Is this too long to wait for a biopsy?

@jeffmarc Jeff,they don’t offer there

@ezupcic my mri in march was a pirads 3, then in October a pirads 2. no focal lesions but psa still fluctuating and elevated at 7.1 and prostate volume decreased from 95ml to 70 ml. My urologist offered a standard 12 core transrectal biopsy but said there would be nothing to target so we agreed to wait and continue with psa monitoring. Yes it’s nerve racking but I work on my diet, exercise, keeping my weight low and staying positive and if the numbers change then reevaluate.

...while in the queue consider an AI second look at the MRI images http://www.precisionprostateconsulting.com
offers ProstatID. The process is FDA cleared but not covered by a 3rd party yet. Cost $529.00.

When you get the biopsies consider getting DECIPHER (genomic testing) and ARTERRA. AI reviews compare yours and thousand of other similarly staged biopsies. They give background information that helps guide treatment choices,

@yarddogman PIRADS 3 lesions are the “gray area” of PIRADS scores. (I did have biopsies with PIRADS 3 lesions.)

A paper that was just published a few weeks ago titled “To biopsy or not biopsy, that is the question - PI-RADS 3 prostate lesions” discusses this topic.

You can search for the paper by its title or by using this reference: "PMID: 41176591"

@yarddogman
Just like my MRI suspicious areas were found. Why would not want to rule out if PC?

It is a personal decision but what are your medical doctors telling you? My urologist gave me a 70% chance the suspicious areas found on my MRI would be cancer. This is from a medical expert with decades of experience and seeing what looks suspicious and history of being cancer or not.

Are you seeing a urologist? For me, and only speaking for me, I did not hesitate to have a biopsy to find out if my suspicious areas were cancer. It was cancer but I was told caught very early and my diagnosis for success was very high. Thus if I had it I wanted to do what was best to catch it at early stages which have excellent success rates.

@yarddogman
I know people that have gone to other centers of excellence to get a transperennial biopsy When it was not offered where they were going originally.

People in this forum have talked about doing that.

If you live outside the United States, it may be a problem you can’t resolve.

You don't mention your age, but at 78 I joined this club with pretty low numbers--PSA rose to 7.67 over a few years, MRI saw one 2mm lesion, have a very large prostate (106 cc) so I did the trans perinial guided biopsy and fortunately had only 2 of the pokes out of 23 show bad cells--3+3 and 3+4 with low percentages in each. My PSA in August was 4.67. Seems like there's no rush to get your biopsy done (January is around the corner)--then you can have a better picture of what you're dealing with. If I had these numbers when I was 58 instead of 78, I'd be more concerned. I'm on AS for now and will do the MRI and biopsy dance again in the spring of 2026. Decipher score was at the top of the lowest range. Something else will probably finish me before PC. My dad was diagnosed around my age and he lived to 100 yrs and 10 months. Good luck!

@tdgillett 71 yrs old. Thank you

@jc76 May I ask what treatment did you chose.

@jeffmarc
Jeff Marchi, You commented, “If you live outside the United States, it may be a problem” to get a transperineal biopsy. My urologist here in Panama offered me a transrectal or transperineal fusion biopsy. With my little knowledge of biopsies, I knew the transperennial fusion biopsy was safer and more precise. Told him to go with that, he then said we need to get prior approval from the insurance plan. My reply, my insurance does not require prior approvals on services or medications received outside of the United States, let us go. Within two weeks I had the procedure and 2 weeks later my report of Gleason 4+4 = 8, in 2 of 6 cores, and Cribriform glands in one core. Total cost, a few pennies short of $2,000.
No serious side effects after the procedure.
Panama may be considered third world by some, but it has some good services, but you do need to be selective. Medical appointments can usually be made within 3 weeks, and the appointment lasts as long as necessary without a rush to get you out.