@ezupcic Yes, my PSA had risen to 7.8, which triggered my GP to schedule a visit with an urologist. My urologist indicated that the next step would to obtain a mpMRI....IMHO a mpMRI is an absolute MUST before submitting to any type of prostate biopsy.
In my case, the mpMRI found three lesions, one PIRADS 3, one PIRADS 4, one PIRADS 5. This triggered a targeted TRUS biopsy. I had a 21 core biopsy, which included the standard 12-core systematic portion.
It turned out the PIRADS 3 lesion was benign and the PIRAD 4 and PIRADS 5 lesions were 3+3, involving 5% of the specimen. The strange thing (at least in my mind) was that the systematic portion of the biopsy found 5 additional low volume cores (3 with 3+3 and 2 with 3+4)...not sure if these additional cores also sampled the mpMRI identified lesions or whether they were from lesions that the mpMRI missed or were just too small to see..
The deciding factor regarding treatment was the Decipher GRID report (attached), which recommended AS, based on their clinical-genomic model...my urologist agreed...I started my "aggressive AS protocol" immediately.
A 12 month mpMRI follow-up indicated that the original PIRADS 3 and PIRADS 4 lesions were no longer visible and the PIRADS 5 lesion had shrunk and it's T2/DWI signals were dropped from "moderate" to "mild" and my post-biopsy PSA levels have averaged ~25% lower than my prebiopsy level. I continue to apply my "aggressive AS" protocol.
All the best!
@handera appreciate that. my most recent MRI was downgraded from a Pirads 3 to a Pirads 2 but I’ll continue with regular PSA tests and monitor prostate density, velocity etc. My urologist still believes I would benefit from a biopsy but I asked him what would be targeted he said “there is nothing to target” I guess implying maybe the MRI reading missed an undiagnosed cancer. But my prostate volume did decrease from 95 to 70ml which could also be connected to BPH. But I’m still hoping that diet and regular vigorous exercise will have some impact.