My PSA level is high. Should I get a biopsy?

Question

Hi doctor,

I am 62 years old. I have severe pain while urinating and having frequent urination at night. My PSA 62.32, prostate 78 g, RUV 142 mL. Should I get a biopsy?

Answer 1

Hi,

Welcome to icliniq.com.

I hope your doctor has examined you physically. If there is a doubt of any tumor on prostate examination, then a biopsy should be done. If there is any history of a recent proven urinary tract infection in the last few days, then PSA (prostate-specific antigen) may be falsely elevated. In this situation, an antibiotic like Levofloxacin 500 once a day is given for two weeks and PSA repeated. If it becomes normal, then a biopsy can be omitted. Otherwise, 12 core TRUS-guided prostate biopsy must be done (transrectal ultrasound guided biopsy). If it is benign, then go for a TURP (transurethral resection of the prostate) or laser prostatectomy as your residual urine is high. Medicines can be tried if your physician feels so. If it comes out to be malignant, then some further tests to ascertain the stage need to be done. It may include bone scan, MRI pelvis or PSMA scan (prostate-specific membrane antigen) and the treatment differs depending on the stage.