@indyguy
You have a huge prostate and a small PSA in comparison. Have you been on antibiotics to try to resolve the BPH? That can frequently shrink the size of the prostate and relieve some of the tumor burden. I’ve heard of people going from over 100 cc down to 60 cc and having their PIRADS Scores that go down along with it.

A friend of ours had a huge prostate and a PSA of 50, but they never found any cancer in multiple biopsies.