Who should get a prostate biopsy? | Peter Attia & Ted Schaeffer

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This clip is from The Drive, 274 - Performance-enhancing drugs and hormones-risks, rewards, & broader implications for the public
In this special episode of The Drive, Peter is joined by Derek, a fitness educator & the entrepreneur behind More Plates More Dates. He is also an expert in molecules commonly used & misused by bodybuilders & athletes.
In this clip, they discuss:
- Who needs a prostate biopsy
- What if an MRI shows a lesion?
- PSA density
- And more
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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17 ноя 2023

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Комментарии : 99

@denniswhite5215 2 месяца назад

I have had 2 prostate biopsies with no lesions either time psa was 7.2 and 10. That was 14 years ago. I have not gone back .

@hypolitej 2 месяца назад

I’m 71 and in 2011 my psa was 4 but I did not get a biopsy. My psa rose to 7.1 two years later but I still did not get a biopsy. Three years later my psa was 21 but still no biopsy and three years later my psa was 28 and still no biopsy. Throughout this entire period I experienced no difficulty or discomfort passing urine or pain of any kind. My quality of life from my view was unaffected. My psa declined first the first time the following year to 26.7. I still have no symptoms that bother me or affects my daily routine. No pain or obstruction symptoms and still no difficulty passing urine. I will be 72 in June and at this point don’t think I will ever get a biopsy unless something drastically changes to affect my quality of life. I respect the decisions taken by others as they see fit but for me these are my decisions for which I’m prepared to take responsibility. I’m left to wonder had I gone in for a biopsy 14 years ago what would have been my situation right now health wise at age 71 with all the risks involved. I feel no different now than I did 14 years ago.

@Troyboy2121 2 месяца назад

As an African-American. do you feel that the rising PSA levels are a concern? It sounds like your PSA was at the limit of 4 at the age of 58 and increased steadily over the years. Did you get an MRI?

@physicsprof.9639 2 месяца назад

That's good but of course it's all about statistics. Some smokers live a long time without getting cancer, but that doesn't mean smoking isn't dangerous. I hope readers don't take your experience to mean they shouldn't follow up if they have similar tests. Statistics of one case mean almost nothing.

@MM-sf3rl 2 месяца назад

The MRI will give you factual information and direct your next action: to have or not have the biopsy. The biopsy should be your second choice.

@michaell3711 2 месяца назад

@@physicsprof.9639,,, Sometimes it is great to AVOID Doctors invasion of your person. I have proven that they're keen on saying "You need treatments " ..... Blah, blah, blah..... Sorry,,, BE your Doctor FIRST!!!!!!

@MM-sf3rl 2 месяца назад

@@thailandbuddy4451 What was your PIRADS? PI-RADS 1 - Very low (clinically significant cancer is highly unlikely to be present) PI-RADS 2 - Low (clinically significant cancer is unlikely to be present) PI-RADS 3 - Intermediate (the presence of clinically significant cancer is equivocal) PI-RADS 4 - High (clinically significant cancer is likely to be present) PI-RADS 5 - Very high (clinically significant cancer is highly likely to be present)

@petegodfrey5735 2 месяца назад

Im 74, & dealing with the PSA roller coaster. God has done more through prayer than these urologits...

@frannybgood 23 дня назад

So you're relying upon your imaginary friend? Good luck with that one 😮

@petegodfrey5735 23 дня назад

@@frannybgood I dont need luck. You will find out just how real God is, when you leave this life.

@FallKingPepe 2 дня назад

Tomato paste

@christishusbandakastan7618 7 месяцев назад

Very good interview/discussion.

@petegodfrey5735 2 месяца назад

Thank you for explaining so clearly!!

@timelston4260 7 месяцев назад

Dr. Attia, when you interrupt your guest with the next question, you and he may be effectively communicating with each other, because you understand where the sentence he is speaking is going. But interruptions do not allow the guest to finish his sentences for those of us who need the whole sentence to be completed to know what he was going to say. The interview has to be for your audience, not for you and him.

