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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Swollen And Painful Prostate. Negative Prostate Biopsy. Is Another Biopsy Needed?

I am a 57-year-old man whose prostate is swollen and painful. This has happened before and I have had two prostate biopsies - both negative for cancer - in the past two years. I am slim and active, and do sport twice a week. My PSA is around 7; it has been higher. My doctor has scheduled another biopsy for next week. My questions are: 1) Do I need this biopsy, 2) Is it possible I have BPH and/or prostatitis, 3) if so, what should the doctor do to rule out any of the above, 4) The fact that I have had this painful condition several times before without cancer being found, is a biopsy necessary? 5) Could these biopsies cause, or irritate in some way, cancer (if I have it)? I look forward to your answers to these questions. Thanks
Mon, 23 Sep 2013
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General & Family Physician,  's  Response
Hi, thanks for using healthcare magic

Your concern is understandable.

It is possible that the high PSA can be related to BPH or prostatitis.Prostatitis would normally cause additional symptoms such as pain in the abdomen or genitialia, frequency of urination, painful urination or difficulty urinating, discomfort on ejaculation.Prostatitis is diagnosed based on symptoms and a sample of urine or semen sent to the lab.

A high PSA cannot distinguish between these conditions and cancer.

Sometimes the free PSA is used to give additional information. If this value is low , then further investigations such as biopsy is warrented because a low free PSA increases the chance of cancer.

If any lesions developed subsequent to the last biopsy , another biopsy would pick it up or if it was missed.
The biopsy would not irritate/spread any cancer if present.

I hope this helps
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Swollen And Painful Prostate. Negative Prostate Biopsy. Is Another Biopsy Needed?

Hi, thanks for using healthcare magic Your concern is understandable. It is possible that the high PSA can be related to BPH or prostatitis.Prostatitis would normally cause additional symptoms such as pain in the abdomen or genitialia, frequency of urination, painful urination or difficulty urinating, discomfort on ejaculation.Prostatitis is diagnosed based on symptoms and a sample of urine or semen sent to the lab. A high PSA cannot distinguish between these conditions and cancer. Sometimes the free PSA is used to give additional information. If this value is low , then further investigations such as biopsy is warrented because a low free PSA increases the chance of cancer. If any lesions developed subsequent to the last biopsy , another biopsy would pick it up or if it was missed. The biopsy would not irritate/spread any cancer if present. I hope this helps