Most men who undergo a prostate biopsy may not have cancer found at all—and the bigger mistake may be rushing from a single elevated PSA straight to the needle.

Dr. James Wysock, an NYU urologist with deep expertise in prostate cancer diagnostics and image-guided biopsy, explains why the modern biopsy decision is no longer about PSA alone. Repeat testing, prostate MRI, PSA density, blood and urine biomarkers, and expert image targeting can dramatically change who should be biopsied and how that biopsy should be performed.

Just as surprising: transperineal biopsy is not automatically “better” in every case. It clearly lowers infection and antibiotic exposure, but biopsy accuracy still depends heavily on imaging, fusion quality, sampling technique, and operator experience.

In this episode, you’ll learn...

• Why one elevated PSA should often be repeated before escalating testing.
• Why MRI may be the most important next test when biopsy risk remains concerning.
• How transperineal and transrectal biopsies really compare.
• How new fusion, needle and tissue-preservation technologies could make future biopsies shorter, more precise and less invasive.

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⚠️ Disclaimer

This podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.