Hi benz57

Sounds like you have a lot of good data to go on including imagery that shows little change. That is good.
So my surgeon (Dr Ahlering , Chair of Urology, at UC Irvine) stated that 8 to 11% of men can develop MRI negative cancer. He said coupled with low PSA expression, it usually goes undiagnosed until it is well advanced.
I was 65 and got concerned when my PSA doubled from 1 to 2 in a year and saw some brown spots in semen. My mother had died of a rare form of breast cancer that had been misdiagnosed early on as benign cysts and my sister had developed a similar and unusual precancerous condition that was successfully treated.
Both my primary care doctor and 2 urologists ( one associated with a major cancer center) told me everything was fine. They said that based on my low PSA and a lot of guys get spotty semen and Mother dying of breast cancer is irrelevant since it was not PC. Not trusting the Doctors, I pushed for a contrast MRI…and it came back clear. …ultrasound also clear.
Offered to pay for biopsy… bingo…there it was … Gleason 3+4, (30% was 4) and the lesion occupied 20% of the prostate. I received apologies from all 3 doctors involved. Apparently some cancers are on a cellular level and dont produce a well defined target mass for an MRI.
One last comment, medical centers are different and while the San Diego center did not place any weight on my mothers cancer history, UC Irvine disagreed with how my case was handled saying there is a link between breast cancer in a woman and PC in her son. UC Irvine would have fast tracked me through all tests based on what I had presented.I learned that Medical science is an art coupled with the bellcurve of treatment afforded by insurance companies and second opinions may differ greatly from original diagnosis.