I am on both sides of the argument. Part of me agrees with my Urologist. Ive already had two biopsies no definitive diagnosis. I do not want to be turned into a pin cushion if the risk is low. Yet I question if my risk is actually low at all.
PIRADS 4 and a PIRADS 3 lesion on MRI - Rads 4 "Clinically significant cancer is likely to be present" That sounds rather ominous.
Benign prostate tissue with a 0.2mm focus of atypical glands "Suspicious for Adenocarcinoma" These cells lack basal cell markers which is a hallmark in Prostate cancer. Yet others tell me Urologists only really worry about 1cm lesions. If that is the case why rate me with a Rads 4 and a Rads 3. Watchful waiting can be good for older men who will likely die of something other than Prostate cancer. But what about younger men? My PSA has been all over the place since I was 42. It rises up and down with 4.58 being the highest which was in 2017. Yet my PSA has never fallen below 2.5 during that time except January 2024. It then rose back up almost a full point from 2.48 to 3.44 a .96 jump. It then rose again 9 months later to 3.58 which is where it is today. I am asking for 2nd opinions and am working through my patient advocate. I have requested a PSE test and the better low risk Perenial biopsy where Sepsis risk is lower and they can sample even more cores. I wish the experts had a standard of when to worry and when not to worry. Is a 0.2mm A.S.A.P finding not that worrisome since it is not a 1cm finding? I have no idea.