Does Prostate Biopsy Result in Increased PSA

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PaulyA
New Member


Date Joined Apr 2013
Total Posts : 4
   Posted 4/3/2013 6:10 PM (GMT -7)   
Has anyone else experienced a sharp rise in PSA after having a Prostate Biopsy? PSA Before Biopsy = 3.1, After Biopsy = 12

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3764
   Posted 4/3/2013 6:20 PM (GMT -7)   
how long after biopsy?  a biopsy sure would make PSA rise but i don't know why a uro would order one soon after biopsy when a skewed reading would cause more harm than good.
 
ed
 
 
age: 58
12/09 -- PSA 6.8
G7 -- 3+4 (12-12 cores pos)
HT, BT and IGRT
9/4/12 -- 2.5-year post treatment PSA 0.1
(PSAs .2, .3, .2, .3, .2, .1)

PaulyA
New Member


Date Joined Apr 2013
Total Posts : 4
   Posted 4/3/2013 6:37 PM (GMT -7)   
Thanks for your reply Ed. The Blood Test was taken almost 3 months after the Biopsy was done. The Biopsy was negative. I was shocked at the result and almost wish I did not have the Biopsy. I am on Antibiotics and will have another PSA Test in a month. He said if it does not go down I would need another Biopsy. I am thinking I have an infection.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3764
   Posted 4/3/2013 7:13 PM (GMT -7)   
Pauly -- three months after a biopsy should not affect PSA.  and if your PSA is rising that quickly even while on antibiotics i can understand your uro's concern.  something is going on.  i only had one biopsy and my uro told me i had a 60-40 chance of having cancer.  he was right because i had 12 of 12 cores positive!  i hope the best for you.  keep us posted and welcome.  i'm sorry you had to join us but there's a chance you are just passing through  cool .
 
ed
 
 
age: 58
12/09 -- PSA 6.8
G7 -- 3+4 (12-12 cores pos)
HT, BT and IGRT
9/4/12 -- 2.5-year post treatment PSA 0.1
(PSAs .2, .3, .2, .3, .2, .1)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25341
   Posted 4/3/2013 7:18 PM (GMT -7)   
I agree with Ed. 3 months after a biopsy should not cause a rise, especially that sharp of a rise in the PSA. In my pre-diagnosis state, my PSA rose from 4.x to over 12.x in a year, with no infection, so a 2nd biopsy was ordered. Even the 2nd one came back negative, and in less than 2 months, PSA rose from 12.x to 16.x, again, no infection, so 3rd biopsy was done, and all 7 cores were positive with up to 90% cancer per core. Sometimes it happens that way.

Hopefully, you will stay clear, and not need permanent membership here. Good luck

david
Age: 60, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incont & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA 4/12 = 37.x
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries
Member of Prostate Cancer & Chronic Pain HW Communities since 10/2008
“I live in the weak and the wounded” – Session Nine (Movie)

starr15
Regular Member


Date Joined Apr 2011
Total Posts : 50
   Posted 4/4/2013 7:15 AM (GMT -7)   
A TRUS biopsy can cause a subclinical non bacterial prostatitis and it could last that long causing the PSA to stay elevated. However, cancer would be a concern too. Did your first biopsy show any HGPIN or ASAP at biopsy? I had a PSA that was around 4 prior to biopsy. 6 months later it was 17. Repeat 6 weeks after cipro it was 18. Right before second biopsy it was 8. Second biopsy 15 core was negative. Had low PCA3 scores. PSA just does things we dont understand sometimes.
You might consider an MRI/US fusion biopsy if you need a second biopsy. Might have to travel to get one.

tdnjam
Veteran Member


Date Joined Jan 2013
Total Posts : 508
   Posted 4/4/2013 10:34 AM (GMT -7)   
I didn't have another PSA after biopsy since cancer was found. But I have wondered if a biopsy that hits cancer cells contributes to the spread of cancer outside the prostate. My pathology report indicated Capsular penetration 1 to 2 mm and I just wonder if the 1 to 2 mm hole was the result of a biopsy needle. I guess there have been studies to prove or dis-prove this but I haven't bothered to research it. I can't imagine any Uro admitting they spread the cancer by doing a needle biopsy. Just my thought as I sit here on pins and needles awaiting the results of my first post op PSA tomorrow. Probably won't sleep a wink tonight.
Age 58
6/12-PSA 4.6, Biopsy 12/19/12 Positive 4 of 12
Gleason 3+4=7 T1C
DaVinci 2-14-13
Updated Gleason 4+3=7
Cancer present left mid and left base approximately 5-10%
Capsular penetration- 1 to 2 mm
Negative margins

