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High PSA, but MRI is negative. Biopsy or Not?
Prostate Cancer | Last Active: Dec 8, 2025 | Replies (55)Comment receiving replies
@jeffmarc Thanks for your reply. I am new to all of this, and haven't heard of PSA density. Having said that, if I use my latest PSA measurement and the estimated prostate volume from my 12-month-old MRI, I calculate a PSA density of 0.17. Unfortunately, nearly all the diagnostic tests I've done so far over the last few years put me in the "grey zone".
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@lookin4answers
Just something to think about.
I had three transrectal biopsies over 3 years The first two found nothing the third one found 3+4.
After my prostatectomy, it was 4+3. I know people that ended up with 4+5 after their prostatectomy.
You may be in a gray area, but I didn’t really find a biopsy to be all that difficult. Yes, it’s slightly painful when they do it, but I never had any after effects and most people don’t.
You couldn’t request a transperennial biopsy, Which has much less chance of infection and can get some more of the prostate.
The thing is, do you want to find out in another year or two that you have a serious cancer case?
Discuss with your doctor what are the main reasons he feels that a biopsy really is necessary.