Brother had biopsy with a PSA of 1.8 ?

Ok my brother is 68 and has had a PSA of 1.8 for awhile .
Nothing felt on digital but they ran what he said was “ some other test”
Then they did a biopsy ...
I can’t imagine with a 1.8 PSA with no rise and normal digital why a biopsy

Just wonder with a low PSA and normal digital why would they even do a biopsy ?
He said “ they did some other test that scores from 1-5 and mine was 4 and that’s why they did a biopsy “

cvc said...
Just wonder with a low PSA and normal digital why would they even do a biopsy ?
He said “ they did some other test that scores from 1-5 and mine was 4 and that’s why they did a biopsy “

you would think he would know the answer to your question since he was the one getting the biopsy, which is not a casual or pleasant procedure

cvc said...
Yea I agree .. I know I would have asked

you are asking haha

My question to him was , why if they just ran a PSA and it was 1.8 . And no other issues or anything with the digital ...
Why did they do an MRI then a biopsy ..
Somehow I think part of the story is missing

Its a very slow rise, that i suppose could be attributed to age. But it is a rising trend nevertheless. I dont know enough to know if that kind of a slow rise warrants an MRI or Biopsy

My first biopsy was with a PSA of 1.7, the trend was clearly up, about 2 years before it was 1.1m then 1.3 something like that. It gradual, but wasnt as slow as your brothers.

I just asked him again .. he said it was his normal yearly check up ..
PSA was 1.8 and had been the last couple years , digital was normal ..
But they did some “ other” test that came back 4 out of 5
Sent him for MRI then biopsy ..
I can’t imagine with normal PSA and digital and no other issues what would cause them to do the rest ..
He meets with the URO tomorrow for results ...
This seems weird to me .. maybe I’m missing something ??

cvc said...
?? He didn’t have a rise in psa

You are right I didn’t. Notice the 2018 and 2020 PSA was the same, sorry. I was focusing on the #s prior to 2018

My guess is that he had a Pirads 4 score from an MRI. A 4 would indicate probable need for a biopsy. Depending on the biopsy outcome he obviously needs to get more knowledgeable and involved...but that's just stating the obvious.

Jim

cvc said...
Yea my whole question is why they felt the need for any of this if PSA was steady at 1.8, digital normal, no other symptoms on a 68 yr old man

Do you know for sure he had no symptoms? They wouldn't do a mpMRI on someone with no signs or symptoms. I hope the PIRADS 4 lesion(s) turn out to be nothing.

You should read the above paper on low-PSA PCa.. The plot of PSA vs. significant PCa is U-shaped, unfortunately, with serious, sometimes metastatic, cancer accounting for the low-PSA arm of the "U"..

Djin

Well I just reconfirmed .. he said general yearly check up , normal Dre, 1.8 PSA and no complaints or symptoms .
I do agree,, I don’t understand I’d Dre and PSA were normal and no other issues why would they check anything

@cvc, sorry, i have screwed this up so badly in my attempt to be helpful, that i think i will back off this thread and leave it to the others from here LOL.

@Melanie, no that was my first biopsy, which was negative, 2 years later i was diagnosed with PSA of 4.3

It's also possible there was some degree of misunderstanding or misscommunication between doctor and patient.

Djin