Every hospital/center and Urologist office is different in their backlog.

From my experiences the past year, general urologists are more difficult in scheduling an appointment. They are seeing general population and 2-5 month backlogs are common.

After my initial MRI and Biopsy with a general urologist and local hospital, I have been going to City of Hope Cancer Center.

Appointments to see Radiation Oncologist, Surgeon, MRI, Biopsy, etc have been in the 2-6 week window.

Since you have a PIRADS4 lesion, I would recommend finding a good Cancer Center for the initial biopsy.

From your information of no EPE seen on the MRI, you should not feel rushed to get the biopsy.

A biopsy is needed, but whether it in July or anytime during the rest of the year, will be fine (in most cases).

Finding a urologist good at Biopsies is more important than when the biopsy is performed.

Also, fusion biopsies are just a sampling and have alot variation due to small and difficulty in sampling.

Even though the MRI image is fused (overlayed) with ultrasound in rectum, it is still difficult to be precise in both grid and targeted needle biopsies. In the past 9 months I have had 2 fusion biopsies. I have a PIRADS (5) lesion about twice the size of your lesion. Out of 6 targeted needles (using the MRI to target lesion) only (2) of the needles found the lesion. (2) of these needles did not even have prostate tissue. Surgeon said even with the best imaging and lots of experience, sampling lesions is still difficult. Over the two biopsies, I have had (5) “Grid” needles with over 90% grade 3+3 or 3+4 cancer cells. The targeted needles only showed 5-20% cancer.

I was on an Ancan webinar this past Monday. One person indicated his PIRADS 4 lesion was not cancer but his cancer was found in a different location in the prostate. He made this assumption due to targeted needles showing no cancer but grid needles showing cancer. He said since it was a fusion biopsy, surely the Doctor was able to sample the lesion and the results were no cancer in the lesion. That is a possibility, but my experience and feeling is: It is difficult to precisely biopsy the prostate. It is likely, the grid needles sampled the Pirads4 lesion and the targeted needles did not.

UCLA doctor discussed this at a conference in 2021 or so. Tge question was whether a Transrectal or Transperineal biopsy was best. He indicated equipment, imaging and practices for transrectal had been in place for many years. He still performed more Transrectal biopsies. He said with the use of antibiotics and good practices the risk of infection was very, very, low. This is different from a general urologist performing a transrectal biopsy without best practices to prevent infection.

Best wishes