I’m sad to hear that a sibling of yours died so young from such a terrible disease. I’m also sorry to learn that you’re dealing with the uncertainty of such a mutation.

My understanding is that an MRI won’t rule out cancer. It’s more of a stepping stone to figuring out an approach to biopsy which, although not 100% accurate, is much more effective than scans in identifying malignancies. So if one gets an MRi, one is almost always headed for biopsy.

I also understand that 66 to 75 percent of PSA spikes are ultimately due to benign causes. (Anyone, please correct me if I am wrong on this.) So reducing unnecessary prostate scans and biopsies has long been the focus of urology. This means living with some short-term uncertainty in order to protect oneself from the potential complications of aggressive testing. So I’m willing to do this for a while with an appreciation of the risk.