I agree with that statement and I am one of those 8-10% of men that had clinically significant PC with a negative MRI, negative Ultrasound, and negative DRE with a PSA of 2.0. The truth is that with a negative MRI (Pirads 1 or 2) unless you have something else going on they may not want to do a biopsy which was my situation so I offered to pay for my own “blind jab” biopsy after the Contrasting 3TMRI showed nothing …12 jabs later there it was….Gleason 3+4 with about 20%G 4 occupying 20% of the right side of the prostate.
The hematuria (brown spots in semen) that I had been experiencing for a year prior was the dead giveaway for my self diagnosis and the Urologist and other doctors discounted that due to my low PSA and negative MRI.
The other fun thing that happens with MRI negative cancer is treatment options slip off the table.. like focal therapy's
and even the Radiation doctor gets skittish about recommending very precise Proton radiation preferring SBRT so he can “throw a broad net” to the prostate and prostate bed since it is hard to tell from scans where the PC was or whether it had spread. He said surgery might be a better choice as then we would have pathology and know the extent of things and he could follow up with salvage radiation if necessary. I did RARP 14 months ago and final pathology was Gleason 3+4 (30% G4) with negative margins and such. The surgeon said “I was lucky as many of the 10% MRI negative guys dont catch it till it is way advanced”
Anyway, when in doubt, get second and third opinions and if all else fails ..advocate for yourself!