Very good tracking of your numbers.

> With each of your earlier PSA tests, was anything going on in the day(s) leading up to the PSA test that might have caused the PSA to increase?: UTI, prostatitis, sex, extreme physical exercise, etc.

> Did your doctor ever do a DRE immediately prior to the PSA test?

> It was after your switch to rowing that your PSA jumped from 5.8 to 10.0 (and has stayed elevated ever since.). A rowing machine (due to the sitting position) might put more pressure/irritation on the prostate than running would (similar to riding a bicycle for a great distance). Just not sure…..

> You had a biopsy a year ago. You’ve basically been on Active Surveillance since then. Your upcoming biopsy is considered a 1-year “confirmation biopsy” just to see if anything has changed. If no change, then (if it were me, I would) continue Active Surveillance

At this point, you know that you have a Gleason 6 (which by itself is nothing to worry about).

> Do you know your PSA Density? That might be in your MRI report. (See if it’s within range. Your elevated PSA might be due to an enlarged prostate.)

> At your next Total PSA test, also ask them to test your Free PSA. (Then calculate to see if your % Free PSA is within range.)

> Ask for a biomarker (genomic) test. There are a dozen of them to choose from (Decipher, Prolaris, OncotypeDx, etc.). These tell more about the tumor itself.

> Ask for a genetic (germline) test. (Have you had a family history of any solid tumors? They sometimes share gene mutations.)

The purpose of collecting more information is to insure that nothing more serious is lurking unseen that the biopsy is missing. With each test showing nothing of concern allows you even more time to collect more information and learn more about the status of your disease (as well as learn more about treatments should that time ever come).

(I followed the same path and was on active surveillance for 9 years before deciding to have treatment. See my attached PSA tracking chart.)