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2206
   Posted 4/4/2013 11:14 AM (GMT -7)   
Welcome to the forum

A prostate biopsy can cause a PSA rise for about 6 weeks if I remember correctly (Mine went up from about 8 to about 13 in a week.)
But if the biopsy causes an infection that doesn't get (fully) dealt with, then the PSA can still be up quite a while after the biopsy.
I hope you will find that this second load of antibiotics work.
I was given antibiotics to start taking the day before my biopsy and continue for three days. But, when I went to my uro after a week, complaining of aches in my bladder etc he put me on a different type of antibiotics and for ten days. I never had any more PSA tests after that prior to my surgery, but the aches etc went away.

Alf
Age dx48
04/09 PSA 8.6, DRE neg. Biop 2/12 pos. G6
07/09 RALP in Amsterdam
PostOp G=3+4 Bladder neck & SVI -T3b. No PNI No vasc.inv. Clear margins
09/09 No pads
07/12 1 pad per day
11/09 PSA 0.1
03/10 PSA 0.4 04/10 CT.
Summer/10 66Gy SRT
09/10 PSA<0.1
01/11 PSA<0.1
04/11 PSA<0.1
07/11 PSA<0.1
10/11 PSA<0.1
03/12 PSA<0.1
08/12 PSA<0.01
03/13 PSA<0.01
Little ED

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8933
   Posted 4/4/2013 10:27 PM (GMT -7)   
I'm no doctor, but it sounds like a prostate infection. Biopsies inject fecal matter into the prostate. The bacteria there are becoming increasingly resistant to the fluoroguinolone antibiotics (e.g., Cipro, Levaquin, Avelox, etc.)

Here's what the AUA said...

Treatment of Infection:

Post-prostate biopsy infections may be serious and, if unrecognized, can lead to significant morbidity or even death. Patients must be counseled to contact their physician immediately if they have fever, lethargy, difficulty voiding, testicular swelling or symptoms suggestive of a urinary tract infection. Infectious complications after prostate biopsy include cystitis, epididymoorchitis, prostatitis, and urosepsis. If a patient demonstrates signs or symptoms of sepsis, immediate intravenous hydration and broad-spectrum antimicrobials should be initiated.

Once culture sensitivities have been ascertained, antimicrobials may be adjusted appropriately.Initial therapy must cover E. coli (the most common pathogen) as well as numerous other organisms. Prior to treatment, a urine culture (and blood cultures if the patient is febrile) should be obtained. Because of widespread ampicillin- and fluoroquinolone-resistance, alternative empiric antimicrobials should be selected.

Older studies evaluating resistance patterns in patients with post-prostate biopsy sepsis noted high rates of resistance to many of the commonly used antimicrobials and recommended the use of a second or third generation cephalosporin, amikacin, or carbapenem.More recent studies have noted significant resistance to fluoroquinolones (90%), piperacillin (72%), trimethoprim/sulfamethoxazole (44%) and even gentamicin (22). However, most of the current literature notes no or minimal resistance to the carbapenems (imipenem and meropenem) and amikacin.

In addition, the second- and third-generation cephalosporins maintain reasonably good sensitivities as well. Clinicians may choose from these options but should be familiar with their local antibiogram.


AUA/SUNA White Paper on the Incidence, Prevention and Treatment of Complications Related to Prostate Needle Biopsy
Allen
•3rd biopsy (4/2010):
PSA=7.3, prostate volume=55cc, 8 of 17 cores G6 5-35% involvement
•SBRT (5x8Gy) at UCLA, 10/2010 at age 57
•PSA since treatment:
+3 mos:3.9 +4 mos:3.5 +7 mos:3.0 +10 mos:3.7 +13 mos:3.6 +19 mos:1.18 +23 mos:1.29 +29 mos:.37
• Side Effects of treatment:
+2 wks: Grade 1 urinary & rectal last 1 wk
+1 yr: Grade 1 urinary last 2 months
no ED

