Great discussions here and right on.
My journey was raising PSA numbers still in normal range. A PSA test is not a cancer diagnosis. It only shows that prostate is making a certain level of PSA. It can be irritation, infection, or cancer.

I was referred to a Mayo urologist who it seems to me now does a more thorough medical exam that not only does DRE, but also testicular, seminal vessels, scrotrum, etc. It was not just a DRE but a thorough medical exam. I thought this level of medical exam was the norm for those having a urologist addressing prostate issues but I can see the norm is the DRE.

Mine medical exam was negative and on to MRI with contrast. Suspicious areas found. A poster was correct a MRI cannot determine cancer. It can see suspicious areas that require a biopsy to be done to determine if it is cancer. I had a MRI/Fusion biopsy done transperineally which came back cancer and worse was 3+4=7 intermediate risk.

The urologist referred me to R/O. R/O went over options but suggested a Decipher and bone scan. Decipher test came back low risk and changed my treatment options and bone scan was negative. At that point I, with the advice of my PCP, did second opinion at UFHPTI who also did a PSMA. I then researched, and made my decision on being informed cancer patient and what was best for me.

My Mayo PCP went over everything with me (basically a 3rd opinion) and we made an informed decision of what was best for me. If I had disagreed, I would have gone on to get another opinion. But my PCP is a fanatic on doing research on prostate cancer. I asked why, and he said so I can provide recommendations to my patients on what is best for them. He constantly tells me even today about new research and information he has found.

I am now a promoter of second opinions, Decipher, and PSMA tests and reserach. And last, but not least, going to an experienced and well renown medical institutions so you can make an informed decision on your care.