Continue PSA surveillance or have a Prostate MRI?

I had 6 cancer in less then 5 percent of one core I have been watching it and had another biopsy 9 months later and that biopsy should no cancer so you can’t always trust a biopsy I would do a mri and a pet scan before doing another biopsy

Thank you for your thoughts, best wishes!

Agree with all other comments. MRI will tell the doctor where to biopsy. Or if you still have doubts, request a PSMA Pet scan. That is about as certain as you can. Biopsy is 100% but only if the needle hits the right spot.

The information from wellness100 is right on. When doing biopsies they will reveal if the biopsy taken is cancerous or not. Problem is that you cannot biopsy the entire prostrate. When I was found to have prostrate cancer from 20 biopsies taken 5 areas were identified as cancer (all different Gleason Scores) my radiologist/oncologist told me the plan was to treat my entire prostrate.

Why I asked not just treat the known areas with cancer. He stated it would be so easy to miss an area that did have cancer and not treat it only to have the cancer continue to grow. So treat the whole prostrate. I have some post where the specific area is treated though versus all prostrate.

The PSMA test mentioned by wellness100 is a great test. It will show if cancer has spread outside of prostrate. I had the PSMA, bone scan, and Decipher tests done to get the most accurate information to provide a specific treatment plan for me.

PSMA Pet scan is the best so far but still misses some cancer (10% ?). It is not perfect but about as good as you get today.

Thanks and best wishes.

Thanks, very helpful, makes sense to me but will discuss with my urologist. When I had a percutaneous biopsy on my kidney years ago, the needle device failed to get a proper sample, so I had to either repeat it later or have open surgery. I repeated. They got the sample and a diagnosis was made. Thanks again.

Best wishes.

Looked at your first post. Your urologist is spot on. You got a good team. Work with them.

I will, thanks!

Just to be clear, in my mind "active surveillance" is not "watchful waiting." Getting an mpMRI is totally compatible with active surveillance. And, of course, acting on the results of surveillance is totally compatible with a period of active surveillance. 🙂
Since prostate cancer generally is not first recognized by directly observable physical symptoms, a case can be made that almost every PC journey begins with active surveillance, so really the question is when to move from passive indifference to active surveillance, and when to move from active surveillance to some sort of intervention. I suppose even a biopsy could be viewed as active surveillance--perhaps hyperactive?!
This really threw me a bit when I got a higher PSA reading than previously. My primary care MD said he could either refer me to a urologist or order an mpMRI. I thought, well, the first thing a urologist is going to do is order an MRI, so I might as well go ahead. It turned out that was cutting edge medicine as far as my insurance company was concerned, but of course it makes a lot of sense, as the MRI is about the cost of two urologist appointments :-). It also helped me realize I didn't want a third party technician with a (out of date?!) manual second guessing my medical care.
Unfortunately (or fortunately), the results accelerated my journey to treatment. I actually first saw the urologist who did my RALP after a transperineal biopsy at a center of excellence and less than a month before the RALP.