Lee:

I would do it.
In my case, I was 52 and my uro offered the same advice to me. I waited
almost 9 months to proceed with the biopsy because frankly I did not
believe him about the possibility that I had PC with a "normal" PSA. My
PSA went up in those 9 months of waiting, but I was lucky that when I
did have the surgery, the path report was good. My PSA so far is <0.01.
The biopsy does not hurt although it sounds scary. Best to get to the
bottom of it now rather than later...pun intended.

B.A.

I'm not a doctor, just a veteran of all this, but my reading on the
subject tells me that with your borderline PSA and normal DRE, a six
month delay would do you no harm.

jimhoney
standard RRP age 52, cured, no significant aftereffects

Lee,

-Biopsy is a very simple + safe procedure
if done with some drowsiness - you won't feel anything.
the fact is that now you worry -
and you will be worrying for 6 month.
might as well get it out of your way -
and continue with a peaceful life.

Reuben

Prostate biopsy feels like a rubber band beign snapped against your skin -
really not that bad.  Rather than worry about it, get it done.  Better to
find out sooner than to spend months worrying about it.

Sandy K.

Last time you asked this question (about 10 days ago), I suggested a
whole list of questions you should ask the urologist. Did you ask them?
If so, what were the answers? Did you get PSA/fPSA test?

What puzzles me is that a normal prostate biopsy does not look at the
region of the prostate closest to the urethra (which is where your
urinary symptoms are most likely coming from). Does the doctor plan to
biopsy that region? What *exactly* is he looking for? I just think you
should get a more detailed explanation - all you seem to have so far is
hand-waving and a degree of "conservatism" that is outside the
mainstream view (my urologist is very conservative, but still thinks
2.5 is a sensible threshold for age <50, which is in line with all the
literature I have seen).

For the record. I found my 8-sample biopsy (without anaesthetic) pretty
painful, both during and after. I still have noticeable discomfort 2.5
weeks later. Others don't have the same experience; I guess I am just
lucky. :-) There is also a risk of sepsis. It takes up a couple of
hours of your life, and costs you money. You deserve a *detailed*
explanation of what the doctor is looking for before going through all
that. But most important of all, you need enough information so that
you are prepared for all eventualities when you get the results.

Meanwhile, what else is the doctor doing to fix the urinary
difficulties? If he is just waiting to do the biopsy, that seems to be
ignoring lots of other explanations for your sympoms and PSA level in
favour of a rather unlikely one. Or have you tried lots of other stuff
for the urinary symptoms already?

Please note that I am not saying you don't need a biopsy. It is just
obvious that your doctor is not doing a good job of communicating with
you (if he was, you wouldn't be asking these questions) - you need to
fix the communication issue or find another doctor.

The biopsy is a fairly simple procedure with little risk if done
properly.  The "danger" in having a biopsy is that you might find you
have cancer, but a not very aggressive case, e.g., small and Gleason 5.
  At this point in time, it is really not known just what your long
term risk would be in such a case.  Many urologists would argue in such
a case that because of your long life expectancy, you need to be
treated, probably by surgery.  But others would feel that it would be
safe to wait to see what happens.   On the other hand, I think almost
all urologists would argue for treating a Gleason 6 or higher cancer in
a man your age.

Some public health experts argue that if you look hard enough for
prostate cancer, you are likely to find it.  They also argue that a lot
of the prostate cancers found that way will never bother the patient.
There is a certain amount of  truth in that position, particularly for
older men.  Unfortunately, there is no good way at present to
distinguish cases in younger men which don't need treatment.  Treatment
can have serious side effects, even though the risk is less for younger
men.  So treatment does involve some casts.  The critics of an aggresive
approach feel that it is better in some cases not to know because
knowing leads inevitably to radical treatment.

It seems to me that one crucial issue is how fast your PSA been rising.

I think the suggestion that you get second (even a third) opinion makes
a lot of sense.

The doctor can only feel a portion of you prostate and 1.6 PSA might be too
small to feel in any case.

If he suggests a biopsy, get it.  If you have cancer at 48, it's bound to be
agressive.  Catch it early.

I'm for not letting that window of opportunity get away.  Get the biopsy
and see what the doc finds, then go from there.  The biopsy is not all
that bad.  For some it's worse and others it's not a problem at all.  I
had eleven samples and by the time the eleventh one I was ready for a
rest.  There was not much pain, but the anticipation of the next sample
got on my nerves.  I'd have the biopsy any day compared to going to the
dentist.

Good luck

Dale j.