My urologist confirmed my own extensive research - a DRE can be "hit or miss" as some PCa are located deep within the prostate, or on the bladder side, so not able to be felt with a DRE. My own DRE was 'normal' - but with my symptoms (LUT) and pains, I will have the mp-MRI with contrast this morning. Additionally, total PSA scores can be dramatically, "clinically significantly" reduced by NSAIDs, along with blood pressure and cholesterol medications. In another post, it was stated that if these meds are taken for more than 7 years, a total PSA score should be multiplied by a factor of 2.