High PSA, Three Negative Biopsies. Now what?
I'm 58, healthy and active.
From July 2016 to today my PSA has gone from 6 to 14. Can't remember my 4K score from 2020, but it was high enough that he ordered an MRI — which was clean — but urologist wasn't freaked out. MRI was followed up with a negative biopsy. PSA kept rising so I had another MRI in Feb 2022. Everything normal except this from path report:
"Mostly encapsulated 13mm T2 hypointensenodule in the left paramedian anterior transitional zone at themid gland demonstrates
associated diffusion restriction. PI-RADS 3 – Indeterminate."
Urologist said to test PSA again in a few months. It went up again so he ordered a fusion MRI biopsy (no fun at all!), which was also negative.
He wants to keep monitoring PSA. He said he has a few patients that just run high.
I like him well enough, but I was disappointed/annoyed that no one shared the biopsy results with me before my follow-up appointment two plus weeks later, especially since they were negative. Also, I was looking at my records in the patient portal and one of the visits has his notes from a different patient. It's a big, busy practice. I get it. But after my first biopsy with an older uro, he called me the day he got the report.
Do I get another opinion? Another doctor? I'm in Phoenix and we have Mayo, which seems to do a lot of cutting edge stuff. Would appreciate any advice. Thanks!