Prostate Biopsy

[bullshark99]

Ok, Fella's my turn..... Any feedback, advice, past experience's, what to expect, regrets are very much welcomed.

Regrets....... My biggest fear is "suspicious cells" are found and I am immediately advised to discontinue TRT and even worse, put on hormone depervation treatment. I have read sometimes cells are found that will never cause a man a problem in their lifetime but these cells cannot be distingused from dangerous ones so a Dr may put you on depervation to play it safe??
Any thoughts??????

Reason for Biopsy..... Im 48, been on TRT for almost 6 yrs. My baseline PSA in 2010 was 1.7. Six months in it rose to 2.4. Had DRE which suggested normal size with no other cause for concern. Over the last 5 yrs, PSA has bounced from 2.5 to 1.5 and usually is about 2.1. I have had it taken 13 times in 6 yrs with the average score being right around 2.1. The last reading however jumped to 2.9 thus causing the RX for Biopsy.

[hammerheart]

Under 4 ng/dl at the age of 50 is normal, biopsy for a PSA of 2.9 is way of an overtreatment IMO, without suspicious signs at digital/ultrasound examinations.

[Mr.BB]

Ditch it.

Prostate biopsy they randomly stick a big needle in your prostate quite a few times, harvesting cells, while injuring the prostate. Its a bad diagnostic procedure IMHO.

Ask for a MRI and/or ultrasound. .

[bullshark99]

^^^^^^ I was actually thinking that, BB. Although 2.9 is normal, it is on the high end of normal. Many age based charts have 2.5 the cut off for under age 50.

yeah, I don't know about this one.....

[hammerheart]

Why not just wait for a lower reading? Mine went from 7 to 2 in a month last winter.

[bullshark99]

Not to be confrontational but what if that doesn't happen ^^^^^^^^^ what if 2.9 goes to 7 and I find I got the cancer and I waited too long?????
Maybe this is one of those things you gotta get it done to find out or live with the consequences... Not looking forward to the procedure but its not the end of the world, its the possibility that if I open up Pandora's box and get the "suspicious cells" then I would be lost on what to do.

[hammerheart]

Good luck then.

[kelkel]

Ditch it.

Prostate biopsy they randomly stick a big needle in your prostate quite a few times, harvesting cells, while injuring the prostate. Its a bad diagnostic procedure IMHO.

Ask for a MRI and/or ultrasound. .

Totally agree with BB. Get the 3T MRI if anything.

[testytim]

bullshark 99..I am 61 and my PSA when i started TRT was 1.5 that was 10 years ago..My PSA went up 2 points first B/W after trt..10 years later 4.2 to 4.9..What i have been told is that you look for sharp spikes like 4.0 next one 9.5 hmm..the Psa test is just a number like test everyone is different just a guilde line to go by.

[ryobi1]

Ditch it.

Prostate biopsy they randomly stick a big needle in your prostate quite a few times, harvesting cells, while injuring the prostate. Its a bad diagnostic procedure IMHO.

Ask for a MRI and/or ultrasound. .

i am with you on this one, your PSA levels arent that out of whack,
is it enlarged?... PSA is not a bonafied guide, people with high PSA
levels are just as at risk as those with low, not a qualified test

[MuscleScience]

That's why I don't use test, wish they gave most men the option of using another anabolic compound with low/no activity on the prostate.

[bullshark99]

Seems to be a general consensus that I would agree with, yeah I'm liking the MRI option best.... Was curious on your take Inc-MYT?

[kelkel]

Seems to be a general consensus that I would agree with, yeah I'm liking the MRI option best....

Just be sure you get signed up for the 3T MRI which is non-invasive. Unless, of course, you prefer things up there........

[bullshark99]

That would be a NO........ Thanks Kel.....

[IncreaseMyT]

I think these guys in the thread hit the nail on the head.

