Should I have a biopsy if PSA is elevated?

PSA analysis is considered the gold standard for prostate health diagnosis. Often, when PSA results are higher than normal, the patient is diagnosed with suspected prostate cancer and sent for a biopsy. However, it is not a fact that a high PSA level is cancer.

Increased PSA – what should I do?

Analysis for PSA, or prostate-specific antigen, makes it possible to suspect the presence of prostate cancer. Every man over the age of 45 must take it annually. In other cases, the analysis is prescribed according to the indications: if the results of ultrasound, MRI or CT, finger rectal examination raise doubts about the presence of a tumor.

There is a belief that if the PSA is below 4 ng/ml, this is the norm, in fact it is not. It has been proven that PSA rates vary depending on age. For men under forty, the lower threshold is 2.5 ng/ml, and for the elderly – 4.5 ng/ml. With age, the prostate increases, this is a normal process, and as a result, PSA production increases.

If you have been prescribed a biopsy, but you want to make sure that the appointment is correct, you can get a second opinion from the specialists of the EMC Urology Clinic.

PHI - prostate cancer diagnosis without biopsy

When a tumor is suspected, but the total PSA is in the range of 2-10 ng/ml, doctors usually choose a wait-and-see approach and regular monitoring, or prescribe a biopsy. The best way to clarify the situation in this case is an additional study – a PHI blood test. If the PHI score is low, the doctor may refuse a biopsy and continue monitoring. Research shows that up to 75% of biopsies are performed in vain, meaning they could be replaced by a PHI blood test.

Magnetic resonance imaging (MRI)

An MRI scan of the prostate can also help avoid a biopsy. MRI of the prostate, unlike biopsy, is a non-invasive diagnostic method that does not injure the body and does not expose it to radiation. MRI allows you to accurately visualize pathological foci even at the earliest stages of the disease and confirm or deny the need for a biopsy.

Fusion biopsy is the most accurate method of cancer diagnosis

Prostate biopsy is a method of examining prostate tissue for cancer cells. Using a special needle, rectal or urethral punctures are made in the prostate in order to take suspicious areas of tissue for examination.

EMC is one of the few clinics in Russia that performs not a classical biopsy, but a fusion biopsy . With a classical biopsy, the doctor acts, one might say, blindly, even if the procedure is performed under the supervision of ultrasound. Fusion biopsy is a procedure performed under the combined supervision of ultrasound and MRI. This technology allows you to take material from exactly the area that is in doubt.

The resulting material is sent to the laboratory and results can be obtained within a few hours. If prostate cancer is confirmed, the doctor chooses the treatment strategy. As a rule, radical prostatectomy is performed – removal of the prostate. If prostate cancer is detected in the EMC, it is possible to perform a radial prostatectomy using The Da Vinci surgical robot is a low–trauma surgical method.

The main feature of the EMC is that, thanks to the highly qualified doctors, modern technical base and comprehensive approach, we can perform the operation within 24 hours after the diagnosis!