an unlikely option. I'm still evaluatiing all treatment options and will make a decision once I get the results of the Combidex scan.