Potential Prostate Cancer with a PSA of 16

Medical oncologist is my answer from several MO.,s

Ecurb: thanks. Makes sense to have multiple opinions. Not sure whether to have multiple opinions from medical oncologists or radiation oncologists if you’ve already made a choice for radiation.

I'm not a medical professional nor an expert on prostate cancer, MRI's or biopsies, so take what I say with a grain of salt. That said, since you asked here's my thoughts. First thought, was his MRI a modern 3T MRI with contrast? If not, he might want to discuss with his doctor about whether he can get another MRI with a 3T MRI with contrast, unless he has some medical or financial reason that's not an option for him. Second thought, if his MRI was a 3T MRI with contrast he might ask about getting an independent 2nd reading of it (or maybe a retest if his doctor thinks there's value in that). Third thought, I'd definitely suggest he discuss his concerns with his doctor and together come up with a plan. I'd be surprised and ask a lot of questions (or maybe get a 2nd opinion from another doctor) if the proposed plan didn't include getting frequent psa tests and staying on top of this until they're both convinced he doesn't have cancer. Maybe there's some other tests that can be done, but if so I'm not aware of them since in my case the MRI found a lesion and the biopsy found cancer so I knew I had (at least) 3+4=7 prostate cancer. Since I didn't have to explore how to deal with a concerning PSA but negative MRI and biopsy, I'm ignorant of what additional testing options currently exist. Best wishes trying to get resolution on this.

bens1 -- I didn't see your response to @ecurb until after I posted my comment to your initial question on this thred. My other comment might not apply if he's already decided on a path forward. I wish him the best of luck however he proceeds.

My RO and MO work together and discuss the situation jointly. I ve been very satisfied with what they do, because it parallels what the Mayo Clinic does.

Thank you retireditguy. I appreciate the thought. Its hard enough for those of us that know we have cancer but to have a high PSA with no infection, with no answers from the doctor, leaves my friend high, dry and in the dark without other professional opinions. I will ask about the 3T MRI. Maybe that is the loophole along with a poor biopsy.

A colleague had a PSA that was increasing... biopsy did not show cancer. But the PSA kept increasing. So they went in the other direction (which doesn't sound fun) and found the cancer. Not sure how rare that is... but a PSA of 16 would be a concern.

bdc1677: thank you. I will mention that to my friend to also ask that. Maybe he should ask for a psma pet scan as well.

"Other direction" meaning a biopsy thru the rectum rather than the perineum?

PSA 9, biopsy negative. I year later, PSA 14, biopsy positive. Gleason 8, stage 3. Don't believe negative results if psa is that high.