Should I have a biopsy?

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I am 61 y.o. male having frequency urination for years. My  Total PSA=4.4 and free PSA 11% these were done last March.  My primary physician  told me before that I have BPH. But my Urologist is recommending a prostate biopsy. My previous MRI taken 2years ago is ok according to my doctor.

Should I go ahead for a biopsy or just monitor my PSA and do it after six months?

2 Answers

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For values of PSA between 4.0 and 10.0 ng/ml, there exist a 22-27% likelihood of cancer, while those above 10 ng/ml yield up to a 67% chance of cancer. So whether you should get a prostate biopsy depends on how you feel a likelihood of "22-27%". If you are concerned but you still do not want a biopsy, you can repeat a MRI scan first. If the MRI is not OK, then you should get the biopsy. If the MRI is OK, you can wait and see
  • If your free PSA results are less than 25%, your risk for developing prostate cancer is between 10% to 20%.
  • If your free PSA results are less than 10%, your risk for developing prostate cancer jumps to around 50%.

So your risk of developing prostate cancer is about 20-50%. You can do a prostate MRI scan again. If the MRI result is also abnormal, then you may need this biopsy

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