Everyone has to make their own decisions.

I am 61 and have had two biopsies in the past year. I was put to sleep for both and they were very easy procedures.

From what I have been told by Doctors, some men have no mri-visible lesions and have Gleason 3+4 or 4+3 cancer. Some have low PSA and cancer and some very high PSA and no cancer.

Guidelines and general recommendations are good for many cases. Some of us will fall outside the “usual cases”.

Over the past 15 years my PSA increased from 1-2. This matched my age and did not raise concern. 2022 PSA increased to 2.7. Repeat tests were between 1.9 and 2.7. 2023-2024 stayed in 2.5-2.8 range. In 2025 yearly test was a 4.0.

This jump was enough for me to visit urologist for 1st time in my life. Prostate not enlarged and no lesion could be felt. Urologist was not alarmed witb the 4.0 PSA value. Repeat PSA at his office was 1.98.

4K blood test was barely high enough to be in the low-intermediate range.

I pushed Urologist for an MRI. My MRI showed a 2cm Pirads5 lesion. Even with MRI, Urologist was not pushing a biopsy due to low PSA and 4K. I pushed for biopsy last September that had 5 Cores of 3+3 with 2 cores over 90% 3+3.

Since biopsy was 3+3, two Urologists said AS and see you in 6 months.

Radiation Oncologist was more concerned. Her experience indicated the lesion was likely a higher grade and in my case along the capsule wall.

I pushed for a follow-up MRI/Biopsy this April and it showed 4 cores of 3+4. One core was 100% cancer and 40% 4.

My PSA is still between 2 and 2.8 on all but two tests. One last year at 4 and one this year at 3.4.

If you have concerns, getting a biopsy will provide information. If Biopsy shows no cancer (hopefully), you can continue PSA and MRI’s until that information changes.

Best Wishes.