PSA went from 3.9 in November to 4.3 yesterday

When you meet with your Urologist ask them to do a PSE blood test. That would be the next step before a biopsy.

I think it is good that you are seeing a urologist soon. One suggestion would be to request the urologist to use one of the newer blood or urine screening tests which can give a good indication of whether prostate cancer is present. A normal or low-risk reading on one of those tests could suggest giving things more time and monitoring the PSA trend; a high-risk reading would suggest further diagnosis such as MRI and biopsy. I had a urine-based test (ExoDX) which led to my diagnosis of prostate cancer even though my physical exam (DRE) was normal, PSA was stable, and MRI showed no lesions. There are other tests besides the ExoDX available - your urologist should know what the best current test is.

54 here too, not a whole lot of us kids on here! Seeing the urologist is what you need to do to determine the next step, be it PSE, biopsy or MRI. If any come up positive you'll end up with all three. Never ignore a PSA jump, ever. It's worth checking out. We are all here for you!

That deductible is always hard to swallow but easy when compared to dying of cancer - better to bite the bullet. Fortunately all this are pretty minor fees if it's just these tests and talking to the doctor. The MRI + biopsy (if you need them) are probably around $4K total.

For me I shelled out all my deductible last year only to have surgery this year and fork it out again. On the up side, no more payments this year so there's that.

@jayhall and you both have provided information I didn't know. Last time I saw the urologist he only mentioned the MRI and some sort of ultrasound, so I will definitely ask about these tests. I'd rather do those before an MRI or biopsy. Thanks!

The ultrasound might be the biopsy. They could do the ultrasound only but while they are in there it would make sense to do the whole thing. It's likely the same device that goes up in you, just a difference if if they pull that dreaded trigger 12 times.

The PSE is just an enhanced PSA test, the likely replacement for it would be my guess, but it's still three times the cost of a standard and cheap PSA so it's step 2 generally.

You could get a PSE test to see if there is cancer. It is very accurate and can help avoid a biopsy.

I have attached a review of different tests, like the PSE test, for comparison.

Thanks. I am actually willing to fork out $$$$ for the PSE if it means more accuracy and avoiding unnecessary biopsies. Will see what the urologist says.

The PSE test and PSA test have different purposes.

The PSE is designed to detect cancer in the bloodstream not the PSA number. The PSA number doesn’t detect cancer and a high PSA means cancer in only 32% of cases according to Episwitch, compared to 93% with the PSE test.

yeoldfogey, men usually have increased prostate growth at middle age. Can cause the difficulty emptying the bladder which can lead to urgency and urinary tract infections. Benign prostate hyperplasia can also raise PSA levels. Hey, you may be in the clear. After you pay for the PSE you can spend the 7800$ on a honeymoon.
Better wait, though to see the urologist there are surgeries and medications for BHP that you may want. https://www.webmd.com/men/prostate-enlargement-bph/enlarged-prostate-time-prostate-surgery

@yeoldefogey
You are feeling what almost all of us felt when diagnosis of your symptoms are not known.

You mentioned what is next. Your symptoms maybe BHA and not cancer. It is very common to have BHA as men get older. You did not mentioned PSA test. Have you had one? That after your prostate exam was done should have already been done or ordered as part of first steps.

If you have an excellent urologist he/she will follow normal steps. A MRI is usually the next step after prostate exam. Just push MRI with contrast. The MRI cannot determine if you have cancer. It can identify suspicious areas and or tumors etc. Thus when that step is done the decision to do a biopsy is made.

Until the biopsy is done you will not know if you have cancer or not. Many, many things can cause symptoms. I was given a 70% chance I had cancer from my MRI. Thus they did biopsies and per my Gleason score I had cancer of prostate. I had a normal PSA but had been rising for years.

Discuss these things with your urologist. Make sure you have an experience one using a medical facility with latest medical equipment and procedures. Once you have a MRI and proceed to biopsies just hope not cancer. But if it is then there are a lot great treatments now and they are changing even now since I have been on MCC.

I am not sure where you read the statistics on survival. Prostate cancer still inside prostate and caught early have great success rates where I have read 5 years survival is around 100%. The problem with prostate cancer is just like any other cancer it can spread to other areas especially if not caught early and type/risk level.

Many prostate cancers are still at celluar level. Biopsies and treatments of biosies areas means could have cancer in other areas of prostate not biopsied. It is why most radiation treatments treat the entire prostate and what the call margins which is treating areas outside the margins of the prostate. I had 18 biopsies done but my R/O did radiation treatment on entire prostate and margins.

Think positive! After skin cancer prostate cancer is the most common type cancer a man can get. You will also hear if a man lives long enough will have prostate cancer. Most and I have to repeat most prostate cancers are very slow growing and can be treated with great success if caught early. It is why medical professionals have really pushed doing PSA test where in past they were not pushed.

Good luck! You have a good chance of not even joining our prostate cancer group!