advice requested

[exile54]

In June 2008 PSA 3.6. In late July 5.4 and Free PSA <10%, pain in groin, lower back and buttock.
Biopsy negative, is there a possibility they missed any cancer cells? Doctor tells me no infection present and no enlargement either. Please advise what I should do now.

[BaldiR]

did they take the 12 samples?
my understanding is that although the false alarm rate (detecting cancer when
none is present) is low or essentially zero,
the miss rate (not detecting a cancer that is there) can be significant.

[HeinrikMD]

Hi,

IF you have undergone the biopsy, that already constitutes the gold standard to which all else is compared. The next step would be to continue monitoring/ surveillance. This kind of event is pretty common in screening schemes as the goal really is to capture the disease earlier – so finding nothing at all is a real possibility during the examination. A common practice is to do the biopsy when the PSA in more than 4, but you did have symptoms so it was indicated.
Regarding the aches and pain, perhaps you could discuss about looking at problems in the anus or the bones – depending on the nature of the pains, what activities are associated with it, what seems to improve it. Discuss your issues with your doctor. Stay positive.