PSA went from 3.9 in November to 4.3 yesterday

A more accurate PSA, more or less. It's 94% accurate in determining if you have prostate cancer versus a PSA that just shows you have elevated prostate specific antigens - which could be the result of several things that are not cancer - plus a PSA can be high with no cancer or low with cancer so it's an imperfect test, just enough to say "hey, something is happening" then the PSE says "ok, now is that something cancer?".

Very encouraging! Thank you for doing that.

You wrote PCE test but I think you mean PSE test, which was recommended. It’s a relatively new test that is FDA certified that has 93% accuracy and tells you whether or not you have prostate cancer. Very useful for somebody with Gleason 3+3 to avoid doing a biopsy when this test shows no cancer.

Here’s a test Comparison check out what’s first.

@yeoldefogey
The statistics on surviving prostate cancer that is still inside prostate and low risk for 5 years is 100%. After 5 years the numbers go down along with any prognosis if has spread or is above the low risk. Not my opinion just echoing statistics like from WEDMD.

You have such an excellent chance of not even having prostate cancer but just BPH. You mentioned have a normal DRE but have you had PSA tests? Have they been rising what is the number?

If you have high PSA numbers and numbers have been rising could still be BPH but chance of cancer also. You mentioned MRI. A MRI with contrast would show suspicious areas and if found would probably be a recommendation for biopsies. A biopsy would be the test to determine if the suspicious area are cancer or not. Most urologist will do many biopsies in addition to suspicious areas to get an overall test of the prostate.

Those biopsies will come back with a Gleason Score. The Gleason score will give you a low risk, intermediate, or high risk prognosis along with treatments. However you will see my urologist and MCC posters get additional test like PSMA, Decipher, bone scans, etc. to get even more precise determinations of your specefic cancer and the treatment options for you.

At this point you should be optimistic you only have BPH and not cancer. Again what is your PSA and has it been climbing?

It's not PCE.............it's PSE.
https://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market
https://www.94percent.com/?gad_source=1&gclid=CjwKCAiAzvC9BhADEiwAEhtlN2cbNv9cTm7HxUTs1QdiGznlbC_Zh10TFnSX3uw6yyQVov28E8FOLxoCApIQAvD_BwE

You may well see people disagreeing with me here and, to be fair, I know little more about RP than what I read here plus my initial research...

All common prostate cancer treatment regimes will seriously affect your 'honeymoon' abilities.

I was your age with a similar PSA and an 'equivocal' biopsy result at the time. Over the next five years I watched my number rise all the way to 26 before having another biopsy in late 2023 and beginning treatment (ADT + IMRT) in 2024. There were reasons for this delay but I would definitely not recommend it. Luckily my cancer had not spread beyond the prostate.

If I was in your position I'm pretty sure I'd have a biopsy, do intensive 'watchful waiting', and enjoy a couple more years of your honeymoon. Once that has matured into a stable, long term relationship, then I'd discuss it deeply with her and begin to explore treatment options.

Having the biopsy sucks. All the options suck. PC sucks. Good luck!

PS: Non-PC PC joke: How do you know that a prostate biopsy is worse than childbirth? Because a year or so after a biopsy no man ever said: "Hmm, maybe I'd like another one."

PPS: I bet you $1M the urologist will shake hands with you at least once per appointment. What other doctor does that? I'm convinced this is because we know they've had their fingers in so many butts and they want to reassure us that they've washed up 🙂