Post Edited (Tall Allen) : 4/7/2013 2:10:37 PM (GMT-6)


PaulyA
New Member


Date Joined Apr 2013
Total Posts : 4
   Posted 5/11/2013 8:05 AM (GMT -7)   
Really unsure what to do. Finished Antibiotics (Cypro) retested PSA. Level went down from 12.1 to 10.9. Uro is ordering another Biopsy. I have been hearing alot about uneccessary biopsies being performed. They cannot be good for the body and is it a coincidence the PSA rose from 3 to 12 right after the Biopsy. The Dilemna I wrestle with is:

1. Did the Biopsy cause an infection of the Prostate that cannot be treated by traditional Antibiotics or:

2. Did the Biopsy itself awaken a sleeping Giant.

I have been reading about the Fusion Biopsy (combo MRI/Sono) and its effectiveness in detecting Prostate Cancers. Work is it is much more accurate. Has anyone had this type performed?

starr15
Regular Member


Date Joined Apr 2011
Total Posts : 50
   Posted 5/30/2013 5:44 AM (GMT -7)   
12 to 10 PSA change means no significant change.
I have just gone through a very similar event. See above post.
In addition, semen has been watery since first biopsy. No one knows why. I believe my first biopsy resulted in subclinical prostatitis.
I felt that an MRI and second biopsy were warranted to rule out an aggressive tumor not found on the first biopsy. It was a difficult decision. Also remember, one can have prostatitis and prostate cancer at the same time.
If you decide on second biopsy, I suggest get an MRI first. Then if second biopsy is negative, you will have more confidence that no anterior tumor was missed. Problem is you would probably have to travel to a place that does MRI/US fusion.
I empathize with you. This diagnostic dilemma is very frustrating and disruptive.
Keep us informed.

starr15
Regular Member


Date Joined Apr 2011
Total Posts : 50
   Posted 5/30/2013 8:53 AM (GMT -7)   
Also, you might get a PCA3 urine test. It is not elevated in prostatitis, however, it would have to be very low (under 10) to not biopsy.
My second biopsy was 9 months after the first biopsy.

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5383
   Posted 5/30/2013 1:07 PM (GMT -7)   
sometimes you need a very persistent anti biotic, cipro, not being one, there is one out there it fails me now tho. get a second opinion prior to 2nd biopsy and ask if there is a stronger antibiotic. Prostatitus can be chronic and very persistent.
Diagnosed 8/14/09 psa 8.1 66,now 70
RPP U of Wash,
pathology 4+3, tertiary5,
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gas,cough < 0.1 since. " Heard melodies are sweet, but those unheard, are sweeter" John Keats 1795-1821 age 25

pascal2014
New Member


Date Joined Jul 2014
Total Posts : 3
   Posted 7/12/2014 8:47 AM (GMT -7)   
Might want to also consider a new test to predict risk of aggressive cancer (Gleason >6) just launched this year with excellent clinical data behind it:

http://www.aua2014.org/webcasts/index.cfm?id=5947,5946,5944,5945,3810&title=6&Languageid=0

Available thru opko (opkolab.com).

toyoung
Regular Member


Date Joined Jun 2012
Total Posts : 148
   Posted 7/13/2014 4:17 AM (GMT -7)   
Pauly, My Dr. at Memorial Sloan Kettering recommends PSA testing every 6 months. He feels there can be to much fluctuations every three months. I am not a Dr., a rise from 3 to 12 in 3 months doesn't seem like PC. Would you consider getting a 3T MRI with a MRI guided biopsy? They are a lot more accurate then the more common TRUS.
2/2/12 PSA 5.3, 3.5, 3.9 Age 51
3/12 Biopsy 1 (23%) core of 12, Gleason 6
6/12 PSA 4.0 Free PSA 10%
9/12 2nd Biopsy All 12 cores Negative
2/13 PSA 4.2,
5/13 PSA 4.2
8/13 PSA 4.3
11/13 PSA 4.6
02/14 PSA 5.3
2/14/MRI Guided biopsy, one suspicious area, all 12 cores were negative
next psa in 6 months, mri in 12 months, another biopsy 24 mo.
Following AS at Memorial Sloan Kettering.
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