Psa is a pita....

[recycled sixtie]

Just got back from the urologist and the good news is my psa is down to 3.7.
The bad news after a rectal exam is my prostate has hardened since the last exam about a year ago. Seeing that my ins. co. may ask for a biopsy(oh joy) because I have reapplied for insurance for a 10 year term. Six months ago I was rejected due to a psa of 5.3. Doc says life ins. co. may request a biopsy so they can cover their
a^^e.

Any input from anybody that has had the biopsy done would be appreciated. Any health profs opinions would be appreciated . I understand that relationship between psa level and prostate cancer is nebulous. You can have high psa number and no cancer and conversely low psa and have cancer.

I am thinking that the life ins. co will ask for a biopsy and what level of discomfort can I expect from a biopsy? I understand that infections from biopsies are fairly typical.
I likely will get a biopsy anyway for piece of mind. Info needed please!I am 66 yo.

[GeorgeK]

PSA values have meaning over time. A one-time elevated value can be due to infection, trauma (bicycle riding for the unaccustomed, for example), and other causes.
3 things that need to be considered:

PSA value
clinical exam
symptoms

After these 3 are evaluated, get an MRI if you can. It will give valuable info on the prostate structure, and can provide info on where to biopsy.

Blind biopsies will have lower yield.

[wdfifteen]

There is another thread here about this.
PSA seems to relate to something being wrong, but not necessarily cancer. I have BPA and my PSA has been about 8.xx for years. I've gotten a biopsy every 2 years for 10 years. Always negative results. The procedure itself isn't too painful, but the next 24 hours can really suck. Next time I'm asking for some Vicodin. Never had an infection and never heard they were common. Ejaculate looks like ketchup for about a week. My doc offered to do the biopsy under mild anesthesia this time, but had never offered it before. I wouldn't use the anesthesia because it costs a good bit more and like I said, the pain of the procedure isn't too bad. I think he charged something like $4000 for the total package, insurance lowered the price to about $2500.

[Hugh R]

Biopsy isn't painful, just weird. I couldn't see what was going on, obviously. but I think they show some sort of tube up your butt, and then they insert a device that the doc "cocks" and then it fires and goes "Thwack" inside you. Weird feeling, but not painful. He takes about six of these. You will see blood in your urine and semen for about a week, which is a good thing the doctor told me to expect it.

[Chocaholic]

That tube is an ultrasound probe so that the biopsy can be viewed under ultrasound guidance. The "thwack" is deployment of the biopsy needle via the guide which is attached to the probe. They will normally make several passes to ensure they capture a useful biopsy. Objective is to make Swiss cheese out of your prostate.

[Tobra]

Do they at least buy you flowers or something first?