Positive ExoDx urine test with negative MRI

Posted by astrodoc @astrodoc, Aug 11 1:18pm

I am curious if anyone during their treatment had this scenario and what was done about it. I am being followed with basically elevated PSA, not huge but it went up 1 full point in the last 9 months, from 2.1 to 3.2. I'm 64 now.
This prompted a workup with the ExoDx urine test and MRI with and without contrast. MRI was completely clean, nothing, zero, suggesting BPH, but the ExoDx test is off the charts, like 56 or something. My dad passed from prostate CA at 79.
Also on a positive note , I have a low PSA density, 0.05. So currently I am told I should have a PSA redrawn in 6 months and if it goes up a lot then biopsy will probably be done, but not before.
I guess I'm worried despite negative MRI, with the super high ExoDx result, that a biopsy should be done now? Or is 6 month recheck reasonable?
Thanks everyone! God bless you all

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kjacko | @kjacko | 5 days ago

I had an Exo with a score of 55. I had BPH with a volume of 68. My first biopsy and MRI in 2016 were negative. My PSA went up and down for a number of years. In 2022 PSA was 7.7. Another MRI came back negative. We decided on a second biopsy: two cores of cancer; one at 3+4. I decided on surgery. Surgeon says he feels confident he got it all. Also, I had ZERO incontinence issues. Pathology report came back at 4+5. Two years out I still have PSA at < 0.01. Based on my experience, get the biopsy. Whatever you decide, make sure you feel as best as possible that your results/scores are accurate so you feel confident about your treatment decision. Obviously, through out my experience, they weren’t. Best wishes.