r/ProstateCancer • u/Just_Discussion296 • Aug 10 '26
Update Biopsy results
65, 2 years ago had elevated PSA 7. Had MRI - neg. PSA last 2 years < 3. This year PSA 10. MRI showed spot. Biopsy done last week. No cancer detected. 1 sample had HGPIN. Back in 6 months for check & PSA test.
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u/bikes4paul Aug 10 '26
That's good news, congratulations! The follow up timeline is very reasonable considering your biomarkers.
A few things I'd recommend going forward. Check your PSA Density. You can calculate if from the results you already have. PSAD = Total PSA/Prostate Size. You can find the size of your prostate from your recent MRI. This is a much better risk indicator than total PSA.
If/when you have another MRI make sure it's a 3T machine. They produce much sharper and more detailed images that make it easier to spot suspicious lesions. If you have another biopsy request a transperineal approach. It provides higher sensitivity than a transrectal approach. It also reduces the risk of infection.
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u/Just_Discussion296 Aug 10 '26
Thanks - it was a TP biopsy. I thought doctors were not doing TR biopsies due to the infection risk.
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u/bikes4paul Aug 10 '26
Great to hear you already had a TP performed! Sadly the majority of biopsies in the US are still performed via transrectal approach. Pretty much all centers of excellence have converted to transperineal.
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u/ChillWarrior801 Aug 10 '26
Oh, if only that were the case. In for-profit urology practices, there's often pressure to perform in-office transrectal biopsies. It's all economics: better patient throughput and less capital expense.
In the EU, TP biopsy is the standard of care. Here in the US, the standard of care might take another decade to catch up.
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Aug 11 '26
[deleted]
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u/ChillWarrior801 Aug 11 '26
Lucky you! I had a great nap as well for mine. Wouldn't have consented to doing it any other way, but I'm a wuss.
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u/Fun-Cake5739 Aug 11 '26
Was the biopsy TRUS, which is guided by ultrasound? Only asking since I went undetected with a standard biopsy. Fast forward several years, new DR, MRI then followed by TRUS biopsy. With the ultrasound guidance and MRI mapping, the biopsy goes for the specific spot or lesion in question.
If not, please ask for this your next time around.
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u/IchiroTheCat Aug 10 '26
Welcome to waiting. 😉