@abrahamkalichman6845 2 месяца назад

All I have to comment on is , the repore that you have with your guests are extremely informative for anyone who has had the slightest fear of this subject matter. I value all of your discussions!

@Blue_Dun 23 дня назад

timelston.... you were reading my mind. I found his interruptions annoying

@tobyhammett6807 3 месяца назад

Thanks for having these conversations, much appreciated - oh and I did buy your book sir :)

@bocapete88 3 месяца назад

I don't see the risk calculator link mentioned at 3:57 mark??

@hugs92104 2 месяца назад

Where can the risk calculator be found? Thank you!

@DeuceDeuceBravo 7 месяцев назад

Where are the reference materials mentioned in this video?

@DS62581 2 месяца назад

What about PSA levels and TSH hormone? Hyperthyreosis might be associated with higher PSA levels. What about ExoDx Prostate test vs Prostate biopsy?

@JuanPerez-bn2jo Месяц назад

Any issues with delaying prostate biopsy a couple of months? In my area, earliest appointment is about 2-3 months out.

@MbongeniMtimkulu-te7hu Месяц назад

I like to know whether the prosted gland can be removed or not?

@buckeye200175 2 месяца назад

My psa around 10-11 past five years two negative biopsy and then a negative MRI

@supportpyango Месяц назад

Same here my friend. PSA of 10-12, 2 negative biopsies and multiple MRI's

@charlesgair8608 2 месяца назад

AT 65 I Had A Prostate Cancer That Was Gleason 4+4 And I Refused To Take The ADT Shot And I Got 4 Weeks Of EBRT And Permanent BRACHY SEED IMPLANTS .10 Months Later My Oncologist Said My PSA Was 0.3 And My Cancer Is Undetectble.

@thailandbuddy4451 Месяц назад

Are you on any therapy now, such as Lupton injections. Lupron may be a testosterone blocker also.

@charlesgair8608 Месяц назад

@thailandbuddy4451 No. I Refused To Go On ADT Hormone Therapy. But They Did Try To Get Me To Get On FIRMAGON Injections .All Have Brutal Side Effects.So Far It Looks Like I Definitly Made The Right Choice.

@charlesgair8608 Месяц назад

@@thailandbuddy4451 FIRMAGON Is The Testoterone Blocker That The V A Hospital Uses.

@DavidDabbs-mz7ht 7 месяцев назад

The percent free PSAi s the ratio of the amount of free PSA compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not. So when my Urologist refuses to do this test and only does PSA total, how can I calculate the present free PSA myself or is it possible?

@PeteHob Месяц назад

Is it difficult to find a medical staff that will give general anesthesia before biopsy or do you have to really “ shop around” to find one?

@janetw9430 3 месяца назад

PiRad score of 2-3 with a 9mm lesion shows mild hypointense and mild hyperintense. Psa density of 0.063. Of a 83 cc prostate?

@waeldeirki2152 2 месяца назад

please advise me where may I find all these figures and statistics mentioned in the interview....

@jimpoole9800 Месяц назад

Has anyone found the link for the risk calculator?

@hencape Месяц назад

I've had 3 negative biopsies and I was scheduled for another in October. My PSA has gone from 5 to 11.5. Will I need a biopsy immediately?

@markfll 2 месяца назад

My MRI showed several lesions, so I had the biopsies done. Six of them showed cancer. I have 2, 4+5s. 2, 3+5s. 1, 4+4. And one 3+4. On the Gleason scale. My doctor told me I need to take care of this as quickly as possible.

@crpunks Месяц назад

Take care how? Removal or chemo? Or both?

@markfll Месяц назад

@@crpunks I consulted with both, and in my situation, opted for surgery knowing there's still a chance of needing radiation therapy down the road.

@crpunks Месяц назад

@@markfll hope everything goes smoothly and turns out well!

@markfll Месяц назад

@@crpunks Thank you.

