Continued Monitoring or Biopsy?

Posted by ezupcic @ezupcic, 2 days ago

My PSA has fluctuated all year:
January: 8.1 and 7.8
March: 5.4
June: 4.4
September: 7.1
Dec: 6
%Free PSA between 15% and 16.6%
First MRI: Pirads 3 with a 95ml prostate.
Second MRI: Pirads 2 with 70 ml prostate. No focal lesions
Some characteristics of BPH/Prostatitis. On Tamsulosin
62 years old. Father had radical prostatectomy in 1992 at my age but lived another 25 years cancer free.
When I look at all the numbers like density, velocity and MRI reports I' m inclined to continue with regular PSA tests every 3 or 6 months and MRI's. My urologist thinks I would benefit from a biopsy but offered a standard office transrectal 12 core, essentially blind since there is nothing to target right now. Anything else I should consider that I'm not? Thanks

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Profile picture for vincenzo66 @vincenzo66

Similar situation. PSA between 6 and 11. PI Rads 3 lesion. Free psa 13%. Center of excellence uro had me submit the ExoDx urine biomarkers test. Their breakpoint is 15.6 for cancer/no cancer and I’m 15.37. Since everything is so borderline it’s a biopsy at this point.

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@vincenzo66 did you have a PSE? Did your prostate density factor into decision-making? But I would agree that if it's all borderline.....probably time for a biopsy. With your Pirads 3 is there something to target or is the biopsy sort of blind?

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