the prostate biopsy debate
it’s time to bring the debate to a broader audience.
okay. here’s the whole deal: my father in law’s PSA (prostate specific antigen) level is elevated. not alarmingly elevated (intermediate), but elevated nonetheless. his doctor suggested a biopsy, just to be on the safe side. the possible risks after the procedure were explained to him, and he was told that it is highly recommended that he gets the biopsy done as soon as he can, even if his prostate, upon examination is not enlarged.
the possibility of bleeding and informations from the internet scared the living daylights out of him. he is more likely going to say no to the biopsy. his wife’s and children’s opinions, and the stories from their fellow seniors (he is in his mid 70s) have a lot of weight in his decision making. they said the risk is so small, that it will be worse for him to create an imbalance in his system by having the procedure done, and it is better just to leave the mighty prostate alone. don’t even touch the thing, you know. leave it alone in peace.
the other strong contender in the list of suggestions is to take herbal based medicines proven to lower PSA levels because “most of the times, doctors just suggest invasive procedures without trying natural ways to solve the elevated levels first. they never think outside the box, before subjecting the human body to foreign invasion”, as pointed out by those who didn’t have any biopsy and are still alive today. and also by my husband, who happened to lean towards natural way of handling anything, who also happened to be his son.
anyway, although my opinion doesn’t really matter in the grand scheme of things, i was still asked to chime in. i told them i have taken care of a lot of patients post biopsy, and so far, i have not seen somebody bleed. for the most part, when the biospy turned out to be negative, it gave the patient that much needed relief. if it turned out to be positive and treatable, it is a better thing. if it turns out to be beyond treatment, at least, the patient is psyched to prepare. my point is: the earlier, the better.
i believe in mind body connection and totally agree that he should not do it if he is scared. thing is, i think, the only reason why he is afraid is that he lacks knowledge about the whole thing. i suggested he gather more information. from his doctor, from other doctors, from reading materials, from people who already went through the same thing, those who did the biopsy, and those who didn’t, listen to both sides. then, if he has all the informations he needs and he still does not want to do it, he has every right to make that decision, and it should be respected.
let’s hear it from you guys. what do you think about this whole elevated-PSA-level-to-biopsy-or-not-to-biopsy-issue?


Personally, I would rather know, than worry about what might be growing inside of me. I would definitely have the biopsy. I’m not a fan of watchful waiting.
Comment by Melissa — June 17, 2008 @ 11:21 pm
“anyway, although my opinion doesn’t really matter in the grand scheme of things, i was still asked to chime in.” That strikes me as ironic- I mean honestly, you are just a nurse after all. *stated sarcastically*
It’s like asking a mechanic if the transmission on a 1965 Ford Mustang is prone to problems. I’m pretty assured he’d know. *also, stated sarcastically*
Comment by alwaysmrsghost — June 18, 2008 @ 6:51 am
Hi May,given his reluctance,his age and the fact most(not sure of percentage) of protate Ca is very slow growing it’s probably alright to wait. When he learns more about the procedure and perhaps feels more like having the procedure to ease his mind(hopefully it’s negative)it would be better to do it then. Also must consider that even if it’s rapid growing would he want the protatectomy with the possible side effects of impotence and incontinence to be done at all?
When all is said and done it is his decision after all.
Good luck.
Comment by ButtercupRN — June 18, 2008 @ 9:43 am
“informations from the internet” - what kind of information, and from what source?
I don’t know if you’ve heard of the new phenomena coined “cyberchondria”. Basically, with the rise of the internet there has also been an increase in hypochondria in the general population. It seems that with so much information available now at people’s fingertips, it’s easy for people to get the wrong information and make decisions based out of fear.
Since you are an RN, I would suggest doing your best to educate him as to the real risks of the procedure versus the real risks of developing prostate cancer. Probably not an emergency, but he is in his 70s, so the earlier the better if they catch it.
Comment by Wounded Healer — June 18, 2008 @ 12:54 pm
My Dad had an elevated PSA at 65. He did go ahead and have the biopsy. He did have prostate CA, and it was caught very early, due to his decision to go ahead with the biopsy. He had radiation, and has been cancer free ever since. When he first got the info that his PSA was elevated, he asked me (his nurse daughter) what he should do. I asked him if he could live with not knowing if it were CA. That sealed it for him. Good post.
Comment by NurseExec — June 18, 2008 @ 12:58 pm
Here’s an instance when evidence based medicine would be more than useful. Did you know many countries don’t screen for prostate cancer as they’ve determined the death rate is low except in instances where the disease is aggressive and in those instances, treatment does very little to save lives. We need more data on this very important subject.
Onehealthpro
Comment by Onehealthpro — June 20, 2008 @ 1:34 pm
This may sound similar to NurseExec but I recommend the biopsy as my Dad had a slightly elevated PSA and had a biopsy because he was having another procedure done and would already be sedated, it turned out that he had prostate CA and had a prostatectomy, he has been cancer free for 5 years. My uncle had prostate CA and treated it by “seeding” the prostate with radiation- turns out it did not work completely and has now spread to his bones.
Comment by Mary — June 21, 2008 @ 7:26 am
May:
If it were me or one of my friends, I’d tell them to find out.
Prostate CA with mets, especially to bone is a terrible, terrible thing.(I had two patients with that this year…horrible pain)
A biopsy will, at least, give them a better idea of what’s going on and the treatment options, too.
Comment by RehabRN — June 23, 2008 @ 10:07 am
My father had a similar experience to yours. He proceeded with the biopsy, and it turned out he had a very agressive cancer, and less than a month later his prostate was gone. If he hadn’t had the biopsy I likely wouldn’t have a father. Just to put this into perspective, at the time my dad was 51 years old.
Comment by R — July 4, 2008 @ 9:24 am