Biopsy or not?

I had a PI-RADS4
Biopsy confirmed cancer.
It's the only way to confirm it - grab little bits of your prostate so they can have a look.
Only mildly uncomfortable, but it's a definitive answer.

Was the cancer still stage 1? So you think I should do this? Mentally I'm going back and forth trying to think positive because the PSA is low

I can't remember. I think it was Stage 2.

The options were surgery or radiation.
I looked at the side effects.
For surgery, it was bladder incontinence.
For radiation, it was bladder & bowel incontinence.
That's a no from me.

Besides... radiation involves multiple trips for multiple treatments.
I wasn't keen.

It's a big decision, though.
The good news is that prostate cancer is one of the slowest-growing cancers.
So you've got time to consider your options.
Plenty of guys will come here with their input.

Pi-Rads 3 only comes up cancerous in 20% of the cases. A PSE Test will give you a good chance of knowing whether or not you actually have cancer. There are other similar tests, Ask your doctor about it. This is a big thing now, having a test to tell you where you are at, to prevent you from having a biopsy you don’t need. The PSE test is 94% accurate.

Thank you very much. I’m really having trouble deciding on the biopsy. I deeply appreciate everyone’s input, thank you all. I’ve had a lot of past problems with severe acute prostatitis including infections. My VA doctor hasn’t advised me to get a biopsy. My primary care Doctor is wanting to wait. A urologist (very young PA not my regular Doctor) was nudging me to get a biopsy. My Doctor wants to do a PSA soon and MRI again in 3 months

@monteshark
Were you told that PSA levels below 4 are normal. What urologist and PCPs look at are rising numbers over time.

WOW your barely moved in 5 years. And you stated that you have prostate troubles which could explain even your 2.3.

For my experience I had a .75 PSA for many years. Then in 2017 started to rise. It kept rising and rising year after year so when it got to 3.75 in 2023 PCP refers me to urologist. Tests, biospies, then prostate cancer diagnosis.

We can't give you medical advice but seems like your PCP is following you closely.

My PSA was 1.0. Right at my normal for 67. I had a biopsy for the urgency to pee and abnormal shape to my prostate. I had cancer.

Most guys in my support group who had radiation did NOT have any urinary or bowel incontinence. I haven't had any (though did have other side effects that have gone away). The multiple trips part is true, and the prep is uncomfortable. Radiation seems to have the opposite side effect of surgery--surgery has incontinence while radiation makes it really hard to pee. Neither one is a picnic.

I read that they now put a "spacer" between the bowel & the area getting targeted by radiation, so there's less collateral damage to the bowel or bladder.
Still glad I had mine out, though.

Did they do an MRI on you to do a focused assessment.