@spitfirekid1 4 дня назад

@@markfllhow are you doing now

@BMT-by5ve 2 месяца назад

I think i missed the conversation. If i have PIRAD 4 with,0.004 cm and PSA density of 0.07, PSA 2.5 on Finasteride, will require biopsy?

@MM-sf3rl 2 месяца назад

PIRADS4 indicates that “clinically significant cancer is likely to be present”. However, the PIRADS could be downgraded or upgraded. You should have an institution that deals with PC read the MRI. I would believe that a prostate doctor would tell you to have the biopsy. Only in the pathology report do you get the most clear evidence of how “significant” the cancer is that is present.

@Ralphdc19 2 месяца назад

I attended a talk by Dr. Scott Eggener of University of Chicago!

@vs-yy5cx 4 месяца назад

I am surprised he did not mention localized treatment of the cancers that preserve the rest of the prostate.

@hamsterdangler 2 месяца назад

I am 74 and am concerned that with a PSA of 17.7 and a prostate 7 times original size, it was noticed in a prostate scan that I had a tumour in the left kidney, tumour removal scheduled for the end of July but the surgeons are not planning a biopsy of the prostate until after the kidney surgery. It seems a long time away.

@bluesky2145 2 месяца назад

Where's the risk calculator guys?

@td4004 Месяц назад

Two prostate biopsies for me. I would not do it again. First, biospies only gather samples from half the prostate. Second, painful and expensive. Third, while most doctors would disagree, psa is a better overall indicator of a problem. Fourth, I wil go on Tippens Protocol before chemo, radiation or surgery. Fifth, inflammmation is not your friend is you have cancer. A biopsy creates a lot of inflamation in the prostate.

@Clay54883 Месяц назад

Can I ask how old you are please?

@tonyberry850 2 месяца назад

I refusedca biopsy with a uroligist when i was only 62 nothing since either at now 85 is thjs luck?

@NShah-rh1xi 12 дней назад

Dr. Attia, thanks for your excellent series to educate all of us. I wonder who your listening audience is- the public or health care professionals. It comes across as the latter. Please tone down your medical terminology to include more of us. Thank you.

@wapickle1 27 дней назад

I had a psa of 4, got an mri, found I might have something,got a biopsy (not pleasant), and discovered I have mostly 95% 3+3, 5% 3+4…Dr suggested for active surveillance (with future biopsies and psa tests), this was a week ago, not sure what to do since the big C is a shock, radiation and surgery both have effects so ..?. I’m 66. Thoughts, opinions?

@JOEH-hn8rp 18 дней назад

Surgery is okay but stay away from chemotherapy go with dog dewormer.

@markscholz1219 Месяц назад

Wish that the urologists were as forward minded as Dr Schaefer implies. Sadly, lots of surgeons and radiation specialists still recommend treating Gleason 6

@John-hq6em 6 дней назад

Whatever you do, don’t let anyone do the Urolift procedure on you, the metal implants cause an MRI to be totally useless (my personal experience).

@Jim-ok9zi Месяц назад

I have a question. Is there any side effects from the Biopsy.

@rteitel1974 24 дня назад

I believe infection in a small %

@williemclean3224 5 дней назад

My PSA was 2.3 in 2021 3.2 in 2022 and 5.7 in 2024. I was sent to a urologist who right away wants to do a biopsy. Very confused. Should I get the biopsy, very confused.

@williemclean3224 5 дней назад

If you get a biopsy, what are the risks besides infection. Can the biopsy cause a spread.

@susandeehutton 7 месяцев назад

Very helpful, thank you! Pardon if I missed it but what is PSA?

@Scottlp2 7 месяцев назад

Blood test for prostate specific antigen.

@karlpk3907 7 месяцев назад

Prostate Specific Antigen. The test for PSA is standard. www.cancer.gov/types/prostate/psa-fact-sheet

@creez1 7 месяцев назад

I'm not a doctor but I had prostate cancer. Prostate-specific antigen, or PSA, is a protein produced by both normal and cancerous prostate cells. Its main role is to keeps semen in liquid form so that sperm can swim. A simple blood test can measure how much PSA is present in your bloodstream. In almost all cases of prostate cancer the PSA level increases. It should be less than 2.5 ng/ml. Mine was 4.7.

