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Have peyronies. Suggested prostrate biopsy. Worried about cancer cells release into blood streams? What can be done?

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General & Family Physician
Practicing since : 2001
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morning, my psa a couple of months ago was 5.1, but we retested a month later and it was 3.1 . i have peyronies and went to urologist and he is suggested doing a prostrate biopsy, but am a bit scared after reading in internet, that this could release cancer cells into the blood stream? not sure if i should proceed or not. thoughts.
Posted Tue, 2 Jul 2013 in Urinary and Bladder Problems
Answered by Dr. Michelle Gibson James 30 minutes later
Hi, thanks for using healthcare magic

The decision to undergo a prostatic biopsy is individualised because of the questions still surrounding PSA.
Initially it was in patients with values greater than 4 but this has changed because some persons have high values with no cancer there is now no definitive value.

It is recommended in persons where (1) the value is above the age specific range- in general the limit for a normal PSA rises with age for example a value of 6 would be more abnormal at age 30 than age 70

(2) if the free PSA is high - free PSA is the amount of PSA that is free and not attached to any proteins. A low free PSA may indicate cancer. If free PSA is less than 7% , cancer is likely. If it is above 25% cancer is unlikely.Free PSA is checked with a blood test

(3) if the prostate feels suspicious on examination

Needle tracking is mainly a concern where the biopsy is done blindly and the possibility of the needle going outside the prostate exists
Prostatic biopsy can be done under imaging now where the doctor can clearly see the area that he or she is taking biopsy and can sample the areas that look suspicious. The main possible complication is infection and for this reason antibiotics are given before the procedure.

The use of imaging to guide the biopsy would significantly reduce the chance of needle tracking because your doctor will be able to see exactly where the needle is at all times.

If this is possible at your center and your doctor believes it may be best to rule our prostatic ca , then you may want to consider it

I hope this helps, feel free to ask any other questions
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