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Is TRUS biopsy recommended for elevated PSA levels?

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Posted on Fri, 20 May 2016
Question: My PSA spiked from 5.5 to 9.1 in 3 months between tests. My most recent PSA is now holding at 8.89. In a recent digital exam no lump was found. At this point would a TRUS biopsy be recommended or should I wait until something more significant occurs?
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Answered by Dr. Ronald Schubert (1 hour later)
Brief Answer:
biopsy vs no biopsy

Detailed Answer:
Thank you for contacting HCM with your health care concerns

You have recently been having elevated PSAs and you are wondering if a boipsy would be indicated. That is a real loaded question. There are several other factors in determining if a biopsy is necessary and the first is because you are 82 years old what is your life expectancy? If you are very healthy and your life expectancy is going to be greater than 10 years then i would recommend a biopsy. If your health is not good then having a biopsy is not a good idea. In all likelihood you have prostate cancer. Since your PSA is rather stable the growth of the prostate cancer is slow. You will probably die from other causes before the cancer will take you life. So why do a biopsy when the diagnosis is rather high for prostate cancer, The biopsy itself can cause substantial risk including, pain, infection, impotence and urine incontinence. Do you want to risk those side effects? Then with a positive diagnosis what treatments are available radiation, chemotherapy or surgery. All these have pros an cons and are they something you would want to go through?

So you have plenty to think about before getting a biopsy. Talk with your urologist and get their perspective. Be open and assertive on what is expected and what risks are.

I hope I answered your question. Please contact us again if you have any additional questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ronald Schubert

General & Family Physician

Practicing since :1984

Answered : 2407 Questions

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Is TRUS biopsy recommended for elevated PSA levels?

Brief Answer: biopsy vs no biopsy Detailed Answer: Thank you for contacting HCM with your health care concerns You have recently been having elevated PSAs and you are wondering if a boipsy would be indicated. That is a real loaded question. There are several other factors in determining if a biopsy is necessary and the first is because you are 82 years old what is your life expectancy? If you are very healthy and your life expectancy is going to be greater than 10 years then i would recommend a biopsy. If your health is not good then having a biopsy is not a good idea. In all likelihood you have prostate cancer. Since your PSA is rather stable the growth of the prostate cancer is slow. You will probably die from other causes before the cancer will take you life. So why do a biopsy when the diagnosis is rather high for prostate cancer, The biopsy itself can cause substantial risk including, pain, infection, impotence and urine incontinence. Do you want to risk those side effects? Then with a positive diagnosis what treatments are available radiation, chemotherapy or surgery. All these have pros an cons and are they something you would want to go through? So you have plenty to think about before getting a biopsy. Talk with your urologist and get their perspective. Be open and assertive on what is expected and what risks are. I hope I answered your question. Please contact us again if you have any additional questions