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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is A Biopsy Needed For An Elevated PSA Level?

Psa at 7.6. Been this way for the last 3 in ahalf years , thats when the biopsy was done. Sence that time I ve been treated for prostatitis. Had a exam 2 weeks ago which was very painful and still have pain till this time and symtoms. Had MRI done last year , they said my prostate was enlarged but clear. Had Ct scan done. Stated it was clear. Went to see urologist at USC he wants another biopsy. Is it needed???? Or should I be check first for infection???
Wed, 21 Feb 2018
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General & Family Physician 's  Response
Hello and thank you for using HCM for your health questions!
Short answer: Not necessarily you need a biopsy.
Detailed answer: The normal PSA level is up to 4 ng/mL. In this context your PSA level is high which means that you need to monitor it regularly. Elevated PSA can be caused by other problems not related to cancer. The most other common causes, as you might know, include an infection of prostate gland (prostatitis), urinary tract infection and benign prostate hyperplasia. When the PSA level is elevated then one should exclude these conditions before considering another biopsy. Your doctor might want to do a digital rectal examination in order to look for any lumps or unusual structure in prostate gland.
You state that your prostate is enlarged but clear (probably this is the cause of elevated PSA), and you have done all other examinations. You can also get examined for an infection of prostate/urinary tract and then monitor again PSA levels.
Please note that about three quarters of men with elevated PSA levels do not have prostate cancer in biopsy.
However, if all other explanations fail to make sense of your elevated PSA level then probably another biopsy is the right thing to do in order to be sure. Please note that in many cases, biopsy detects small, slow-growing tumors that do not need to be treated at all and your doctor should be aware of this in order to avoid unnecessary "over-treatment".
I hope that my answer will help and I wish you good luck!
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Is A Biopsy Needed For An Elevated PSA Level?

Hello and thank you for using HCM for your health questions! Short answer: Not necessarily you need a biopsy. Detailed answer: The normal PSA level is up to 4 ng/mL. In this context your PSA level is high which means that you need to monitor it regularly. Elevated PSA can be caused by other problems not related to cancer. The most other common causes, as you might know, include an infection of prostate gland (prostatitis), urinary tract infection and benign prostate hyperplasia. When the PSA level is elevated then one should exclude these conditions before considering another biopsy. Your doctor might want to do a digital rectal examination in order to look for any lumps or unusual structure in prostate gland. You state that your prostate is enlarged but clear (probably this is the cause of elevated PSA), and you have done all other examinations. You can also get examined for an infection of prostate/urinary tract and then monitor again PSA levels. Please note that about three quarters of men with elevated PSA levels do not have prostate cancer in biopsy. However, if all other explanations fail to make sense of your elevated PSA level then probably another biopsy is the right thing to do in order to be sure. Please note that in many cases, biopsy detects small, slow-growing tumors that do not need to be treated at all and your doctor should be aware of this in order to avoid unnecessary over-treatment . I hope that my answer will help and I wish you good luck!