@Maiden4eva1995 7 месяцев назад

@@creez1 What age were you? Mine at age 30 is 1.3

@creez1 7 месяцев назад

@Maiden4eva1995 I was 58. My PSA was increasing year over year and I was finally referred to a Urologist. They say one in nine men get Prostate cancer. It is among the most treatable and curable and like most cancers the earlier it is treated the better.

@brucecampbell6133 2 месяца назад

It would be helpful if you would let your guest answer the current question before interrupting with a different question.

@Adamas11 2 месяца назад

💯 What a douche!

@scooter29 2 месяца назад

I had a biopsy and got sepsis. I’ll pass. I do MRIs now

@Freedom24560 Месяц назад

Doesn't a Psma pet scan, combined with a 3T MP MRI give you most of the critical information you need to go forward, without punching numerous holes in someone's prostate? Gleason scores are great, but are they absolutely mandatory? In addition, the biopsy procedure itself seems rather random and unreliable....."hit and miss".

@onlineaccount63 Месяц назад

I'll put my trust in the math and science.

@johnjordan9538 21 день назад

I just had a biopsies when i went he said it was enlarged but my result came back nomad

@Troyboy2121 Месяц назад

The makes no sense. If you have a high PSA and low Free PSA, but have a clean DRE, Pi-rad 1 or 2, and a low prostate density, you still need a biopsy. This process is starting to sound like witchcraft.

@AllenTweed 7 месяцев назад

What about 3+4=7? Inquiring minds want to know!

@user-vv9np5iq7n 4 месяца назад

Those 3 + 4 = 7 are a part of the biopsy pathology report and are for determining the Gleason score which is the aggressiveness of the tumor. The best is 3+3=6 because Gleason 6 never grows. Gleason 7 is by two ways: 3+4 and 4+3. 3+4 Gleason 7 means that the tumor is mostly Gleason 6 but has some aggressive Gleason 8. 4+3 means that it’s more of a aggressive Gleason 8 with a bit of Gleason 6. 4+3 types need surgery to treat their cancer.

@threeftr3349 3 месяца назад

@@user-vv9np5iq7n Your explanation is a generalization from person who does not specialize in cancer, your explanation "4+3 need surgery to treat cancer" is so absolutely incorrect.

@threeftr3349 3 месяца назад

Gleason Score 7 =3+4---Grade 2--Risk Group Intermediate (favorable) Gleason Score 7 =4+3----Grade 3--Risk Group--Intermediate (unfavorable) A Decipher Test-is a tissue-based genomic test that helps in treatment decision-making for localized prostate cancer. It uses the tissue samples from the biopsy. You can get a 2nd opinion of the pathology of the biopsy to check the accuracy of the Gleason Score Your oncology can order a 3TMRI of the prostate

@threeftr3349 3 месяца назад

When it comes to the possibility of cancer a doctor never says it will never grow Gleason score 6 is the lowest grade of prostate cancer. This rating means that the prostate cancer is considered to be low- or very low-risk disease, or group 1.1 Most of these tumors are found during routine prostate cancer screenings. Gleason 6 prostate tumors grow slowly and may never cause a problem-or even need treatment. Still, they should be monitored

@normturcotte4206 2 месяца назад

@@threeftr3349 YOU ARE CORRECT. The statement “4+3 need surgery to treat cancer.” Is TOTALLY FALSE.

@jaybrox1652 2 месяца назад

The best solution of ANY kind of tumor in prostate if if it is 3+3 is to remove it immediately...the longer you wait the bigger and worse it becomes.Forget monitoring with treatments available today.I have plenty of experience with tumors talking for the sake of talking And gor sure I would NOT use this expert. Hahaha.