Is biopsy for prostate nodule always necessary?

Not really an answer for you, but an information source.
"A benign or noncancerous prostate nodule could form because of an infection or as a reaction to inflammation in the body. It may also be a sign of benign prostatic hyperplasia (BPH), which is an enlarged prostate. BPH does not increase your risk of cancer."
https://www.healthline.com/health/mens-health/prostate-nodule#symptoms

I am not a healthcare professional, I have just been diagnosed with PC and am reading a lot to understand it.

Kind regards, Mike

Hi Will and welcome

This is a difficult one, Finasteride could well be responsible for lowering the psa, trouble is unless u come off it you won't know if the psa is rising or not, possibly. Having said that it was only 3.7 before u started on Finasteride.

I wouldn't be too concerned about Sepsis and biopsy it is quite a rare occurrence. I had a truss biopsy which wasn't too bad, there is also a template biopsy where u are less likely to get an infection but I shied away from that one as it involved up to 50 needles.

how big is the nodule in mm?, where is it located in the prostate?

You don't say if u have had a MRI, if you haven't  I would be asking for that first, at the moment it looks like they want to carry out a biopsy on the back of a DRE only.

see what others say

best wishes

Steve

The trouble is I don't think they can tell if PC is a slow type or an aggressive type without a biopsy. You are still a fairly young fit man and if it did turn out to be PC you would have a very good chance of a full cure at present even if it was aggressive and if it was slow growing they may just watch it. Best result it's not PC at all and you can relax and forget about it.

My husband had very little sign of PC just a slightly raised PSA, he had a biopsy that confirmed it was PC and had RT treatment after which he was clear for 5 years, although unfortunately it has now recurred.

Although there is some risk of infection with a biopsy, many men have them with no problems.

Hi Will

Its an interesting case you have. Having read your post a few times, I can see why your urologist would like you to have a biopsy to clarify the state of your nodule.

Your urologist mentions a targeted biopsy, so I assume an MRI would be carried out to locate the exact position of the nodule is known. However, and I’m no expert in these matters, just personal experience, I wouldn’t be at all surprised to discover that a highly skilled practitioner, would be able to locate and identify your nodule using ultrasound, especially as they are likely to conduct their own DRE first.

My own personal experience of a biopsy was 10 needles. The sound of the first was a surprise, the rest a walk in the park. It all helped too by having a cracking team looking after me. Despite the risks that have to be mentioned, I suffered nothing untoward as many men do.

Personally speaking I’d want to know for peace of mind, however the final choice is yours and therefore there is no right or wrong in your decision. It’s down to your own personal circumstances.

Wishing you well, what ever you choose to do. 

If you have to have a biopsy keep it to the minimum. I had a 38 needle template biopsy 20 months ago and I am still suffering from it.

Hi Will, my understanding is that the doctors should adjust your PSA number to account for you taking Finasteride.

See text below from https://www.uptodate.com/contents/screening-for-prostate-cancer#H4242494349

The 5-alpha reductase inhibitors finasteride and dutasteride lower PSA levels, thus mathematical adjustment of the PSA result can help with interpretation in men taking one of these medications. Some experts recommend doubling the measured PSA value before interpreting the result for patients on finasteride or dutasteride [30-32]. Results from the Prostate Cancer Prevention Trial suggest that PSA values be corrected by a factor of 2 for the first two years of finasteride therapy, and by 2.5 for longer-term use [33].

i had the ten needle trus biopsy 

i had read about a few bad experiences so was a bit worried myself !

 the noise is slighty weird but felt nothing , just a bit uncomfortable 

had a bit of blood in my pee for about 5 days but that was it 

no infection no other side effects or pain 

Many thanks to all of you that have responded. You've given me plenty to think about.

I'll post again here when I've been through all the detail. I'm very grateful.

Hi 

To avoid a biopsi you could have an MRI with rectal coil and contrast solution.

I have just been treated in VITUS Clinic, Offenbach  Germany.

The state of art MRI +coil will show everything to mm precision.

Regards,

Wayne Baxter 

Thanks Wayne.

Is this the same as a multi-parametric (mpMRI) scan?

Will...