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Answered in 1 hour by:
10/26/2010
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20,444
Experience: I am fellowship trained specializing in general urology and reconstructive urology.
VerifiedHi there,
Thanks for your question. Please be patient for a response as I may be in the OR or driving, but will get back to you ASAP.
WHile your PSA is the highest it has ever been and your free PSA is suspicious for you having prostate cancer, you also had these similar stats in the past when your biopsy was negative. If you have more than 10 years life expectancy left, then we generally recommend that a biopsy be done to rule out prostate cancer. However, this is totally up to you and it is your decision as to whether or not you want to go opening up a whole bag of worms (ie. finding prostate cancer and then having to worry about what to do about it). Treatment options are not benign (ie, surgery or radiation) except for active surveillance, but even then this involves watching your PSA if a diagnosis of cancer is found on biopsy and then repeating a biopsy in 1 year to see if the cancer become more aggressive or not. This would give you at least an additional year without having to be treated. The fact of the matter is that about 30-40% of men your age has prostate cancer anyway and most of them go on to die of other causes without even knowing they had prostate cancer. So you just have to take these facts into account and discuss them with your urologist. Hope this helps.
Thanks for your question. Please be patient for a response as I may be in the OR or driving, but will get back to you ASAP.
WHile your PSA is the highest it has ever been and your free PSA is suspicious for you having prostate cancer, you also had these similar stats in the past when your biopsy was negative. If you have more than 10 years life expectancy left, then we generally recommend that a biopsy be done to rule out prostate cancer. However, this is totally up to you and it is your decision as to whether or not you want to go opening up a whole bag of worms (ie. finding prostate cancer and then having to worry about what to do about it). Treatment options are not benign (ie, surgery or radiation) except for active surveillance, but even then this involves watching your PSA if a diagnosis of cancer is found on biopsy and then repeating a biopsy in 1 year to see if the cancer become more aggressive or not. This would give you at least an additional year without having to be treated. The fact of the matter is that about 30-40% of men your age has prostate cancer anyway and most of them go on to die of other causes without even knowing they had prostate cancer. So you just have to take these facts into account and discuss them with your urologist. Hope this helps.
THis notion that Dr. Douglass has about a biopsy spreading cancer is absolutely false as this just does not happen. Hundred of thousands of biopsies are performed each year without this problem. Trust me, if it did happen, it would be all over the news and we would have to stop screening for prostate cancer with our current means. The AMAS test has been found to be unreliable in the diagnosis of prostate cancer. However, there is one good option that I think would fit you well. This is a urine based test called the PCA-3 and is designed for men in your scenario (ie, negative prostate biopsy in the past with persistently elevated PSA). Here is the link to this test and you should ask your urologist about this as it can help to determine your odds of needing a repeat biopsy.
http://www.pca3.org/public
Hope this helps and please don't forget to hit accept so I can get credit for helping you. Thanks.
http://www.pca3.org/public
Hope this helps and please don't forget to hit accept so I can get credit for helping you. Thanks.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20,444
Experience: I am fellowship trained specializing in general urology and reconstructive urology.
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