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Saturday, May 25, 2013
Biopsies for Men Over 80 Years Old
In regard to your recent question, "Increase in PSA Level but Negative Biopsies for an 80 Year Old ," 10/28/1999, can you comment?
Suppose the next biopsies in this case are cancerous, what would be the action taken? According to merck manual men over 90 all have cancer. So should a Gleason test be advised now? The PSA numbers seem to be inadequate and require some companion test to give verifiable answers.
It is true that many men in their 80`s have histologic evidence of prostate cancer. In many of these instances, biopsies are not performed because treatment would not be required. Whether or not a biopsy is performed depends on the level of PSA. If PSA is very high (for example over 100), biopsy may be indicated, because that level of PSA may be associated with spreading of the disease. This would require treatment. I hope this information is helpful to you.
Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University