Researchers noted that while their initial analysis showed an uptick (of 35 percent) in prostate cancer in men shortly after starting therapy, the increase was only in prostate cancers that were at low risk of spreading and was likely a result from more doctor visits and biopsies performed early on. The authors stressed that the long-term reduction in aggressive disease was observed only in men after more than a year of testosterone use, and the risk of prostate cancer did not differ between gels and other types of preparations.

Study Suggests Testosterone Therapy Does Not Raise Risk of Aggressive Prostate Cancer

[kelkel]

I think these guys in the thread hit the nail on the head.



Study Suggests Testosterone Therapy Does Not Raise Risk of Aggressive Prostate Cancer

Think "saturation model" as the prostate saturates with testosterone at around 240 Ng/dl. More makes no difference other than with DHT.

[IncreaseMyT]

I totally agree. I just think its real important to also point out that in the above study they did find an initial climb in cancerous cells.

What they found though was that these were not the aggressive cells and they had a very low likelihood of spreading.

So I am thinking its possible this is what they are seeing, especially since PSA is not elevated.

PSA is usually not accurate for men over 50, but I believe this is because of the decline in T levels. When one has optimal T levels the PSA reading should be accurate regardless of age. I believe this is why a few studies have found that proper T levels helped in early detection of prostate cancer.

Obviously I agree with everyone to follow up on this, but my gut feeling is androgen depravation would only make things worse.

Hope this makes sense.

[mazguy]

As a prostate cancer survivor (had it removed by robotic surgery six years ago) I researched this subject extensively. First, if you had a biopsy you should have been assigned a Gleason Score, not to be confused with PSA number. Gleason Scores range from 2 to 10 and are computed by adding two different numbers such as a 4+3=7 Gleason or 3+4=7 with a slightly different meaning. A GS of 6 or below can be treated as "watch and wait" but above that, you need further evaluation to see if the cancer has escaped the prostate capsule and some kind of treatment.

Can high testosterone cause prostate cancer? Nope. The latest findings all indicate a greater chance of getting prostate cancer with lower readings. But...if you did have PC and had your prostate removed or otherwise treated, and upon subsequent/necessary PSA testing and a rise was discovered, the protocol can be chemical castration to eliminate testosterone in your body. The reason is that cancer cells feed on testosterone like fertilizer to a weed. The frustrating thing is that even if the chemical castration works to halt tumor growth, this cure is temporary because cancer tumors can eventually create their own testosterone to feed on.

Why PSA tests if you don't have a prostate gland? Because a PSA test ONLY detects PSA which can only be created by prostate cells. Hence, any PSA in your body without the gland there anymore means that cancerous prostate cells exist and are on the rise.

Absent testing post cancer surgery, the PSA test means little because a number of things can cause a rise in PSA from hot sex the night before to a long bicycle ride or anything else that irritates the prostate. So excessive PSA, unless extremely high, is not a reason to panic. The creator of the PSA test recently wrote an article declaring that he almost wished he'd never invented the test because of so many false positives that led to dangerous biopsies. Sorry to say that the best first method for PC detection is the dreaded Digital Rectal Exam. A doctor needs to touch the gland feeling for hard spots which indicate a tumor.

That being said, since my post surgical biopsy indicated that my prostate margins were clear and cancer cells had likely not escaped the capsule, I waited four years to return to TRT. But just to be safe I get tested every ninety days.

[kelkel]

Great post Mazguy! Glad you recovered well!

[mazguy]

Thanks and my apologies for hijacking this thread but while on the subject of prostate cancer, I would encourage, plead or beg any of you over the age of 45 to get the dreaded digital rectal exam every year and not be content with the PSA test. When doctors catch it quick the solutions are simple. I skipped a few years so mine progressed unnoticed almost too far. Learn from my mistake.
Remember guys, we ALL have the prostate cancer cells growing at one stage or another so it's not a matter of if, but when.

[macmathews]

Thanks and my apologies for hijacking this thread but while on the subject of prostate cancer, I would encourage, plead or beg any of you over the age of 45 to get the dreaded digital rectal exam every year and not be content with the PSA test. When doctors catch it quick the solutions are simple. I skipped a few years so mine progressed unnoticed almost too far. Learn from my mistake.
Remember guys, we ALL have the prostate cancer cells growing at one stage or another so it's not a matter of if, but when.

