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11.16 PSA, two negative biopsies, queued up for a third

Posted by ma740988 @ma740988, Dec 13, 2025

Switched urologist 11/25 and I’m now queued up for biopsy number 3 in Feb 26 with new urologist. I am starting to feel some uncertainty about current path. Curious to hear thoughts / recommendations. I’ve outlined my journey below.

Thanks

3/22 - PSA: 3:39
1/23 - MRI wo/Contrast
(PIRADS 2)
6/23 - PSA: 5.25
2/24 - PSA: 5.37
3/24 - PSA: 5.5
3/24 - MRI w/Contrast & wo/Contrast
(Suspicious 8 mm nodule)
4/18/24 - Prostate Biopsy # 1 (Rectal)
(Pathology Report: Atypical Glands at Left Apex)
1/25 - PSA: 7.2
2/14/2025 - Prostate Biopsy # 2 (Perineal)
(Pathology Report: 12-core biopsy. right base (no tumor), right mid (no tumor), right apex (no tumor), left base (no tumor), left mid (no tumor), left apex (no tumor). Increasing LUTS)
8/25 - PSA: 8.71
9/25 - MRI w/Contrast & wo/Contrast
(Normal sized prostate with estimated volume of 35.8 to be centimeters yielding a maximum predicted PSA of 4.3)
Switched Urologist
10/25 - Doxycycline recommended to treat bacteria/infection. 2x per day @ 14 days
12/25 - PSA: 11.16
02/26 - to do: Biopsy # 3

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bellasdad | @bellasdad | Dec 14, 2025
In reply to @ma740988 "@bens1 The new urologist wants to start off with an isoPSA test before biopsy #3 so..." + (show)
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@bens1
The new urologist wants to start off with an isoPSA test before biopsy #3 so will be doing that Wednesday. Never ran across the isoPSA test in all my research so it’ll be interesting how that turns out. I ran across the PSE test a few days ago so it’s up for consideration as well.

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@ma740988 - I had the ISO PSA test done after my PSA went to 4.2. That med to an MRI, which led to the biopsy. My doctor was very thorough and didn't skip a step. Biopsy led to a 3+4, grade 2, 2 small lesions which were 7mm and 8mm. PET scan was negative except the prostate. Culminated in 5 Radixact treatments over a 2-week period. That ended 3 weeks ago so dealing with some annoyances. Bottom line of all this...don't let them skip steps and guess. If a doctor is including the ISO, then you probably have a good one.

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ma740988 | @ma740988 | Dec 24, 2025
In reply to @bellasdad "@ma740988 - I had the ISO PSA test done after my PSA went to 4.2. That..." + (show)
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@ma740988 - I had the ISO PSA test done after my PSA went to 4.2. That med to an MRI, which led to the biopsy. My doctor was very thorough and didn't skip a step. Biopsy led to a 3+4, grade 2, 2 small lesions which were 7mm and 8mm. PET scan was negative except the prostate. Culminated in 5 Radixact treatments over a 2-week period. That ended 3 weeks ago so dealing with some annoyances. Bottom line of all this...don't let them skip steps and guess. If a doctor is including the ISO, then you probably have a good one.

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@bellasdad The isoPSA came back at 30.8 with a total PSA of 12.2.

I purchased a PSA at Quest the same day (12/17/2025) I did the isoPSA at Quest and the Quest PSA test result was 8.84.

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