The T2 weighted image is what's important in discerning things. That image indicates a 4/5 which means in my understand a lesion with a PIRAD-4 rating. There is definitely something there, probably not advanced yet to PIRAD-5. You have a 90 cc prostate which is large, hence BPH and difficulty urinating. Mine was 100cc, so I understand your concern. A prostate of 90cc might yield a PSA in the range of 9. A rough rule of thumb is prostate volume divided by 10...........but I'm sure that varies somewhat. Although I'm not a doctor, my read on this is you've most likely caught this early, which to me means you have some time. I took from March to October to navigate this process. You may want to get a second opinion of the read of your MRI to make sure you have consistent, reliable information. Interpretation of these images depends heavily on the radiologist reading it. Find a center of excellence to give you a second opinion you know you can trust. You need the best reliable information in order to chart a good decision for you. I believe you have time. Get a fusion biopsy, so that you have the highest probability of targeting the lesion. Get a second opinion on the biopsy core samples as this is also critical to deciding on a course of action. Johns Hopkins has a website. They are a center of excellence for such readings. It's only a couple hundred dollars for the read and insurance paid for mine. Well worth it if you have to pay for it yourself. Get a Decipher or Oncotype dx test done on your biopsy samples to assess aggressiveness of the cancer if it's determined that you have cancer. Get yourself educated. You're going to be the one making the final decisions. I found tremendously useful the website pcri.org. There's a wealth of information there by a medical oncologist who spent his entire career on prostate cancer. Extremely well done and current information. I urge you to take a look. Hope this is helpful.