New guy here darn it

Your prostate is quite large, which gives you a higher PSA normally, The thing is a PIRADS 3 Does mean there is a chance of prostate cancer. A fusion biopsy is a great way to find and eliminate or confirm the presence of cancer.

You could get a PSE test. It is 94% accurate in figuring out whether or not you have cancer. If it says you do the biopsy really is the best option. If it says you don’t, then normally you don’t have to do the biopsy.

Ask your doctor if you can have that test first.

@jeffmarc Thank you Jeff. I admire your and the others insight and info. I will check around for PSE test

Welcome to the club no-one wants to be in.
A PSE test is certainly less invasive than a biopsy.

A PIRADS 3 can suggest further tests before a biopsy.
But a biopsy is the definitive way to know if it's actually cancer.
Nothing like grabbing a bit of the tissue & shoving it under a microscope.

@jeffmarc how do I determine my density and why

@yarddogman
An MRI or CT scan can determine the prostate size.

A large prostate can make the PSA much higher. I know someone who had a huge prostate his PSA was always around 50 but biopsies were always negative.

@yarddogman
You need to asked and discuss your questions with your medical professionals. They have your complete medical history and have examined you.

You have not gotten a Gleason Score or been diagnosed with PC yet. Hopefully will not happen and you can disengage from this club that no one wants to be part off if we had an option.

From your post your PSA at 4 was just outside of normal (per Mayo Jacksonville they use below 4 as normal PSA level) but then you had a bump up then a bump down. Have you discussed with your urologist a possible infection or irritation going on in your prostate.

Your urologist (are you seeing a urologist?) mentioning a MRI/Fusion biopsy is the same type of biopsy I had. The biopsy is looking at the areas found on MRI. If you and your urologist move to doing the biopsy discuss with him/her about the pros and cons of doing it transperneal versus transrectal.

Lots of test you can still have and hopefully you fail the test of joining MCC PC forum.

@jeffmarc I didn’t mention that my PSA density is .06. What is your take on that ? My doc want to do a MRI guided fusion transrectal biopsy. Thought on that please. Thanks

The company that makes the PSE test is Oxford Biodynamics. Contact joe.abdo@oxfordbiodynamics.com. He, and others there will answer questions. He is a VP of Clinical Diagnostics.

@yarddogman
As I mentioned, your PSA doesn’t sound unusual with such a large prostate, but, a high PSA density (e.g., \(>0.2\) raises concern, below .15 is associated with a low risk of progression. .06 is quite low.

You should ask your doctor, whether your PSA density shows there really isn’t an issue And see what he is basing his desire to do a biopsy on. They do make a lot of money doing it. Then again there is a PIRADS 3 lesion involved.

@jeffmarc
Hello Jeff,
I saw you mentioned enlarged prostate.
My urologist wrote that mine was 94 cc.
How does an enlarged prostate affect prostate?