Where you go depends on what you already know. A few questions:
(1) Was an effort made to rule out other sources of elevated PSA?:
- enlarged prostate (BPH)
- urinary obstruction
- sex or bike-riding 2 days before the PSA test
(2) Are there any clues on your biopsy report?:
- evidence of acute or chronic inflammation
If other causes have been ruled out, you might want to talk to your Uro about
the least-invasive, and lowest-cost diagnostics first. That might include a PCA3 urine test after a prostate massage, and a PHI blood test (don't get blood drawn right after the prostate massage). Those are both covered by insurance or Medicare. PHI includes PSA and free PSA as part of it, so you would have this instead of your next PSA test. Your Uro can order a PHI test through the following link:/www.accureference.com/phi/
There are several other, more expensive blood tests, but they are all about
equal in detecting PC. If PCA3 and PHI are negative, you might want to wait 6 months and test again. If they are positive, you might want a different kind of biopsy next time.
There are 2-4 kinds of biopsies worth considering. The more widely available ones are:
• Multiparametric MRI-targeted biopsy. This looks for areas suspicious for higher grade cancer, and they can take some extra cores from that area. This depends on having an experienced radiologist.
• Transperineal template mapping biopsy. This very systematically takes a lot of cores (often, about
30) from every part of your prostate.
They can even do both of those together. You often have to go to a large regional cancer center to have these done.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEsmy PC blog