Been on TRT for over 10yrs: Upcoming biopsy & PSA levels

Just wanted to give an update, for my lab work finally came in. One good note (which i know it dosent pertain to prostate issues) is that my hemoglobin has dropped to 16, so back in the normal range. My PSA was at 4.69 on 8/18/25, and it dropped to 3.5 as of this week. This is with not being on TRT FOR 3 months. Ive researched on the normal drop of being off TRT, and its usually 15-20%, and mine is 25% drop since August. Curious if I should just hold off, and monitor for another 3-6 months. Of course ill take in consideration of of primary doctors advice.

@mpersonne
Your PSA sure doesn’t say you have prostate cancer. Of course, there are many other ways to find out if it really does exist. Hopefully your doctor has that under control.

Not feeling anything with the digital exam is good news but not doing an MRI sure seems to be rushing it.

I’m not sure if you told the doctor you wanted to hold off on the biopsy but You could get a PSE test, which would pretty much clear up whether or not you need a biopsy.

@mpersonne
Listen to what Jeff says!
You're new here, so probably don't realize that he's one of a handful of PC gurus on this site, from what I've observed.

Sounds like promising news on that latest result, so best of luck!

Well after talking to my primary care doctor about my psa dropping to 3.5 from 4.69, he still thinks its too high, and wants me to continue with my urologist. I did call my urologist office today, and asked if I had a choice for a MRI over going straight to a biopsy, and they said yes, so they are calling in the order for MRI. The nurse said my urologist main protocol is to do a biopsy, and try's to avoid extra cost when doing MRI'S first. Now just waiting for the call to schedule.

Maybe someone else made this observation, but I didn't see it: very good reason to do the MRI before the biopsy is that the biopsy can be "coordinated" with the MRI images so that questionable prostate areas can be pinpointed during the biopsy.

Toay is the big day, and my MRI is at 6pm this evening. Hoping it all comes back clear. Yesterday was suppose to be my biopsy, but i took you guys advice, and changed to a MRI. Now the wait. Hope it dont take weeks for a verdict.

@mpersonne
MRI results usually only take a couple of days at most.

Always insist on a MRI scan otherwise the surgeon is completely in the dark he's having to guess where to keep sticking that great big needle.

I had a similar experience with rising PSA while on TRT that led to the discovery of my PC. I started on TRT in April, 2024 when a routine Testosterone check (at my request) during my annual physical exam showed it at 86 ng/dl. I was 55 years at that time, very active and in great health. I requested the check as I had almost all the symptoms associated with low T. When I started on T, my PSA was 3.9. After being on T for about 3 months, my PSA shot up to 6.2. At that time, I was told to stop the TRT and was referred to a Urologist. The Urologist did a DRE and said my prostate was slightly enlarged and referred me to get a biopsy. Back then, I didn't know about getting an MRI first and didn't know about this forum. The biopsy showed 7 of 12 cores as positive with a Gleason 7. I had RARP with partial nerve sparing done in March of this year. I've had monthly PSA checks which still show undetectable. A couple recent Testosterone checks show that I'm in the 220-235 range. I still have most of the symptoms of low T so both my Primary and Urologist suggest going back on T, but at a lower dose. I'm feeling almost back to normal, with very minor leakage when lifting heavy weights, but the biggest issue is ED. The daily Cialis (5 mg) does nothing and increasing to 20 mg for sex, has not worked. Still working with the Urologist on the next step as he just ordered a pump. Just my experience.

@kmc1372 Thanks for you input, for its almost just like mine. Im currently still waiting on my MRI results, and the suspense is killing me. I did steroids from gym bodybuilders for years before i started going to a doctor for help, so since my first blood test in 2022, i can at least say my baseline was 2.12, then it went up and down ever since. I too work out everyday, and pretty good shape, and no issues, so just hoping for the best until i get my results.