I'm sort of new here as well but wanted to reply. My history is being dumb enough to not get a blood test for a few years, find an elevated PSA 11.5, biopsy, Gleasons of 6-7, prostatectomy, in recovery from the surgery and doing pretty well.

I'm sorry to hear that this is something you have to deal with.

Obviously the biopsy will give you the answers you're looking for, but, 6.49 seems like it could really be anything. Also the history here is a little hard to unpack for me. It sounds like you're saying....you had hematuria in Spring of 2020?, went for an office visit with a urologist who did a digital exam and ultra sound and didn't find anything. I'm absolutely NOT a medical professional but I had this exact thing happen and the concern with my urologist when presenting with hematuria and no back pain was a bladder problem. It seemed to be his diagnostic flow chart if you will. We did a cystoscopy, have you done this? (mine actually did turn out to be kidney stones at that time, they were the rare kind that had zero pain associated and easily passed)

Then it sounds like you're saying things were normal as recent as this April. Sounds like you are being considerably more proactive than I was, kudos.

I was unaware there was a grading system for lesions, so I don't know what the 5 indicates, can't comment at all on this.

With the PSA going up and down, I'd think it could be a lot of things depending on how much it's fluctuating. My PSA started up, and kept climbing. Taking the lesion out of the equation, I'd think it could easily be a recurring prostatitis. I've had that happen after a 50 mile bike ride, ( a change of seat fixed that).

My point for all the storytelling is, there are a few other possibilities. Unfortunately this is going to be a looming factor in your mind till you get the biopsy results. In my case, keeping busy and keeping my mind occupied with other things got me through.

I applaud you're decision to find out for sure. My digital exam found no lesions and the ultrasound showed normal size, we came close to not doing the biopsy for three months, that three months in my case could have made a huge difference in spread.

Lastly, you're having a biopsy on Christmas? 🙂 (what? it was a thought!)

If you have any specific questions, don't hesitate to ask them here. It's a great group and was very helpful to me.

Best of luck to you, keep us posted!