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PSA levels at 74

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User
Posted 01 Nov 2023 at 12:29

I'm a 74 year old man. Had an MRI and fusuon biopsy in 2018. Results negative. Have had regular PSA tests and MRIs since (annually). PSA levels are elevated but MRI results consistently show no evidence on cancer despite elevated PSA levels. My PSA level at the time of my biopsy was 8. Since then it has been lower (down to 4.5) as I have been taking finasteride. 6 monts ago, I stopped taking finasteride on the recommendation of my urologist and the PSA level has gone up again to 8 (the level it was at when I had by biopsy in 2018). I have mostly been treated by a uroloist in Canada where I have been living. Now resident back in the UK, my urologist here is taking a more aressive approach and advocating a biopsy under GA. Throughs from members will be very welcome. As you see, I have two urologists takinng rather different aoproaches to my care. If I opt for a biopsy, can I insist on a local anaesthetic rather than a general?

User
Posted 01 Nov 2023 at 13:54

It may be that your urologist wants to do a template biopsy taking more samples more accurately than is possible to do under a local anesthetic, and therefore if done under local with fewer samples, it might not produce useful results. Another option might be to have the procedure done under a regional anesthetic such as a spinal block. You need to talk with your consultant, since only they know why they said under a general anesthetic - my guess would be that they want to do a template biopsy, which isn't normally done under a local.

User
Posted 02 Nov 2023 at 18:02

Presumably they don't think you have an enlarged or inflamed prostate.   I think if it was me I'd be looking at the trend of rise and trying to work out if it's going to carry on rising beyond 8.  Also considering if a psa test every 3 months would be enough.   At 74 they might no longer offer surgery depending how fit you are.

 
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