I am taking proscar daily. I have not had prostate cancer. I am 70 yo. I just had a yearly PSA test and my PSA went from 1.1 to 1.3. My urologist wants to schedule me for a biopsy. He says that if I am taking proscar my PSA should never rise at all. I dont think the rise is that significant. Can I please have your opinion?


First, I am glad you continue to do well ten years after your visit. Before I would recommend a biopsy in this situation, I would want additional indicators of a problem. Patients without cancer can still have a PSA that varies month to month by more than the 1.1 to 1.3 ng/ml you mention. Rather than a one-time increase in this range, I would be more concerned by an increasing trend. For example, if the PSA has gone 1.0, 1.1, 1.2, 1.5, I would then think transrectal ultrasound. I would also look for a change in the size or texture of the gland by digital rectal exam. If your PSA was higher, we could use the total and %free PSA – a dropping %free PSA would be an indication for biopsy. Perhaps, your urologist has noted something that triggered his concern and he has failed to mention this to you?