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Questions to Ask Your Doctor: PSA Screening and Biopsy

Depending on your age and family history, your doctor might suggest a PSA or prostate specific antigen test. This is a simple blood test that is used to screen for prostate cancer. Based on those results, your doctor may want to run further tests.

About PSA Screening

  • If I have a family history of prostate cancer, should I be screened more frequently?
  • If my results come back showing a high PSA, what’s next?
  • Should my PSA results ultimately lead to a biopsy? If so, what can I expect?
  • What kind of information does a biopsy provide?
  • How often does a biopsy miss the diagnosis of prostate cancer?
  • I’ve been told that prostate cancer is a slow-growing cancer.  If the biopsy finds cancer in my prostate, is treatment always required?

If You Need a Biopsy

A prostate cancer screening by a primary care physician or urologist may reveal results that prompt a doctor to recommend a biopsy. Other supplementary tests and considerations may help you and your doctor decide if a biopsy is necessary.  

  • What percentage of my prostate gland was sampled during biopsy and how many tissue sections of “cores” were removed during my biopsy?
  • I’m worried about infection from the biopsy.  What precautions do you take to lower my risk?
  • How representative of my entire prostate are these tissues cores likely to be?
  • What did the pathologist look for when she or he examined my tissue samples under a microscope?
  • What is my Gleason Score?
  • What is the value of an MRI-guided biopsy for prostate cancer?  

About Your Biopsy Results

  • Aside from my Gleason score, will the biopsy results include any genetic tests?
  • What is high-grade prostatic intraepithelial neoplasia, or PIN? Is this cancer?
  • Can I get a second opinion from another pathologist on my biopsy?
  • If I have prostate cancer, what is my clinical stage? Do I need treatment?
  • My biopsy results are negative, but my PSA is still elevated, what’s next?
  • Will I need a repeat biopsy?