I saw this thread bumped and thought I'd give an update. 2024 was a strange year. My second biopsy found no cancer and the second MRI found no change in the size of the existing cancer lesion that was found previously in the first MRI and biopsy. So how is that possible? Most likely the lesion is small enough that the sampling from the second biopsy just didn't happen to capture any cancer cells. Good news for sure. I was relieved and Mayo said I could go 3-5 years before another biopsy. Awesome. However...

My PSA number in Jan 2025 came in high at 7.6. I had a partial TURP surgery (the median lobe only) in the summer of 2024. That helped my BPH symptoms some, but since then I've still had some issues and started taking Tamsulosin again. So it's possible the higher PSA is from irritation due to BPH, or something else.

I meet with the local urologist next week. I assume they will recommend another MRI which I will do either at Mayo, or have Mayo read it if I have it done locally in my city. I'm still trying to figure out whether another BPH treatment will have to be done before undergoing radiation, if the next MRI and next biopsy show an evolution of the cancer to something that needs treatment. I've thoroughly researched the BPH treatments and am pretty sure I would do aquablation or HoLep if treatment is necessary before radiation for the cancer. Appreciate all the input.