@wever59 Was this a fusion or MRI guided biopsy where they took at least 2 cores from the PIRAD3 lesion? If a random biopsy the lesion could have been missed, but if they sampled the lesion and it was benign than you are unlikely to have significant prostate cancer. Over 70% of initial biopsies when PSA is 3-10 are negative (probably less with MRI PIRAD3). PIRAD3 lesions are also benign about half the time. To be sure follow up with PSA tests to see if it is still increasing. Steady increase of PSA is a stronger sign of PCa than a low steady level below 10. Have your GP order so you have a historic reference as there can be significant differences based on lab procedures used. Free PSA of 16 is in the middle of the gray area (11-24) where it is inconclusive.

PSEs are great if covered but cost about $1000. Even if covered the PSE it is likely considered unnecessary after a MRI and/or Biopsy. The selling point of the test is to avoid the cost/patient impacts by reducing MRIs and Biopsies. Its binary result (Likely or Unlikely Cancer) has no info about its gray area (false+ 6%, false- 8%). If your PSA keeps rising this test might be worth it before another MRI and biopsy.