New, PSA 20, Just Starting Process

@jeffmarc just some minor bph symptoms like frequency to urinate, but the tamsulosin is helping with that and my stream. I’ll see what today’s MRI results are and discuss with Urologist. I appreciate your feedback. Trying to stay relatively calm.

Well, gosh, you certainly start with a DRE!
If anything feels suspicious to a doctor/urologist, the normal sequence would be to then do an MRI scan, followed by a rectal or perineal biopsy guided by what the MRI shows, if it indeed does show something.
If that is the sequence followed, please don't be too nervous or scared of the biopsy; it's typically not a big deal, and not particularly painful.

I was able to get into a cancellation tomorrow morning, otherwise it was into Nov.
This is with a urologist, solid background from what I see. I will ask about the PSE test, but don’t mean to jump ahead to any conclusions.

What other things? Again, 1st visit, PSA at 20. Thanks.

@widude63
Your doctor should do a digital rectal exam to see if he feels anything in your prostate. You can have an MRI, which finds well whether your prostate has anything in it that is problematic. This can all be done before you have a biopsy.

BPH can cause your PSA to rise as well as as a large prostate, Frequently that is caused by an infection and they will give you antibiotics to treat the infection and reduce the PSA as a result. Ask about this possibility. Are you aware of your Prostate size?

No idea of the size of my prostrate. It’s something to easily keep out of the mind. I have had the DRE a few times, not from a ‘pro’ though, just the general doctor.

I do have many symptoms of the enlarged prostrate, high frequency to the restroom, and similar.

@sandguy
I would think that an MRI is much more definitive and a better next step. Isn’t the DRE now considered somewhat redundant given the advances in imaging? The reliability of the DRE is entirely in the hands of the inspector so to speak.

Yes, BPH can raise levels even higher than that. But you have to explore it as if it’s NOT simple prostatic enlargement before you just assume that it is. MRI probable first step and then you go from there.
IMO , none of the myriad supplements you hear about - even the ones boasting ‘pharmaceutical grade’ - do any good. Take it from a guy who tried anything and everything NOT to be here, but here I am…
I could’ve taken a first class Mediterranean cruise on an ultra luxury sailboat for all the $$$ I wasted on that crap!
Phil

@widude63

I agree with a few of the guys here suggesting that you do a PSE blood test. It has 94% accuracy over 55% with PSA alone and it tests 5 genetic biomarkers. The test results will read...you are likely OR you are unlikely to have prostate cancer.
As @jeffmarc suggested, I would not wait to make decisions as time can be, but not always is, your enemy. Whatever choices you are given, come back here to ask questions and get more than one opinion from doctors (through telehealth or otherwise) who have trained or are at a center of excellence.

Thanks, great info, off soon.

2 very good resources for information are:
Patrick Walsh MDs book Surviving Prostate Cancer
Prostate Cancer Foundation website PCF.org has free Patient Guides in hard copy or downloadable.
Best wishes.