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Is Prostate Biopsy Advisable When PSA Is 4.2?

Posted on Thu, 11 Sep 2014

Question: what is your opinion of getting a prostate biopsy done if your PSA number is 4.2? I am 68 years old and have a family history of prostate cancer (father died from it at 79 years of age, and 2 brothers have had prostate cancer and were treated, one with a radical removal of the prostate and the other treated with radiation). I understand that the biopsy is very invasive and can change a slow growing cancer into an agressive one.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Repeat Serum PSA after one month.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have recently done your serum PSA levels and revealed it to be 4.2 .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Do you have any urinary symptoms like frequency for urination ,urgency,painful urination etc suggesting enlarged prostate.?
2) Have you consulted any Urologist and carried out Digital Rectal Examination?
3) Have you done Ultrasound scanning of abdomen and pelvis and Trans Rectal Ultrasound Scanning ?

Normal higher range for PSA 4,and your PSA is slightly higher than normal level,This could be due to mild infection of the prostate or Enlarged prostate.

Looking at the family history of Prostate Cancer it is advisable to keep close watch on serum PSA levels at frequent intervals of every three months before taking decision for doing Prostate Biopsy.

At present I would suggest you take antibiotics for 2-3 weeks and repeat serum PSA after one month and if the reading turns out to show raising trend you may get Biopsy done.

Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (14 hours later)

Regarding the question you asked, the following are the answers.
Question #1: I do have to get up once or twice per night to urinate. I have also suffered from Erectile Dysfunction for the past 10 months.
Question #2: I have been to see a Urologist and have had a digital rectal exam four months ago. I was also told by my family doctor that my prostate is enlarged.
Question #3: I haven't had an ultrasound scanning of my abdomen and pelvis or a transrectal ultrasound.

I trust this will help you further.

Answered by Dr. Dr. P. T. Patil (9 hours later)

Brief Answer:
Please get Ultrasound scanning of abdomen done.

Detailed Answer:
Hello
Thanks for feedback.

You do have symptoms suggestive of Enlarged prostate

.I would advise you to get Ultrasound scanning of abdomen and pelvis and Trans Rectal Ultrasound scanning (TRUS) done to confirm the diagnosis.

If it turns to be positive take medications like antibiotics and Tomsulosin for 3 weeks and repeat your Serum PSA to take decision regarding Prostate Biopsy.

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar