Hello Mel53

Thank you for posting a question for us.  With most types of cancer a biopsy is necessary to confirm the diagnosis.  However, in some cases of prostate cancer it may not always be necessary. 

As his PSA reading is quite high, this strongly indicates prostate cancer.  Also an experienced urologist can get a good idea of whether it is likely to be cancer from how the prostate feels from a physical examination.  Usually they will also do an MRI scan of the prostate which again gives a very clear indication of whether or not it is cancer.  When they put all this information together they may feel that they wouldn't get any additional information from a biopsy that would change his treatment in any way.

Prostate cancer can often be suppressed by reducing levels of testosterone.  Testosterone is produced by the testicles.  So an orchidectomy (removal of the testicles) can be used to treat prostate cancer.  Sometimes they can achieve similar results by giving tablets and regular injections to reduce testosterone levels and it may be worth your father asking if this is likely to be an option for him. 

Until they get the results back from the bone scan it is difficult to give you an impression of how serious things are likely to be, but even if they don't think they can cure your father, there are treatments that can slow the cancer down and control things.

It might be helpful to look at the prostate cancer section on our website here for further information.

I hope this has been helpful

Martin