There was a rush to biopsy that should have been avoided. It's tragic that you had to go through all of that. He is quite right that all that irritation has made your PSA go up. The problem now is that those resistant e coli have been injected into your prostate, causing prostatitis. Antibiotics may get rid of the bacteria in your blood, but they are seldom able to get rid of the bacteria introduced into your dense prostate that is not as well suppled with blood vessels compared to most organs.
So I would expect you to have prostatitis for a long time, and that may cause your PSA to skyrocket sometimes.It usually relapses and remits, so if you wait long enough it probably will go down at some point. But it is impossible to know when. A see-saw pattern of PSAs is typical of prostatitis.
HGPIN, although it is labeled a "pre-cancerous condition" often does not lead to cancer (just as every mole does not lead to skin cancer). In one study (below), only 27% of those with a negative biopsy and HGPIN were found to be positive on a follow-up biopsy vs. 22% who had no HGPIN - not a meaningful difference. But what is interesting is that in those who had a positive follow-up biopsy, disease characteristics were found to be more
favorable among those with HGPIN.www.canjurol.com/abstract.php?Articleid=&version=1.0&PMid=26688133
So how can you rule out prostate cancer without undergoing another unnecessary biopsy? First, there is a blood test called prostate Health Index (PHI), which is less affected (but not entirely unaffected) by prostatitis because it is PSA based.
There is a genetic test called Confirm Dx. It analyzes your biopsy tissue from your negative biopsy to see if there are certain epigenetic markers that have found to be predictive for prostate cancer. If Confirm Dx does not find any of those markers in your biopsy sample, you have about
a 90% chance that a follow-up biopsy would find no evidence of cancer.www.jurology.com/article/S0022-5347(12)04906-3/fulltext
I don't know the cost or whether your insurance will cover it, but I think it is your best hope of avoiding another biopsy.
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: 0.1,no lasting urinary, rectal or sexual SEsmy PC blog