Without hijacking this further, I'll stick to prostate exam..
While I would not enjoy getting digitized .. Its really not the patient with the issue..
Its the fact that doctors HATE doing it.. I mean who really wants to ask a Doc for the old finger.. nobody..
but its rare for any doc to offer it either

Mac

[hammerheart]

Without hijacking this further, I'll stick to prostate exam..
While I would not enjoy getting digitized .. Its really not the patient with the issue..
Its the fact that doctors HATE doing it.. I mean who really wants to ask a Doc for the old finger.. nobody..
but its rare for any doc to offer it either

Mac

It's their job!

At some point during my first urologic visit, whilst I was still on the bed with my pants down, the doc asked "Sorry, can I put a finger in your ***?" It was hilarious. I didn't feel it at all btw.

[marcus300]

It's their job!

At some point during my first urologic visit, whilst I was still on the bed with my pants down, the doc asked "Sorry, can I put a finger in your ***?" It was hilarious. I didn't feel it at all btw.

I felt mine, he had fingers like bananas

[KINGKONG]

I felt mine, he had fingers like bananas

Lollol..I got my first one in prison..first time I had seen a women in 18 months ..she was like "so would you like a prostate exam" I said "yes", "yes I would" wasn't so bad

[APIs]

Good Luck Bullshark, hoping that everything turns out well for you!

[kelkel]

I felt mine, he had fingers like bananas

How often have you been back?

[marcus300]

How often have you been back?

24 times in the last 6 months

[IncreaseMyT]

But...if you did have PC and had your prostate removed or otherwise treated, and upon subsequent/necessary PSA testing and a rise was discovered, the protocol can be chemical castration to eliminate testosterone in your body.

Great post but we are going to have to disagree here. There is no good evidence that cancer cells "feed" on testosterone .

Its just simply not true.

"For many decades it had been believed that a history of prostate cancer, even if treated and cured, was an absolute contraindication to testosterone therapy , due to the belief that testosterone activated prostate cancer growth, and could potentially cause dormant cancer cells to grow rapidly," says Abraham Morgentaler, MD of Men's Health Boston. "Generations of medical students and residents were taught that providing testosterone to a man with prostate cancer was like pouring gasoline on a fire."

This study, involving 13 symptomatic testosterone deficient men who also had untreated prostate cancer, suggests this traditional view is incorrect, and that testosterone treatment in men does not cause rapid growth of prostate cancer. It is the first to directly and rigorously assess changes in the prostate among men with prostate cancer who received testosterone therapy.

The men received testosterone therapy while undergoing active surveillance for prostate cancer for a median of 2.5 years. Median age was 58.8 years. The initial biopsy Gleason score was 6/10 for 12 of the men, 7/10 for the other (Gleason score grades the aggressiveness of prostate cancer by its microscopic appearance on a scale of 2-10. Gleason 6 is generally considered low to moderately aggressive, and Gleason 7 moderately aggressive).

Mean testosterone concentration increased from 238 to 664 ng/dl with treatment, yet neither prostate specific antigen (PSA) concentrations nor prostate volume showed any change. Follow-up biopsies of the prostate were performed in all men at approximately yearly intervals, and none developed cancer progression. In fact, 54 percent of the follow-up biopsies revealed no cancer at all.

Although the number of men in the study was small, and none had aggressive or advanced prostate cancer, Morgentaler observed, "These men were rigorously followed. The cancers in these men were typical of the prostate cancers for which men have undergone invasive treatment with surgery or radiation for 25 years. Clearly, the traditional belief that higher testosterone necessarily leads to rapid prostate cancer growth is incorrect."

https://www.sciencedaily.com/release...0419121353.htm

[mazguy]

When it was finger time during the examination and the doctor said to put my elbows on the counter I asked him, "Aren't you supposed to buy me a drink first?"